Observation of <i>Bothrops atrox</i> Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights

In the Brazilian Amazon, <i>Bothrops atrox</i> snakebites are frequent, and patients develop tissue damage with blisters sometimes observed in the proximity of the wound. Antivenoms do not seem to impact blister formation, raising questions regarding the mechanisms underlying blister for...

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Autores principales:	Sarah N. C. Gimenes, Jacqueline A. G. Sachett, Mônica Colombini, Luciana A. Freitas-de-Sousa, Hiochelson N. S. Ibiapina, Allyson G. Costa, Monique F. Santana, Jeong-Jin Park, Nicholas E. Sherman, Luiz C. L. Ferreira, Fan H. Wen, Wuelton M. Monteiro, Ana M. Moura-da-Silva, Jay W. Fox
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	<i>Bothrops atrox</i> blister local damage DAMPs snake venom antivenom Medicine R
Acceso en línea:	https://doaj.org/article/e2d38df7b19d40e8be2eb5fde135cb1d
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spelling	oai:doaj.org-article:e2d38df7b19d40e8be2eb5fde135cb1d2021-11-25T19:08:57ZObservation of <i>Bothrops atrox</i> Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights10.3390/toxins131108002072-6651https://doaj.org/article/e2d38df7b19d40e8be2eb5fde135cb1d2021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6651/13/11/800https://doaj.org/toc/2072-6651In the Brazilian Amazon, <i>Bothrops atrox</i> snakebites are frequent, and patients develop tissue damage with blisters sometimes observed in the proximity of the wound. Antivenoms do not seem to impact blister formation, raising questions regarding the mechanisms underlying blister formation. Here, we launched a clinical and laboratory-based study including five patients who followed and were treated by the standard clinical protocols. Blister fluids were collected for proteomic analyses and molecular assessment of the presence of venom and antivenom. Although this was a small patient sample, there appeared to be a correlation between the time of blister appearance (shorter) and the amount of venom present in the serum (higher). Of particular interest was the biochemical identification of both venom and antivenom in all blister fluids. From the proteomic analysis of the blister fluids, all were observed to be a rich source of damage-associated molecular patterns (DAMPs), immunomodulators, and matrix metalloproteinase-9 (MMP-9), suggesting that the mechanisms by which blisters are formed includes the toxins very early in envenomation and continue even after antivenom treatment, due to the pro-inflammatory molecules generated by the toxins in the first moments after envenomings, indicating the need for local treatments with anti-inflammatory drugs plus toxin inhibitors to prevent the severity of the wounds.Sarah N. C. GimenesJacqueline A. G. SachettMônica ColombiniLuciana A. Freitas-de-SousaHiochelson N. S. IbiapinaAllyson G. CostaMonique F. SantanaJeong-Jin ParkNicholas E. ShermanLuiz C. L. FerreiraFan H. WenWuelton M. MonteiroAna M. Moura-da-SilvaJay W. FoxMDPI AGarticle<i>Bothrops atrox</i>blisterlocal damageDAMPssnake venomantivenomMedicineRENToxins, Vol 13, Iss 800, p 800 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	<i>Bothrops atrox</i> blister local damage DAMPs snake venom antivenom Medicine R
spellingShingle	<i>Bothrops atrox</i> blister local damage DAMPs snake venom antivenom Medicine R Sarah N. C. Gimenes Jacqueline A. G. Sachett Mônica Colombini Luciana A. Freitas-de-Sousa Hiochelson N. S. Ibiapina Allyson G. Costa Monique F. Santana Jeong-Jin Park Nicholas E. Sherman Luiz C. L. Ferreira Fan H. Wen Wuelton M. Monteiro Ana M. Moura-da-Silva Jay W. Fox Observation of <i>Bothrops atrox</i> Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights
description	In the Brazilian Amazon, <i>Bothrops atrox</i> snakebites are frequent, and patients develop tissue damage with blisters sometimes observed in the proximity of the wound. Antivenoms do not seem to impact blister formation, raising questions regarding the mechanisms underlying blister formation. Here, we launched a clinical and laboratory-based study including five patients who followed and were treated by the standard clinical protocols. Blister fluids were collected for proteomic analyses and molecular assessment of the presence of venom and antivenom. Although this was a small patient sample, there appeared to be a correlation between the time of blister appearance (shorter) and the amount of venom present in the serum (higher). Of particular interest was the biochemical identification of both venom and antivenom in all blister fluids. From the proteomic analysis of the blister fluids, all were observed to be a rich source of damage-associated molecular patterns (DAMPs), immunomodulators, and matrix metalloproteinase-9 (MMP-9), suggesting that the mechanisms by which blisters are formed includes the toxins very early in envenomation and continue even after antivenom treatment, due to the pro-inflammatory molecules generated by the toxins in the first moments after envenomings, indicating the need for local treatments with anti-inflammatory drugs plus toxin inhibitors to prevent the severity of the wounds.
format	article
author	Sarah N. C. Gimenes Jacqueline A. G. Sachett Mônica Colombini Luciana A. Freitas-de-Sousa Hiochelson N. S. Ibiapina Allyson G. Costa Monique F. Santana Jeong-Jin Park Nicholas E. Sherman Luiz C. L. Ferreira Fan H. Wen Wuelton M. Monteiro Ana M. Moura-da-Silva Jay W. Fox
author_facet	Sarah N. C. Gimenes Jacqueline A. G. Sachett Mônica Colombini Luciana A. Freitas-de-Sousa Hiochelson N. S. Ibiapina Allyson G. Costa Monique F. Santana Jeong-Jin Park Nicholas E. Sherman Luiz C. L. Ferreira Fan H. Wen Wuelton M. Monteiro Ana M. Moura-da-Silva Jay W. Fox
author_sort	Sarah N. C. Gimenes
title	Observation of <i>Bothrops atrox</i> Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights
title_short	Observation of <i>Bothrops atrox</i> Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights
title_full	Observation of <i>Bothrops atrox</i> Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights
title_fullStr	Observation of <i>Bothrops atrox</i> Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights
title_full_unstemmed	Observation of <i>Bothrops atrox</i> Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights
title_sort	observation of <i>bothrops atrox</i> snake envenoming blister formation from five patients: pathophysiological insights
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/e2d38df7b19d40e8be2eb5fde135cb1d
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Observation of <i>Bothrops atrox</i> Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights

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