Santos Barreto Gabriella Neves Leal, de Oliveira Sâmella Silva, Dos Anjos Isabelle Valle, Chalkidis Hipocrates de Menezes, Mourão Rosa Helena Veras, Moura-da-Silva Ana Maria, Sano-Martins Ida Sigueko, Gonçalves Luis Roberto de Camargo
Laboratorio de Fisiopatologia, Instituto Butantan, São Paulo, São Paulo, Brazil.
Laboratório de Pesquisas Zoológicas, Faculdades Integradas do Tapajós/Faculdade da Amazônia (FIT/UNAMA), Santarém, Pará, Brazil.
PLoS Negl Trop Dis. 2017 Mar 17;11(3):e0005458. doi: 10.1371/journal.pntd.0005458. eCollection 2017 Mar.
Bothrops atrox snakes are the leading cause of snake bites in Northern Brazil. The venom of this snake is not included in the antigen pool used to obtain the Bothrops antivenom. There are discrepancies in reports on the effectiveness of this antivenom to treat victims bitten by B. atrox snakes. However, these studies were performed using a pre-incubation of the venom with the antivenom and, thus, did not simulate a true case of envenomation treatment. In addition, the local lesions induced by Bothrops venoms are not well resolved by antivenom therapy. Here, we investigated the efficacy of the Bothrops antivenom in treating the signs and symptoms caused by B. atrox venom in mice and evaluated whether the combination of dexamethasone and antivenom therapy enhanced the healing of local lesions induced by this envenomation. In animals that were administered the antivenom 10 minutes after the envenomation, we observed an important reduction of edema, dermonecrosis, and myonecrosis. When the antivenom was given 45 minutes after the envenomation, the edema and myonecrosis were reduced, and the fibrinogen levels and platelet counts were restored. The groups treated with the combination of antivenom and dexamethasone had an enhanced decrease in edema and a faster recovery of the damaged skeletal muscle. Our results show that Bothrops antivenom effectively treats the envenomation caused by Bothrops atrox and that the use of dexamethasone as an adjunct to the antivenom therapy could be useful to improve the treatment of local symptoms observed in envenomation caused by Bothrops snakes.
矛头蝮蛇是巴西北部蛇咬伤的主要原因。这种蛇的毒液不包含在用于制备矛头蝮抗蛇毒血清的抗原库中。关于这种抗蛇毒血清治疗被矛头蝮蛇咬伤受害者有效性的报道存在差异。然而，这些研究是在毒液与抗蛇毒血清预孵育的条件下进行的，因此没有模拟真正的蛇伤中毒治疗情况。此外，抗蛇毒血清疗法对矛头蝮蛇毒液引起的局部损伤效果不佳。在此，我们研究了矛头蝮抗蛇毒血清治疗小鼠由矛头蝮毒液引起的体征和症状的疗效，并评估地塞米松与抗蛇毒血清联合治疗是否能促进这种蛇伤中毒所致局部损伤的愈合。在蛇伤中毒后10分钟给予抗蛇毒血清的动物中，我们观察到水肿、皮肤坏死和肌肉坏死明显减轻。当在蛇伤中毒后45分钟给予抗蛇毒血清时，水肿和肌肉坏死减轻，纤维蛋白原水平和血小板计数恢复正常。接受抗蛇毒血清与地塞米松联合治疗的组水肿减轻更明显，受损骨骼肌恢复更快。我们的结果表明，矛头蝮抗蛇毒血清能有效治疗矛头蝮蛇伤中毒，并且使用地塞米松作为抗蛇毒血清疗法的辅助药物可能有助于改善对矛头蝮蛇伤中毒所观察到的局部症状的治疗。
