Department of Clinical Analysis, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-903, SP, Brazil.
Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, SP, Brazil.
Biomolecules. 2020 May 20;10(5):794. doi: 10.3390/biom10050794.
Respiratory compromise in (C.d.t.) snakebite is an important pathological condition. Considering that crotoxin (CTX), a phospholipase A from C.d.t. venom, is the main component of the venom, the present work investigated the toxin effects on respiratory failure. Lung mechanics, morphology and soluble markers were evaluated from Swiss male mice, and mechanism determined using drugs/inhibitors of eicosanoids biosynthesis pathway and autonomic nervous system. Acute respiratory failure was observed, with an early phase (within 2 h) characterized by enhanced presence of eicosanoids, including prostaglandin E2, that accounted for the increased vascular permeability in the lung. The alterations of early phase were inhibited by indomethacin. The late phase (peaked 12 h) was marked by neutrophil infiltration, presence of pro-inflammatory cytokines/chemokines, and morphological alterations characterized by alveolar septal thickening and bronchoconstriction. In addition, lung mechanical function was impaired, with decreased lung compliance and inspiratory capacity. Hexamethonium, a nicotinic acetylcholine receptor antagonist, hampered late phase damages indicating that CTX-induced lung impairment could be associated with cholinergic transmission. The findings reported herein highlight the impact of CTX on respiratory compromise, and introduce the use of nicotinic blockers and prostanoids biosynthesis inhibitors as possible symptomatic therapy to snakebite.
(C.d.t.)蛇咬伤导致的呼吸功能障碍是一种重要的病理状况。考虑到(crotalictoxin),即响尾蛇毒液中的一种磷脂酶 A,是毒液的主要成分,本研究调查了该毒素对呼吸衰竭的影响。通过瑞士雄性小鼠评估了肺力学、形态和可溶性标志物,并使用内源性生物活性物质合成途径和自主神经系统的药物/抑制剂来确定其作用机制。结果观察到急性呼吸衰竭,其早期阶段(2 小时内)以前列腺素 E2 等内源性生物活性物质的存在增加为特征,这导致了肺中的血管通透性增加。早期阶段的变化可以被吲哚美辛抑制。晚期阶段(12 小时达到峰值)的特征是中性粒细胞浸润、促炎细胞因子/趋化因子的存在,以及肺泡间隔增厚和支气管收缩的形态改变。此外,肺力学功能受损,肺顺应性和吸气量降低。烟碱型乙酰胆碱受体拮抗剂六烃季铵阻碍了晚期损伤,表明 CTX 引起的肺损伤可能与胆碱能传递有关。本研究结果强调了 CTX 对呼吸功能障碍的影响,并提出使用烟碱受体阻滞剂和前列腺素生物合成抑制剂作为蛇咬伤的可能对症治疗方法。