Laboratory of Neuroimmunoendocrinology and Toxinology, Federal University of Bahia, Salvador, BA, Brazil.
College of Medicine, Federal University of Bahia, Salvador, BA, Brazil.
J Photochem Photobiol B. 2021 Jan;214:112087. doi: 10.1016/j.jphotobiol.2020.112087. Epub 2020 Nov 22.
Bothrops leucurus is the major causative agent of snakebites in Brazil's Northeast. The systemic effects of its venom are effectively neutralized by antivenom therapy, preventing bitten patients' death. However, antivenom fails in neutralizing local effects that include intense pain, edema, bleeding, and myonecrosis. Such effects can lead to irreversible sequels, representing a clinically relevant issue for which there is no current effective treatment. Herein, the effects of photobiomodulation therapy (PBMT) were tested in the local actions induced by B. leucurus venom (BLV) in mice (n = 123 animals in 20 experimental groups). A continuous emission AlGaAs semiconductor diode laser was used in two wavelengths (660 or 780 nm). Mechanical nociceptive thresholds were assessed with the electronic von Frey apparatus. Local edema was determined by measuring the increase in paw thickness. Hemorrhage was quantified by digital measurement of the bleeding area. Myotoxicity was evaluated by serum creatine kinase (CK) activity and histopathological analysis. PBMT promoted anti-hypernociception in BLV-injected mice; irradiation with the 660 nm laser resulted in faster effect onset than the 780 nm laser. Both laser protocols reduced paw edema formation, whether irradiation was performed immediately or half an hour after venom injection. BLV-induced hemorrhage was not altered by PBMT. Laser irradiation delayed, but did not prevent myotoxicity caused by BLV, as shown by a late increase in CK activity and histopathological alterations. PBMT was effective in the control of some of the major local effects of BLV refractory to antivenom. It is a potential complementary therapy that could be used in bothropic envenoming, minimizing the morbidity of these snakebite accidents.
矛头蝮是巴西东北部地区蛇伤的主要致病原。抗蛇毒血清疗法可有效中和其毒液的全身作用，防止被咬伤的患者死亡。然而，抗蛇毒血清无法中和局部作用，包括剧烈疼痛、水肿、出血和肌坏死。这些影响可能导致不可逆的后遗症，是目前尚无有效治疗方法的临床相关问题。本文研究了光生物调节疗法（PBMT）在矛头蝮蛇毒（BLV）引起的小鼠局部作用中的效果（20 个实验组共 123 只动物）。采用连续发射砷化镓铝半导体二极管激光两种波长（660nm 或 780nm）。使用电子 von Frey 仪器评估机械性痛觉过敏阈值。通过测量爪子厚度的增加来确定局部水肿。通过数字测量出血面积来量化出血。通过血清肌酸激酶（CK）活性和组织病理学分析评估肌毒性。PBMT 可促进 BLV 注射小鼠的抗痛觉过敏作用；660nm 激光照射比 780nm 激光更早起效。两种激光方案均能减少爪子水肿的形成，无论照射是在毒液注射后立即进行还是半小时后进行。PBMT 未改变 BLV 诱导的出血。激光照射虽然延迟，但不能预防 BLV 引起的肌毒性，表现为 CK 活性和组织病理学改变的延迟增加。PBMT 对抗蛇毒血清难治的 BLV 的一些主要局部作用有效。它是一种潜在的补充疗法，可用于矛头蝮蛇咬伤，最大限度地减少这些蛇咬伤事故的发病率。
