Laboratório de Farmacognosia, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, 90610-000, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, 90610-000, Porto Alegre, RS, Brazil.
Laboratório de Toxicologia, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, 90620-170, Porto Alegre, RS, Brazil.
Toxicon. 2022 Oct 15;217:17-40. doi: 10.1016/j.toxicon.2022.08.002. Epub 2022 Aug 8.
Snakebite envenoming is a potentially fatal disease categorized as a neglected public health issue for not receiving the appropriate attention from national and international health authorities. The most affected people by this problem usually live in poor rural communities, where medical resources are often sparse and, in some instances, there is even a scarcity of serum therapy. The administration of the appropriate antivenom is the only specific treatment available, however it has limited efficacy against venom-induced local effects. In this scenario, various plant species are used as local first aid for the treatment of snakebite accidents in Brazil, and some of them can effectively inhibit lethality, neurotoxicity, hemorrhage, and venom enzymes activities. This review compiles a list of plants used in the treatment of snakebites in Brazil, focusing on the native Brazilian species registered in the databases Pubmed, Scielo, Scopus and Google Scholar. All these searches were limited to peer-reviewed journals written in English, with the exception of a few articles written in Portuguese. The most cited native plant species were Casearia sylvestris Sw., Eclipta prostrata (L.) L., Mikania glomerata Spreng., Schizolobium parahyba (Vell.) S.F.Blake and Dipteryx alata Vogel, all used to decrease the severity of toxic signs, inhibit proteolytic and hemorrhagic activities, thus increasing survival time and neutralizing myotoxicity effects. Different active compounds showing important activity against the snake venoms and their toxins include flavonoids, alkaloids and tannins. Although some limitations to the experimental studies with medicinal plants were observed, including lack of comparison with control drugs and unknown active extracts compounds, species with anti-venom characteristics are effective and considered as candidates for the development of adjuvants in the treatment of snake envenomation. Further studies on the chemistry and pharmacology of traditionally used plant species will help to understand the role that snakebite herbal remedies may display in local medical health systems. It might also contribute to the development of alternative or complementary treatments to reduce the number of severe disabilities and deaths.
蛇伤中毒是一种潜在的致命疾病，由于未受到国家和国际卫生当局的重视，被归类为被忽视的公共卫生问题。受这一问题影响最大的人通常生活在贫困的农村社区，那里的医疗资源往往稀缺，在某些情况下，甚至缺乏血清疗法。使用适当的抗蛇毒血清是唯一可用的特效治疗方法，但它对毒液引起的局部效应的疗效有限。在这种情况下，巴西各地使用各种植物作为蛇伤事故的急救方法，其中一些植物可以有效地抑制致死性、神经毒性、出血和毒液酶活性。本综述列出了巴西用于治疗蛇咬伤的植物，重点介绍了在 Pubmed、Scielo、Scopus 和 Google Scholar 数据库中注册的巴西本土物种。所有这些搜索都仅限于同行评议的英文期刊，只有少数几篇文章是用葡萄牙语写的。引用最多的本土植物物种是 Casearia sylvestris Sw.、Eclipta prostrata (L.) L.、Mikania glomerata Spreng.、Schizolobium parahyba (Vell.) S.F.Blake 和 Dipteryx alata Vogel，所有这些植物都被用于减轻毒性症状的严重程度，抑制蛋白水解和出血活性，从而延长存活时间并中和肌毒性作用。表现出对蛇毒及其毒素重要活性的不同活性化合物包括类黄酮、生物碱和单宁。尽管对药用植物进行的实验研究存在一些局限性，包括缺乏与对照药物的比较和未知的活性提取物化合物，但具有抗蛇毒特性的物种是有效的，并被认为是治疗蛇咬伤的辅助剂开发的候选者。对传统使用的植物物种的化学和药理学进一步研究将有助于了解草药治疗蛇咬伤可能在当地医疗保健系统中发挥的作用。这也可能有助于开发替代或补充疗法，以减少严重残疾和死亡的人数。
