Napathorn S, Tejachokviwat M, Maneesri S, Kasantikul V, Sitprija V
Department of Medicine, Faculty of Medicine, Chulalongkorn University Hospital, Bangkok, Thailand.
J Nat Toxins. 1998 Feb;7(1):73-85.
The effects of Russell's viper venom (RVV) on human erythrocytes were studied in vitro with respect to packed cell volume (hematocrit), the erythrocyte morphology, and the effect of antivenom. Venom at various dosages ranging from 50 ng to 120 micrograms increased hematocrit significantly. The maximal effect was detected at 800 ng of venom. The biconcave erythrocytes shown by scanning electron microscopy became sphero-echinocytes. Such altered morphology was observed immediately at 1 minute and reached maximum at 30 minutes. The mild degree of erythrocyte deformation was observed at 60 and 120 min with 100 ng of RVV. There were no morphologic changes when ethylenediaminetetracetate (EDTA) was used as an anticoagulant or when plasma was substituted by isotonic saline, acetar, albumin added acetar solution. Phospholipase A2 at equivalent dose as compared to the venom could also produce the sphero-echinocytosis. The phospholipase A2 inhibitor, p-bromophenacyl bromide markedly reduced the degree of RVV induced sphero-echinocytosis. Verapamil, a phenylalkylamine calcium channel blocker, could not prevent the RVV induced sphero-echinocytosis. Although antivenom could not reverse the RVV induced sphero-echinocytosis, it minimized these effects. The RVV induced sphero-echinocytosis is likely caused by phospholipase A2. Calcium and some plasma factors are required for this process. Early treatment with antivenom plays some role in prevention of RVV induced sphero-echinocytosis which may reduce hypoxic cell injury.
在体外研究了罗素蝰蛇毒（RVV）对人红细胞的影响，涉及红细胞压积（血细胞比容）、红细胞形态以及抗蛇毒血清的作用。不同剂量（50纳克至120微克）的毒液显著增加了红细胞压积。在800纳克毒液时检测到最大效应。扫描电子显微镜显示的双凹形红细胞变成了球形棘红细胞。这种形态改变在1分钟时立即观察到，并在30分钟时达到最大程度。使用100纳克RVV时，在60分钟和120分钟观察到轻度的红细胞变形。当使用乙二胺四乙酸（EDTA）作为抗凝剂时，或者当血浆被等渗盐水、醋酸盐、添加白蛋白的醋酸盐溶液替代时，没有形态学变化。与毒液等效剂量的磷脂酶A2也可产生球形棘红细胞症。磷脂酶A2抑制剂对溴苯甲酰溴显著降低了RVV诱导的球形棘红细胞症的程度。维拉帕米，一种苯烷基胺类钙通道阻滞剂，不能预防RVV诱导的球形棘红细胞症。虽然抗蛇毒血清不能逆转RVV诱导的球形棘红细胞症，但它使这些效应最小化。RVV诱导的球形棘红细胞症可能是由磷脂酶A2引起的。这个过程需要钙和一些血浆因子。早期使用抗蛇毒血清治疗在预防RVV诱导的球形棘红细胞症中起一定作用，这可能减少缺氧细胞损伤。
