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Bleeding and Thrombosis: Insights into Pathophysiology of Bothrops Venom-Related Hemostasis Disorders

1
INSERM, UMRS-1144, Paris University, 75006 Paris, France
2
Department of Medical Biology, Bégin Military Teaching Hospital, 94160 Saint-Mandé, France
3
MERIT, IRD, Paris University, 75006 Paris, France
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CRT, Pasteur Institute, 75015 Paris, France
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Clinical Toxicology Unit, Critical Care Department, University Hospital of Martinique, Fort de France, 97200 Martinique, France
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INSERM, UMRS-1140, Paris University, 75006 Paris, France
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Laboratory of Hematology, Lariboisière Hospital, 75010 Paris, France
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Department of Medical and Toxicological Critical Care, Lariboisière Hospital, 75010 Paris, France
*
Author to whom correspondence should be addressed.
Academic Editor: Loïc Quinton
Int. J. Mol. Sci. 2021, 22(17), 9643; https://doi.org/10.3390/ijms22179643
Received: 2 August 2021 / Revised: 29 August 2021 / Accepted: 3 September 2021 / Published: 6 September 2021
(This article belongs to the Special Issue Venom Proteomics and Transcriptomics 2.0)
Toxins from Bothrops venoms targeting hemostasis are responsible for a broad range of clinical and biological syndromes including local and systemic bleeding, incoagulability, thrombotic microangiopathy and macrothrombosis. Beyond hemostais disorders, toxins are also involved in the pathogenesis of edema and in most complications such as hypovolemia, cardiovascular collapse, acute kidney injury, myonecrosis, compartmental syndrome and superinfection. These toxins can be classified as enzymatic proteins (snake venom metalloproteinases, snake venom serine proteases, phospholipases A2 and L-amino acid oxidases) and non-enzymatic proteins (desintegrins and C-type lectin proteins). Bleeding is due to a multifocal toxicity targeting vessels, platelets and coagulation factors. Vessel damage due to the degradation of basement membrane and the subsequent disruption of endothelial cell integrity under hydrostatic pressure and tangential shear stress is primarily responsible for bleeding. Hemorrhage is promoted by thrombocytopenia, platelet hypoaggregation, consumption coagulopathy and fibrin(ogen)olysis. Onset of thrombotic microangiopathy is probably due to the switch of endothelium to a prothrombotic phenotype with overexpression of tissue factor and other pro-aggregating biomarkers in association with activation of platelets and coagulation. Thrombosis involving large-caliber vessels in B. lanceolatus envenomation remains a unique entity, which exact pathophysiology remains poorly understood. View Full-Text
Keywords: snake venom; hemorrhage; microthrombi; thrombocytopenia; coagulopathy snake venom; hemorrhage; microthrombi; thrombocytopenia; coagulopathy
MDPI and ACS Style

Larréché, S.; Chippaux, J.-P.; Chevillard, L.; Mathé, S.; Résière, D.; Siguret, V.; Mégarbane, B. Bleeding and Thrombosis: Insights into Pathophysiology of Bothrops Venom-Related Hemostasis Disorders. Int. J. Mol. Sci. 2021, 22, 9643. https://doi.org/10.3390/ijms22179643

AMA Style

Larréché S, Chippaux J-P, Chevillard L, Mathé S, Résière D, Siguret V, Mégarbane B. Bleeding and Thrombosis: Insights into Pathophysiology of Bothrops Venom-Related Hemostasis Disorders. International Journal of Molecular Sciences. 2021; 22(17):9643. https://doi.org/10.3390/ijms22179643

Chicago/Turabian Style

Larréché, Sébastien, Jean-Philippe Chippaux, Lucie Chevillard, Simon Mathé, Dabor Résière, Virginie Siguret, and Bruno Mégarbane. 2021. "Bleeding and Thrombosis: Insights into Pathophysiology of Bothrops Venom-Related Hemostasis Disorders" International Journal of Molecular Sciences 22, no. 17: 9643. https://doi.org/10.3390/ijms22179643

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