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Toxins
Special Issues
Venoms and Toxin-Mediated Local Manifestations
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Venoms and Toxin-Mediated Local Manifestations

A special issue of Toxins (ISSN 2072-6651). This special issue belongs to the section "Animal Venoms".

Deadline for manuscript submissions: closed (20 July 2023) | Viewed by 7096

Special Issue Editors

Dr. Jacqueline Sachett

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Guest Editor
Higher School of Health Sciences, Amazonas State University, Manaus 69065-001, Amazonas, Brazil
Interests: snakebite; animal poisons; disability; epidemiology; antivenom
Dr. Anna Tupetz

E-Mail Website
Co-Guest Editor
Division of Emergency Medicine, Duke University School of Medicine, Durham, NC 27708, USA
Interests: implementation science; rehabilitation; function; recovery; disability
Dr. Marco Sartim

E-Mail Website
Co-Guest Editor
Research & Development Department, Nilton Lins Foundation, Manaus 69058-030, Brazil
Interests: snake venom; coagulopathy; immunotoxicity; bioprospection

Special Issue Information

Dear Colleagues,

Snake envenomation can trigger local and systemic manifestations that result in several complications according to the composition of the venom. Among these complications, local venom-induced effects are the most common, since snake bites usually occur in the extremities of the body. In addition, antivenom treatment is known to be very effective for neutralizing systemic effects but less so in peripheral tissues.

So far, there are few preclinical and clinical studies on local manifestations following snake bites, and those that do exist are typically published in an isolated manner and in different types of journals. Therefore, this Special Issue aims to put together a series of innovative studies on snake bites, including the mechanisms for understanding the complexity of the related local pathophysiology and the challenges involved in their treatment.

Original research, case reports, reviews, and mini-reviews articles of local snakebite manifestations, complications that describe secondary infections, necrosis, muscle loss, compartmental syndrome, amputations, inflammatory mediators, and in vitro and in vivo related studies are very welcomed.

Dr. Jacqueline Sachett
Dr. Anna Tupetz
Dr. Marco Sartim
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Toxins is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • wound
  • snake bite
  • envenomation
  • local damage
  • local complications
  • local treatment

Published Papers (4 papers)

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Research

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20 pages, 8963 KiB  
Article
Inflammatory Profile Associated with Secondary Infection from Bothrops atrox Snakebites in the Brazilian Amazon
by Távila Tatiane Amorim Cavalcante, Márcia Beatriz Silva de Souza, Juliana Costa Ferreira Neves, Hiochelson Najibe Santos Ibiapina, Fabiane Bianca Albuquerque Barbosa, Karolaine Oliveira Bentes, Eliane Campos Alves, Hedylamar Oliveira Marques, Monica Colombini, Suely Vilela Sampaio, Manuela Berto Pucca, Iran Mendonça da Silva, Luiz Carlos de Lima Ferreira, Vanderson de Souza Sampaio, Ana Maria Moura-da-Silva, Allyson Guimarães Costa, Wuelton Marcelo Monteiro, Jacqueline Almeida Gonçalves Sachett and Marco Aurélio Sartim
Toxins 2023, 15(9), 524; https://doi.org/10.3390/toxins15090524 - 26 Aug 2023
Viewed by 1099
Abstract
Bothrops snakebite envenomation (SBE) is consider an important health problem in Brazil, where Bothrops atrox is mainly responsible in the Brazilian Amazon. Local effects represent a relevant clinical issue, in which inflammatory signs and symptoms in the bite site represent a potential risk [...] Read more.
Bothrops snakebite envenomation (SBE) is consider an important health problem in Brazil, where Bothrops atrox is mainly responsible in the Brazilian Amazon. Local effects represent a relevant clinical issue, in which inflammatory signs and symptoms in the bite site represent a potential risk for short and long-term disabilities. Among local complications, secondary infections (SIs) are a common clinical finding during Bothrops atrox SBE and are described by the appearance of signs such as abscess, cellulitis or necrotizing fasciitis in the affected site. However, the influence of SI in the local events is still poorly understood. Therefore, the present study describes for the first time the impact of SBE wound infection on local manifestations and inflammatory response from patients of Bothrops atrox SBE in the Brazilian Amazon. This was an observational study carried out at the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus (Brazil), involving victims of Bothrops SBE. Clinical and laboratorial data were collected along with blood samples for the quantification of circulating cytokines and chemokines before antivenom administrations (T0) and 24 h (T1), 48 h (T2), 72 h (T3) and 7 days after (T4). From the 94 patients included in this study, 42 presented SI (44.7%) and 52 were without SI (NSI, 55.3%). Patients classified as moderate envenoming presented an increased risk of developing SI (OR = 2.69; CI 95% = 1.08–6.66, p = 0.033), while patients with bites in hands showed a lower risk (OR = 0.20; CI 95% = 0.04–0.96, p = 0.045). During follow-up, SI patients presented a worsening of local temperature along with a sustained profile of edema and pain, while NSI patients showed a tendency to restore and were highlighted in patients where SI was diagnosed at T2. As for laboratorial parameters, leukocytes, erythrocyte sedimentation ratio, fibrinogen and C-reactive protein were found increased in patients with SI and more frequently in patients diagnosed with SI at T3. Higher levels of circulating IL-2, IL-10, IL-6, TNF, INF-γ and CXCL-10 were observed in SI patients along with marked correlations between these mediators and IL-4 and IL-17, showing a plurality in the profile with a mix of Th1/Th2/Th17 response. The present study reports for the first time the synergistic effects of local infection and envenoming on the inflammatory response represented by local manifestations, which reflected on laboratorial parameters and inflammatory mediators and thus help improve the clinical management of SI associated to Bothrops SBE. Full article
(This article belongs to the Special Issue Venoms and Toxin-Mediated Local Manifestations)
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17 pages, 15330 KiB  
Article
Exploring the Profile of Cell Populations and Soluble Immunological Mediators in Bothrops atrox Envenomations
by Kerolaine Fonseca Coelho, Juliana Costa Ferreira Neves, Hiochelson Najibe Santos Ibiapina, Fábio Magalhães-Gama, Fabiane Bianca Albuquerque Barbosa, Flavio Souza Silva, Irmgardt Alicia María Wellmann, Jacqueline Almeida Gonçalves Sachett, Andréa Monteiro Tarragô, Luiz Carlos Lima Ferreira, Adriana Malheiro, Wuelton Marcelo Monteiro and Allyson Guimarães Costa
Toxins 2023, 15(3), 196; https://doi.org/10.3390/toxins15030196 - 4 Mar 2023
Cited by 2 | Viewed by 1978
Abstract
Bothrops atrox envenomations are common in the Brazilian Amazon. The venom of B. atrox is highly inflammatory, which results in severe local complications, including the formation of blisters. Moreover, there is little information on the immune mechanisms associated with this condition. Thus, a [...] Read more.
Bothrops atrox envenomations are common in the Brazilian Amazon. The venom of B. atrox is highly inflammatory, which results in severe local complications, including the formation of blisters. Moreover, there is little information on the immune mechanisms associated with this condition. Thus, a longitudinal study was carried out to characterize the profile of the cell populations and soluble immunological mediators in the peripheral blood and blisters in B. atrox patients s according to their clinical manifestations (mild and severe). A similar response in both B. atrox patient groups (MILD and SEV) was observed, with an increase in inflammatory monocytes, NKT, and T and B cells, as well as CCL2, CCL5, CXCL9, CXCL10, IL-1β and IL-10, when compared with the group of healthy blood donors. After the administration of antivenom, the participation of patrolling monocytes and IL-10 in the MILD group was observed. In the SEV group, the participation of B cells was observed, with high levels of CCL2 and IL-6. In the blister exudate, a hyperinflammatory profile was observed. In conclusion, we revealed the involvement of cell populations and soluble mediators in the immune response to B. atrox envenomation at the local and peripheral level, which is related to the onset and extent of the inflammation/clinical manifestation. Full article
(This article belongs to the Special Issue Venoms and Toxin-Mediated Local Manifestations)
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Review

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19 pages, 1089 KiB  
Review
Prospecting Local Treatments Used in Conjunction with Antivenom Administration Following Envenomation Caused by Animals: A Systematic Review
by Érica S. Carvalho, Isadora Oliveira, Thaís P. Nascimento, Alexandre Vilhena da Silva Neto, Brenda A. S. Leal, Felipe Q. Araújo, Bruno F. V. Julião, Andrea R. N. Souza, Andreza W. Abrahim, Bruna B. O. Macedo, Jéssica T. S. de Oliveira, Fan Hui Wen, Manuela B. Pucca, Wuelton M. Monteiro and Jacqueline A. G. Sachett
Toxins 2023, 15(5), 313; https://doi.org/10.3390/toxins15050313 - 28 Apr 2023
Cited by 1 | Viewed by 1988
Abstract
Envenomation caused by venomous animals may trigger significant local complications such as pain, edema, localized hemorrhage, and tissue necrosis, in addition to complications such as dermonecrosis, myonecrosis, and even amputations. This systematic review aims to evaluate scientific evidence on therapies used to target [...] Read more.
Envenomation caused by venomous animals may trigger significant local complications such as pain, edema, localized hemorrhage, and tissue necrosis, in addition to complications such as dermonecrosis, myonecrosis, and even amputations. This systematic review aims to evaluate scientific evidence on therapies used to target local effects caused by envenomation. The PubMed, MEDLINE, and LILACS databases were used to perform a literature search on the topic. The review was based on studies that cited procedures performed on local injuries following envenomation with the aim of being an adjuvant therapeutic strategy. The literature regarding local treatments used following envenomation reports the use of several alternative methods and/or therapies. The venomous animals found in the search were snakes (82.05%), insects (2.56%), spiders (2.56%), scorpions (2.56%), and others (jellyfish, centipede, sea urchin—10.26%). In regard to the treatments, the use of tourniquets, corticosteroids, antihistamines, and cryotherapy is questionable, as well as the use of plants and oils. Low-intensity lasers stand out as a possible therapeutic tool for these injuries. Local complications can progress to serious conditions and may result in physical disabilities and sequelae. This study compiled information on adjuvant therapeutic measures and underscores the importance of more robust scientific evidence for recommendations that act on local effects together with the antivenom. Full article
(This article belongs to the Special Issue Venoms and Toxin-Mediated Local Manifestations)
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Other

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13 pages, 4813 KiB  
Case Report
Children Growing Up with Severe Disabilities as a Result of Snakebite Envenomations in Indigenous Villages of the Brazilian Amazon: Three Cases and Narratives
by Altair Seabra de Farias, Joseir Saturnino Cristino, Macio da Costa Arévalo, Alceonir Carneiro Junior, Manoel Rodrigues Gomes Filho, Sediel Andrade Ambrosio, João Nickenig Vissoci, Fan Hui Wen, Vinícius Azevedo Machado, Jacqueline Sachett and Wuelton Monteiro
Toxins 2023, 15(6), 352; https://doi.org/10.3390/toxins15060352 - 23 May 2023
Cited by 4 | Viewed by 1379
Abstract
Snakebites are a major public health problem in the Brazilian Amazon and may lead to local complications and physical deficiencies. Access to antivenom treatment is poorer in indigenous populations compared to other populations. In this study, we report three cases of long-term severe [...] Read more.
Snakebites are a major public health problem in the Brazilian Amazon and may lead to local complications and physical deficiencies. Access to antivenom treatment is poorer in indigenous populations compared to other populations. In this study, we report three cases of long-term severe disabilities as a result of Bothrops atrox snakebites in indigenous children, according to the narratives of the parents. The three cases evolved to compartment syndrome, secondary bacterial infection and extensive necrosis. The cases are associated with delayed antivenom treatment due to very fragmented therapeutic itineraries, which are marked by several changes in means of transport along the route. The loss of autonomy at such an early stage of life due to a disability caused by a snakebite, as observed in this study, may deprive children of sensory and social experiences and of learning their future roles in the community. In common to all cases, there was precarious access to rehabilitation services, which are generally centralized in the state capital, and which leads to a prolonged hospitalization of patients with severe snakebite, and distances them from their territory and family and community ties. Prospective studies should be conducted in the Amazon that estimate the burden of disabilities from snakebites in order to formulate public policies for the treatment and rehabilitation of patients through culturally tailored interventions. Full article
(This article belongs to the Special Issue Venoms and Toxin-Mediated Local Manifestations)
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