Heparin-antivenom association: differential neutralization effectiveness in Bothrops atrox and Bothrops erythromelas envenoming

Abstract

Heparin, in some regions of Brazil has been used in the treatment of bothropic accidents, but the data found in the literature are inconclusive about its effectiveness. The venoms of Bothrops atrox and of B. erythromelas were characterized according to their biological activities. The capacity of heparin in neutralizing these activities was tested with doses of 3 and 6 IU in isolated form and associated to Antibothropic Serum (ABS). It was verified that heparin, in doses of 3 and 6 IU, was not effective in neutralizing the desfibrinating and edema-forming activities of B. atrox venom and the hemorrhagic and coagulant actions of both venoms. Heparin diminished the effectiveness of the ABS in the neutralization of the hemorrhagic and edema-forming activities of the B. atrox venom. However, heparin in the 6 IU dose was capable of neutralize the edema-forming of the B. erythromelas and increase the effectiveness of the ABS. Heparin also neutralized the phospholipasic A2 activity of B. atrox (14.3%) and B. erythromelas (28.0%) venoms. For B. erythromelas venom, the associated treatment, heparin and ABS, was more effective in the neutralization of its lethal activity.

Heparin and commercial bothropic antivenom against the paralyzing effect of Bothrops jararacussu snake venom

“…Under a different protocol, heparin addition after 50% blockade (about 50 minutes after incubation) induced by the venom itself, produced a 40% contractile response after 120 minutes, demonstrating that heparin was efficient in the heparin-venom complex, even when added in the presence of neuromuscular blockade, which indicates the use of different incubation time-points. Boechat et al (30) found the association between heparin and antivenom to be more effective in neutralizing the lethal activity of Bothrops envenomation. In this study the mixture (heparin:antivenom) was also effective in neutralizing its neurotoxic venom effects, but no significant difference was observed when compared to heparin:venom and antivenom:venom incubations.…”

“…As examples of venom or toxin neutralization, many other substances have been assayed, ranging from manganese salt, which provides significant protection against Bjssu venom and its toxin neurotoxicity, to medicinal plants, as shown by hydroalcoholic extract of Casearia sylvestris against the neuromuscular paralyzing effect of BThTX-I (31)(32)(33). Therefore, new therapies in parallel with the antivenom treatment would be fundamental in minimizing local effects induced by snake venoms, specially those from the Bothrops genus (30).…”

An overview of Bothrops erythromelas venom

“…In 2001, Boechat et al (16) verifi ed the action of heparin (Liquemine, Roche, Brazil) on the main biological activities (hemorrhagic, in vitro and in vivo coagulating, edematogenic, phospholipasic, and lethal) of Bothrops atrox and Bothrops erythromelas venoms. This study verifi ed that heparin (3 and 6IU) was not effective in neutralizing the hemorrhagic and coagulating activities of both venoms.…”

Gigitan Ular Berbisa

“…6 Pada kasus yang berat bisa ular dapat menyebabkan kerusakan permanen, gangguan fungsi bahkan dapat terjadi amputasi pada ekstremitas. 7 Bisa ular dari famili Crotalidae/Viperidae bersifat sitolitik yang menyebabkan nekrosis jaringan, kebocoran vaskular dan terjadi koagulopati. 1 Komponen dari bisa ular jenis ini mempunyai dampak hampir pada semua sistem organ.…”