Acute kidney injury caused by venomous animals: inflammatory mechanisms

Abstract

Either bites or stings of venomous animals comprise relevant public health problems in tropical countries. Acute kidney injury (AKI) induced by animal toxins is related to worse prognostic and outcomes. Being one the most important pathways to induce AKI following envenoming due to animal toxins, inflammation is an essential biological response that eliminates pathogenic bacteria and repairs tissue after injury. However, direct nephrotoxicity (i.e. apoptotic and necrotic mechanisms of toxins), pigmenturia (i.e. rhabdomyolysis and hemolysis), anaphylactic reactions, and coagulopathies could contribute to the renal injury. All these mechanisms are closely integrated, but inflammation is a distinct process. Hence, it is important to improve our understanding on inflammation mechanisms of these syndromes to provide a promising outlook to reduce morbidity and mortality. This literature review highlights the main scientific evidence of acute kidney injury induced by bites or stings from venomous animals and their inflammatory mechanisms. It included observational, cross-sectional, case-control and cohort human studies available up to December 2019. Descriptors were used according to Medical Subject Headings (MeSH), namely: “Acute kidney injury” or “Venom” and “Inflammation” on Medline/Pubmed and Google Scholar; “Kidney disease” or “Acute kidney injury” on Lilacs and SciELO. The present review evidenced that, among the described forms of renal inflammation, it can occur either directly or indirectly on renal cells by means of intravascular, systemic and endothelial hemolysis, activation of inflammatory pathway, as well as direct action of venom cytotoxic components on kidney structures.

Machine-Learning Based Prediction Model for Acute Kidney Injury Induced by Multiple Wasp Stings: Incorporating Four Admission Clinical Indices

“…Wasp venom initiates allergic and toxic reactions, activating immune and in ammatory pathways that increase in ammatory cytokines (IL-6, IL-8) and coagulation factors [27][28][29] ,leading to hemoglobin breakdown and enhancing in ammation through hemolysis products (heme, ferrous heme, oxygen free radicals) 30 .This process mediated by the STING-TBK1-p65/IRF3 signaling pathway and involves dysregulated lipid metabolism (HDL-C, Apo-A1) 31,32 . Our study demonstrates that elevated levels of the Systemic In ammatory Response Index (SIRI), which re ects systemic in ammation and immune status correlate with MODS and AKI in patients stung by wasps 8 .SIRI, easily assessed in emergency settings, offers a timely evaluation of the in ammatory response, proving more immediate than C-Reactive Protein (CRP) and Procalcitonin (PCT) in identifying high-risk patients.…”

Comparison of the Scorpionism Caused by Centruroides margaritatus, Tityus pachyurus and Tityus n. sp. aff. metuendus Scorpion Venoms in Colombia

“…This is due to a relative loss of oxygen because of the low blood supply, generating a mitochondrial deficiency which elevates the organelle's reduced state because of an increment of the NADH:NAD+ ratio then, diminishing the ATP production from ADP. As a consequence, there is a reduction of the mitochondrial function as well as a fall at the intracellular enzymatic production inhibiting reactions related to water and electrolytes excretion causing enlargements seen as the observed vacuole [45].…”