37Background: 38 The hyaluronidase enzyme is generally known as a spreading factor in 39 animal venoms. Although its activity has been demonstrated in several 40 organisms, a deeper knowledge about hyaluronidase and the venom spreading 41 process from the bite/sting site until its elimination from the victim's body is still in 42 need.
43Methods and principal findings: 44 We used technetium-99m radiolabeled Tityus serrulatus venom ( 99m Tc-45 TsV) to evaluate the venom distribution kinetics in mice. To understand the 46 hyaluronidase's role in the venom's biodistribution, 99m Tc-TsV was 47 immunoneutralized with specific anti-T.serrulatus hyaluronidase serum. Venom 48 biodistribution was monitored by scintigraphic images of treated animals and by 49 measuring radioactivity levels in tissues as heart, liver, lungs, spleen, thyroid, and 50 kidneys. In general, results revealed that hyaluronidase inhibition delays venom 51 components distribution, when compared to the non-neutralized 99m Tc-TsV 52 control group. Scintigraphic images showed that the majority of the 53 immunoneutralized venom is retained at the injection site, whereas non-treated 54 venom is quickly biodistributed throughout the animal's body. At the first 30 55 minutes, concentration peaks are observed in the heart, liver, lungs, spleen, and 56 thyroid, which gradually decreases over time. On the other hand, 57 immunoneutralized 99m Tc-TsV takes 240 minutes to reach high concentrations in 58 the organs. A higher concentration of immunoneutralized 99m Tc-TsV was 59 observed in the kidneys in comparison with the non-treated venom. Further, in 60 situ neutralization of 99m Tc-TsV by anti-T.serrulatus hyaluronidase serum at zero, 61 ten, and 30 minutes post venom injection showed that late inhibition of 62 hyaluronidase can still affect venom biodistribution. In this assay, 63 immunoneutralized 99m Tc-TsV was accumulated in the bloodstream until 120 or 64 240 minutes after TsV injection, depending on anti-hyaluronidase administration 65 time. Altogether, our data show that immunoneutralization of hyaluronidase 66 prevents venom spreading from the injection site.67Conclusions: 68 The results obtained in the present work show that hyaluronidase has a 69 key role not only in the venom spreading from the inoculation point to the 70 bloodstream, but also in venom biodistribution from the bloodstream to target 71 organs. Our findings demonstrate that hyaluronidase is indeed an important 72 spreading factor of TsV, and its inhibition can be used as a novel first-aid strategy 73 in envenoming. 74 Author summary 75 Hyaluronidases are known as the venom components responsible for 76 disseminating toxins from the injection site to the victim's organism. Therefore, 77 understanding how the venom distribution occurs and the role of hyaluronidases 78 in this process is crucial in the field of toxinology. In this study, we inhibited Tityus 79 serrulatus venom (TsV) hyaluronidase's action using specific anti-Ts-80 hyaluronidase antibodies. Labeling TsV with a r...