Aspirin plus tirofiban inhibit the thrombosis induced by Russell’s viper venom

Wu, Ren-Chieh; Chou, Ping-Tse; Chen, Li‐Kuang

doi:10.1186/s12959-016-0093-1

Cited by 6 publications

(7 citation statements)

References 39 publications

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“…ASA is the most widely used drug in the world 60 and, since the 1970s, it has been known that mechanism of anti-inflammatory, analgesic and antipyretic activities by this molecule occurs through cyclooxygenase (COX) inhibition 35,60 . Furthermore, other studies have investigated different applications of ASA, including its action against whole venom from Daboia russelii ( Viperidae ) 36 and its toxic effects against catalytic PLA 2 61–64 . Singh and colleagues (2005) proposed the structural basis of an elapid PLA 2 inhibition by ASA, but no functional assays were performed 65 .…”

Section: Discussionmentioning

confidence: 99%

“…Rosmarinic acid (RA) is a polyphenolic compound found in those plants 21,32 , and more recently, several studies have demonstrated the efficiency of this molecule against the myotoxic effects induced by different Bothrops venoms and isolated toxins 20,21,31,33,34 . By contrast, acetylsalicylic acid (ASA) is a largely used commercial drug with anti-inflammatory and analgesic activities 35,36 . ASA inhibited the catalytic activity of pancreatic PLA 2 37 but was not tested against the myotoxic effects induced by PLA 2 -like proteins from snake venom.…”

Section: Introductionmentioning

confidence: 99%

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Search for efficient inhibitors of myotoxic activity induced by ophidian phospholipase A2-like proteins using functional, structural and bioinformatics approaches

Marchi-Salvador

Cardoso

Gomes

et al. 2019

Sci Rep

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Ophidian accidents are considered an important neglected tropical disease by the World Health Organization. Particularly in Latin America, Bothrops snakes are responsible for the majority of the snakebite envenomings that are not efficiently treated by conventional serum therapy. Thus, the search for simple and efficient inhibitors to complement this therapy is a promising research area, and a combination of functional and structural assays have been used to test candidate ligands against specific ophidian venom compounds. Herein, we tested a commercial drug (acetylsalicylic acid, ASA) and a plant compound with antiophidian properties (rosmarinic acid, RA) using myographic, crystallographic and bioinformatics experiments with a phospholipase A2-like toxin, MjTX-II. MjTX-II/RA and MjTX-II/ASA crystal structures were solved at high resolution and revealed the presence of ligands bound to different regions of the toxin. However, in vitro myographic assays showed that only RA is able to prevent the myotoxic effects of MjTX-II. In agreement with functional results, molecular dynamics simulations showed that the RA molecule remains tightly bound to the toxin throughout the calculations, whereas ASA molecules tend to dissociate. This approach aids the design of effective inhibitors of PLA2-like toxins and, eventually, may complement serum therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Search for efficient inhibitors of myotoxic activity induced by ophidian phospholipase A2-like proteins using functional, structural and bioinformatics approaches

Marchi-Salvador

Cardoso

Gomes

et al. 2019

Sci Rep

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“…After the application of the above two drugs, thrombosis can be avoided. Tirofiban is a highly-specific non-peptide platelet GPIIb/IIIa receptor antagonist, which can effectively block the common pathway of platelet activation and aggregation ( 15 ). The synergistic effect of the above three drugs can effectively improve the myocardial cell tissue perfusion, so that the myocardial perfusion in blood supply area is sufficient and the anti-thrombosis effect is more obvious.…”

Section: Discussionmentioning

confidence: 99%

Effects of tirofiban on stent thrombosis, Hs-CRP, IL-6 and sICAM-1 after PCI of acute myocardial infarction

et al. 2018

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Effects of tirofiban on stent thrombosis, high-sensitivity C-reactive protein (Hs-CRP), interleukin-6 (IL-6) and soluble intercellular adhesion molecule-1 (sICAM-1) after percutaneous coronary intervention (PCI) of acute myocardial infarction (AMI) were investigated. A total of 94 AMI patients receiving PCI in Shouguang City People's Hospital from January 2016 to September 2016 were selected and randomly divided into control (n=47) and observation group (n=47). The control group was treated with aspirin + clopidogrel before and after operation, while the observation group was treated with tirofiban based on the treatment of control group. The postoperative stent thrombosis was compared between the two groups, and the serum Hs-CRP, IL-6 and sICAM-1 levels before operation and at 24 and 48 h after operation were also compared between two groups. Moreover, the incidence rates of adverse reactions in the groups were observed. Finally, patients were followed-up for 1 year to observe the total incidence rate of adverse cardiac events and life quality of patients in both groups. The thrombolysis in myocardial infarction flow grading in observation after treatment was significantly superior to that in control group (P<0.05). The levels of Hs-CRP, IL-6 and sICAM-1 in both groups at 24 and 48 h after operation were significantly decreased compared with those before operation, and they were decreased more obviously in observation group (P<0.05); there were no significant differences in the incidence rates of adverse reactions between the groups (P>0.05). Besides, the 1-year follow-up showed that the total incidence rate of adverse cardiac events in observation was significantly lower than that in control group, and the life quality scores were obviously higher than those in control group (P<0.05). The treatment of AMI patients undergoing PCI with tirofiban can effectively prevent stent thrombosis, and alleviate the inflammatory response of patients, it is safe and reliable with important clinical significance.

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“…However, thrombocytopenia in D. siamensis is thought to be related to thrombin-induced platelet aggregation and activation [34]. The pro-coagulation proteins found in D. siamensis venom produce massive fibrin clots and consume platelets to form systemic microthrombi [9, 41]. Although severe thrombocytopenia may also occur in D. siamensis envenomation, it usually takes more than 12 h after the snakebite for thrombocytopenia to occur in these patients [8].…”

Section: Discussionmentioning

confidence: 99%

Clinical and laboratory features distinguishing between Deinagkistrodon acutus and Daboia siamensis envenomation

Huang

Mao

et al. 2018

J Venom Anim Toxins Incl Trop Dis

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BackgroundThere are 6 species of venomous snakes in Taiwan. Two of them, Deinagkistrodon acutus (D. acutus) and Daboia siamensis (D. siamensis), can cause significant coagulopathy. However, a significant proportion of patients with snakebites cannot identify the correct snake species after envenomation, which hampers the application of antivenom. Hence, the differential diagnosis between the two snakebites by clinical presentations is important. This study aims to compare their clinical and laboratory features for the purpose of differential diagnosis between the two snakebites.MethodsWe retrospectively reviewed the medical records of patients who arrived at the emergency department due to D. acutus or D. siamensis envenomation, between 2003 and 2016, in one medical center in eastern Taiwan. Since these snakebites are rare, we also included 3 cases reported from another hospital in central Taiwan.ResultsIn total, 15 patients bitten by D. acutus and 12 patients by D. siamensis were analyzed. Hemorrhagic bulla formation and the need for surgical intervention only presented for D. acutus envenomation cases (Both 53.3% vs. 0.0%, P = 0.003). As to laboratory features, lower platelet counts (20.0 × 103/μL [interquartile range, 14–66 × 103/μL] vs. 149.0 × 103/μL [102.3–274.3 × 103/μL], P = 0.001), lower D-dimer level (1423.4 μg/L [713.4–4212.3 μg/L] vs. 12,500.0 μg/L [2351.4–200,000 μg/L], P = 0.008), higher proportion of patients with moderate-to-severe thrombocytopenia (platelet count < 100 × 103/μL) (80% vs. 16.7%, odds ratio (OR) = 20.0, 95% CI, 2.77–144.31; P = 0.002), and lower proportion of patients with extremely high D-dimer (> 5000 ng/mL) (16.7% vs. 66.7%, adjusted OR = 0.1 (95% CI, 0.01–0.69; P = 0.036) were found among cases of D. acutus envenomation compared to D. siamensis envenomation. The combination of hemorrhagic bulla, thrombocytopenia, and a lack of extremely high D-dimer had good discriminatory power (area under the curve (AUC) = 0.965; 95% CI, 0.904–1.00) for distinguishing D. acutus from D. siamensis envenomation.ConclusionsThe presentation of moderate to severe thrombocytopenia (platelet count < 100 × 103/μL) and hemorrhagic bulla formation may indicate D. acutus envenomation. However, the envenomed patient with extremely high D-dimer levels may indicate a D. siamensis envenomation. These findings may help diagnose and select the right antivenom in patients with unknown snakebites who present significant coagulopathy.

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Aspirin plus tirofiban inhibit the thrombosis induced by Russell’s viper venom

Cited by 6 publications

References 39 publications

Search for efficient inhibitors of myotoxic activity induced by ophidian phospholipase A2-like proteins using functional, structural and bioinformatics approaches

Search for efficient inhibitors of myotoxic activity induced by ophidian phospholipase A2-like proteins using functional, structural and bioinformatics approaches

Effects of tirofiban on stent thrombosis, Hs-CRP, IL-6 and sICAM-1 after PCI of acute myocardial infarction

Clinical and laboratory features distinguishing between Deinagkistrodon acutus and Daboia siamensis envenomation

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