Bites by Philodryas olfersii (Lichtenstein, 1823) and Philodryas aestiva (Duméril, Bibron and Duméril, 1854) (serpentes, dipsadidae) in São Paulo, Brazil: A retrospective observational study of 155 cases

Castro, Felipe Corrêa; Souza, Solange Nogueira de; Almeida‐Santos, Selma Maria; Miyaji, Karina Takesaki; Medeiros, Carlos Roberto de

doi:10.1016/j.toxicon.2021.04.014

Cited by 9 publications

(10 citation statements)

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“…Although only a small number of NFFS were investigated, the studies suggest a 3FTx/SVMP dichotomy, with NFFS venoms being either 3FTx dominant or SVMP dominant. NFFS as a group are not generally considered dangerous, with bites to humans usually only presenting painful local inflammation, and rarely systemic effects (Weinstein and Keyler, 2009;Medeiros et al, 2019;Ineich et al, 2020;Castro et al, 2021). The few species that have caused human fatalities appear to all belong to the group containing predominately SVMP [e.g.…”

Section: Relationship Between Toxin Diversity and Protein Family Abun...mentioning

confidence: 99%

Investigating Toxin Diversity and Abundance in Snake Venom Proteomes

2022

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Understanding snake venom proteomes is becoming increasingly important to understand snake venom biology, evolution and especially clinical effects of venoms and approaches to antivenom development. To explore the current state of snake venom proteomics and transcriptomics we investigated venom proteomic methods, associations between methodological and biological variability and the diversity and abundance of protein families. We reviewed available studies on snake venom proteomes from September 2017 to April 2021. This included 81 studies characterising venom proteomes of 79 snake species, providing data on relative toxin abundance for 70 species and toxin diversity (number of different toxins) for 37 species. Methodologies utilised in these studies were summarised and compared. Several comparative studies showed that preliminary decomplexation of crude venom by chromatography leads to increased protein identification, as does the use of transcriptomics. Combining different methodological strategies in venomic approaches appears to maximize proteome coverage. 48% of studies used the RP-HPLC →1D SDS-PAGE →in-gel trypsin digestion → ESI -LC-MS/MS pathway. Protein quantification by MS1-based spectral intensity was used twice as commonly as MS2-based spectral counting (33–15 studies). Total toxin diversity was 25–225 toxins/species, with a median of 48. The relative mean abundance of the four dominant protein families was for elapids; 3FTx–52%, PLA2–27%, SVMP–2.8%, and SVSP–0.1%, and for vipers: 3FTx–0.5%, PLA2–24%, SVMP–27%, and SVSP–12%. Viper venoms were compositionally more complex than elapid venoms in terms of number of protein families making up most of the venom, in contrast, elapid venoms were made up of fewer, but more toxin diverse, protein families. No relationship was observed between relative toxin diversity and abundance. For equivalent comparisons to be made between studies, there is a need to clarify the differences between methodological approaches and for acceptance of a standardised protein classification, nomenclature and reporting procedure. Correctly measuring and comparing toxin diversity and abundance is essential for understanding biological, clinical and evolutionary implications of snake venom composition.

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Section: Relationship Between Toxin Diversity and Protein Family Abun...mentioning

confidence: 99%

Investigating Toxin Diversity and Abundance in Snake Venom Proteomes

2022

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“…9 The patient was also seen only 10 h after the bite, which does not allow us to rule out the possibility of transient coagulopathy. However, no clinically documented or confirmed coagulopathy from envenomation by P olfersii has been reported in the literature, 5 and the continuous elevation of the D-dimer levels without fibrinogen or platelet consumption observed in subsequent days does not support this hypothesis. Nevertheless, further studies are needed to clarify this issue.…”

Section: Discussionmentioning

confidence: 94%

“…8 In a recent study, semicircular bite marks were observed in less than a quarter of 141 cases of bites by P olfersii. 5 Regarding the laboratory tests, in Case 1, the patient did not present with venom-induced consumption coagulopathy (VICC), only leukocytosis and high CRP and D-dimer levels, without consumption of fibrinogen and platelets or changes in prothrombin time, INR, or activated partial thromboplastin time. In the following days, D-dimer levels continued to increase (Table 1), accompanied only by a small increase in creatinine kinase, with no other changes suggestive of VICC.…”

Section: Discussionmentioning

confidence: 98%

“…8 In a recent study, semicircular bite marks were observed in less than a quarter of 141 cases of bites by P olfersii. 5…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the problem is not restricted to the identification of snakes, but includes misinformation about the differences between the medical risks posed by front-fanged venomous snakes and NFFC snakes, thus contributing to the inappropriate treatment of these bites. 2,5 In many snakebite cases, the snake responsible remains unidentified, which frequently results in difficulties in deciding which antivenom to administer. However, the diagnosis of a venomous snakebite or determination of the snake possibly responsible for envenomation can be made using clinical criteria.…”

Section: Discussionmentioning

confidence: 99%

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Differential Diagnosis Between Venomous (Bothrops jararaca, Serpentes, Viperidae) and “Nonvenomous” (Philodryas olfersii, Serpentes, Dipsadidae) Snakebites: Is It Always Possible?

Medeiros

Duarte

Souza

2021

Wilderness & Environmental Medicine

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Bites of "nonvenomous" snakes can sometimes be mistaken for the bites of venomous snakes. As an example of this confusion, this report describes confirmed bites by Philodryas olfersii and Bothrops jararaca. In the first case, a 55-y-old man with a history of controlled hypertension was bitten on his right forearm by P olfersii. Physical examination revealed extensive edema, erythema, and widespread ecchymoses throughout his right upper limb. Laboratory tests indicated leukocytosis and high D-dimer levels, but normal coagulation, suggestive of a resolved recent coagulopathy. He received only supportive treatment. In the second case, a healthy 35-y-old man was bitten by B jararaca. Although the anatomic region of the bite and the results of physical examination were similar to those in the first case, laboratory tests showed mild coagulopathy, leukocytosis, and high D-dimer levels. The patient was treated with antivenom. In both cases, the 20-min whole blood clotting test results were normal. Patients bitten by P olfersii may present with local symptoms resembling B jararaca envenomation. Without snake identification and the detection of venom-induced consumption coagulopathy, especially in places where the 20-min whole blood clotting test is the only clotting test available, it is almost impossible to establish an accurate and safe differential diagnosis. In this context, the best alternative is to take the risk of prescribing antivenom for a possible P olfersii bite rather than failing to do so for a real Bothrops bite. Late treatment for Bothrops bite can result in severe complications and sequelae.

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2022

Venomous Bites From Non-Venomous Snakes

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Bites by Philodryas olfersii (Lichtenstein, 1823) and Philodryas aestiva (Duméril, Bibron and Duméril, 1854) (serpentes, dipsadidae) in São Paulo, Brazil: A retrospective observational study of 155 cases

Cited by 9 publications

References 26 publications

Investigating Toxin Diversity and Abundance in Snake Venom Proteomes

Investigating Toxin Diversity and Abundance in Snake Venom Proteomes

Differential Diagnosis Between Venomous (Bothrops jararaca, Serpentes, Viperidae) and “Nonvenomous” (Philodryas olfersii, Serpentes, Dipsadidae) Snakebites: Is It Always Possible?

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