Challenges and Opportunities in Clinical Diagnostic Routine of Envenomation Using Blood Plasma Proteomics

Abstract

Specific and sensitive tools for the diagnosis and monitoring of accidents by venomous animals are urgently needed. Several diagnostic and monitoring assays have been developed; however, they have not yet reached the clinic. This has resulted in late diagnoses, which represents one of the main causes of progression from mild to severe disease. Human blood is a protein-rich biological fluid that is routinely collected in hospital settings for diagnostic purposes, which can translate research progress from the laboratory to the clinic. Although it is a limited view, blood plasma proteins provide information about the clinical picture of envenomation. Proteome disturbances in response to envenomation by venomous animals have been identified, allowing mass spectrometry (MS)-based plasma proteomics to emerge as a tool in a range of clinical diagnostics and disease management that can be applied to cases of venomous animal envenomation. Here, we provide a review of the state of the art on routine laboratory diagnoses of envenomation by snakes, scorpions, bees, and spiders, as well as a review of the diagnostic methods and the challenges encountered. We present the state of the art on clinical proteomics as the standardization of procedures to be performed within and between research laboratories, favoring a more excellent peptide coverage of candidate proteins for biomarkers. Therefore, the selection of a sample type and method of preparation should be very specific and based on the discovery of biomarkers in specific approaches. However, the sample collection protocol (e.g., collection tube type) and the processing procedure of the sample (e.g., clotting temperature, time allowed for clotting, and anticoagulant used) are equally important to eliminate any bias.

Crosstalk of Inflammation and Coagulation in Bothrops Snakebite Envenoming: Endogenous Signaling Pathways and Pathophysiology

“…However, the complex interaction between hemostasis and activation of innate immunity makes it difficult to precisely define the relative contribution of each of these two processes to the pathogenesis of different complications, possibly explaining the absence of a direct association between the classic biomarkers of hemostasis activation and the risk or severity of some of these clinical manifestations [200]. Therefore, the crossing of inflammation and thrombosis is very well exemplified during snakebite envenoming, due to the presence of a wide variety of characterized proteins that can activate the innate immune system and/or hemostasis.…”

Unveiling the Pain Relief Potential: Harnessing Analgesic Peptides from Animal Venoms

“…Some venoms are able to induce pain [ 6 , 42 ], edema, local and systemic inflammatory process [ 50 , 51 , 52 ], oxidative stress [ 53 ], the functional destabilization of the coagulation system [ 54 , 55 ], acute kidney injury [ 56 ], rhabdomyolysis, and necrosis. In addition, other snake venoms can trigger a neurotoxic syndrome: flaccid paralysis (bilateral ptosis and ophthalmoplegia) and flaccid neuromuscular paralysis (descending), which can be aggravated by involving the bulbar blockade (mouth and throat muscles responsible for speech and swallowing) and respiratory muscles [ 57 ].…”