White-Lipped Tree Viper ( Cryptelytrops albolabris ) Envenomation in an American Viper Keeper

Greene, Spencer; Galdamez, Laura A.; Tomasheski, Richard

doi:10.1016/j.jemermed.2017.09.003

Cited by 12 publications

(9 citation statements)

References 7 publications

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“…These laboratory findings are consistent with the haemorrhagic clinical manifestations of envenomation by Trimeresurus species (Chan et al, 1993;Chotenimitkhun and Rojnuckarin, 2008;Cockram et al, 1990;Greene et al, 2017;Hutton et al, 1990;Rojnuckarin et al, 2007;Rojnuckarin et al, 1999;Tan et al, 2017a;Visudhiphan et al, 1989;Witharana et al, 2019;Wongtongkam et al, 2005). In particular, the venoms have been shown clinically to produce rapid and pronounced decrease in fibrinogen levels leading to a net anticoagulant state (Collet et al, 2000;Longstaff and Kolev, 2015;Ryan et al, 1999), which is consistent with the results presented here.…”

Section: Discussionsupporting

confidence: 91%

“…The inhibition of clotting enzymes would have a synergistic relationship with the depletion of fibrinogen levels, thereby potentiating the net anticoagulant effect. Indeed, anticoagulation is a major clinical feature in patients envenomated by Trimeresurus species (Chotenimitkhun and Rojnuckarin, 2008;Cockram et al, 1990;Greene et al, 2017;Hutton et al, 1990;Rojnuckarin et al, 2007;Rojnuckarin et al, 1999;Rojnuckarin et al, 1998). Fibrinogenolytic effects have frequently been reported leading to swelling, excessive bleeding and defibrination.…”

Section: Discussionmentioning

confidence: 99%

“…albolabris envenomation and venom composition has been the centre of much research focus (Chotenimitkhun and Rojnuckarin, 2008;Greene et al, 2017;Hutton et al, 1990;Lin et al, 2009;Muanpasitporn and Rojnuckarin, 2007;Peng et al, 1992;Pradniwat and Rojnuckarin, 2015;Rojnuckarin et al, 1999;Tan et al, 2017a;Tan et al, 2012) and is the main Trimeresurus species targeted by available antivenoms, such as the monovalent Green Pit Viper Antivenin produced by the Thai Red Cross. However, in many of the regions where Trimeresurus species exist, a specific antivenom is lacking (Tan et al, 2017a).…”

Section: Introductionmentioning

confidence: 99%

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A blood bond: evolutionary, pathophysiological and biodiscovery implications of coagulotoxic snake venoms

Debono¹

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Snakebite is a massive global burden and is a neglected area of tropical diseases. Snake venom neurotoxins have been the subject of intense research efforts, albeit significantly less is known about coagulotoxins. Venoms can deleteriously affect any physiological system reachable by the bloodstream, including being able to directly interfere with the coagulation cascade. Such coagulopathic toxins may be either anticoagulant or procoagulant and snake venoms are unique in their use of procoagulant toxins for predatory purposes. Our limited knowledge into the mechanisms of action of snake venom hinders our understanding of the clinical pathologies and also restricts our use of these powerful natural products as lead compounds in drug design and development. Two snake families which exhibit coagulant properties and lead to a range of clinical pathologies are vipers, Viperidae, and non-front-fanged snakes, Colubridae. The primary focus of this thesis was to investigate and compare the coagulotoxicity effects and mechanisms of various species of known venomous snakes that effect coagulation. Species chosen for this investigation have had limited previous research conducted, thus a knowledge gap in the literature remains. These coagulant properties were investigated through a multi-disciplinary approach, highlighting key results from both families.Data chapters 2 and 3 explore venom from the boomslang (Dispholidus typus) and the twig snakes (Thelotornis species) -iconic African snakes belonging to the family Colubridae. Both species produce strikingly similar lethal procoagulant pathologies. Despite these similarities, antivenom is only produced for treating bites by D. typus, and the mechanisms of action of both venoms have been understudied. We found that T. mossambicanus produced a significantly stronger coagulation response compared to D. typus, governed by strong prothrombin activation through PIII-SVMPs.Despite similarities in symptoms and clinical manifestations, venom composition differs widely between the two species, recovered from a combined approach of venomics and transcriptomics. The neutralising capability of the available boomslang antivenom was also investigated on both species, with it being 11.3 times more effective upon D. typus venom than T. mossambicanus. Envenomation by Crotalinae such as Asian pit vipers can induce multiple clinical complications resulting from coagulopathic and neuropathic effects. Data chapters 4 -8 investigate the Asian Pit Viper clade. While intense research has been undertaken for some species, such as Calloselasma rhodostoma, functional coagulopathic effects have been neglected. As these species' venoms affect the blood coagulation cascade and are known to produce haemorrhagic shock in envenomed patients, we investigated their effects upon coagulation using venoms of 33 species from the Asian pit viper clade including Azemiops, Calloselasma, Deinagkistrodon, Gloydius, Hypnale, Protobothrops, Trimeresurus and Tropidolaemus. Fibrinogen was the main coagulation target among th...

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A blood bond: evolutionary, pathophysiological and biodiscovery implications of coagulotoxic snake venoms

Debono¹

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“…Trimeresurus venom varies in toxicity between species; prolonged clotting time is a significant symptom observed in humans [10], and tissue damage and hematotoxicity in bite victims have also been reported [11,12]. Since there is no species-specific antivenom available for Trimeresurus, except T. albolabris, the only treatment available for bite cases has been a hetero-specific antivenom [13]. Antivenoms raised in horses are the most common therapeutic agents for snakebite treatment; however, they can cause several side effects, such as anaphylactic shock and serum sickness [14].…”

Section: Introductionmentioning

confidence: 99%

Venomics and Cellular Toxicity of Thai Pit Vipers (Trimeresurus macrops and T. hageni)

Kumkate

Chanhome

Thiangtrongjit

et al. 2020

Toxins

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The two venomous pit vipers, Trimeresurus macrops and T. hageni, are distributed throughout Thailand, although their abundance varies among different areas. No species-specific antivenom is available for their bite victims, and the only recorded treatment method is a horse antivenom raised against T. albolabris crude venom. To facilitate assessment of the cross-reactivity of heterologous antivenoms, protein profiles of T. macrops and T. hageni venoms were explored using mass-spectrometry-based proteomics. The results show that 185 and 216 proteins were identified from T. macrops and T. hageni venoms, respectively. Two major protein components in T. macrops and T. hageni venoms were snake venom serine protease and metalloproteinase. The toxicity of the venoms on human monocytes and skin fibroblasts was analyzed, and both showed a greater cytotoxic effect on fibroblasts than monocytic cells, with toxicity occurring in a dose-dependent rather than a time-dependent manner. Exploring the protein composition of snake venom leads to a better understanding of the envenoming of prey. Moreover, knowledge of pit viper venomics facilitates the selection of the optimum heterologous antivenoms for treating bite victims.

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“…The treatment of venomous snakebite is performed with intravenous administration of snake antivenom and is not performed through any other route due to their lower efficacy and the need for rapid action of the snake antivenom (13)(14)(15) . Due identification of the snake provides a better management of care and the administration of an appropriate serum (16) .…”

Section: Introductionmentioning

confidence: 99%

Profile of snakebite victims reported in a public teaching hospital: a cross-sectional study

Souza

Silva

Chavaglia

et al. 2021

Rev. esc. enferm. USP

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Objective: To understand the epidemiological and clinical profile of snakebite victims in a public teaching hospital. Method: Exploratory, descriptive, cross-sectional study with a quantitative approach conducted in a public hospital in the Triângulo Sul region of Minas Gerais state, Brazil. The data were collected from medical records and compulsory case report forms of patients admitted in the Emergency Service from June 2018 to May 2019. The data were descriptively analyzed and presented in tables. Results: The 137 patients were predominantly male (74.5%), rural workers (33.4%), in their working age (mean of 43.49 years), and in rural areas (87.6%). Bothrops was the most common genus (70.8%), and most occurrences were classified as mild (53.3%). The most performed treatment was snake antivenom administration (73%). Conclusion: Snakebite victims were mostly men in their working age and rural workers. Bothrops bites and mild occurrences were prevalent. Most treatments employed the appropriate snake antivenom. These occurred mostly in rural areas. The prevalent bitten body parts were feet, legs, and hands. Care was provided in less than six hours.

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White-Lipped Tree Viper ( Cryptelytrops albolabris ) Envenomation in an American Viper Keeper

Cited by 12 publications

References 7 publications

A blood bond: evolutionary, pathophysiological and biodiscovery implications of coagulotoxic snake venoms

A blood bond: evolutionary, pathophysiological and biodiscovery implications of coagulotoxic snake venoms

Venomics and Cellular Toxicity of Thai Pit Vipers (Trimeresurus macrops and T. hageni)

Profile of snakebite victims reported in a public teaching hospital: a cross-sectional study

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