Epidemiological profile of accidents caused by venomous animals in Amazonas state

Introduction: The Amazonas is the largest state of Brazil, being located in the northwestern of the country. Nevertheless, the Amazonas is not so populous; its population corresponds only to 1.9% (4,063,614 habitants) from the population of Brazil. On the other hand, the state is famous for its rich flora and fauna including venomous animals such as snakes, spiders and scorpions. Therefore, epidemiological studies of venomous animal accidents in the region becomes essential for the development of better therapeutical strategies and preventing actions to reduce the occurrence of these accidents. Objective: The present study aimed to perform an epidemiological analysis of accidents caused by venomous animals in the Amazonas state from 2012 to 2015. Methods: The data were obtained by consulting the Sistema de Informação de Agravos de Notificação (SINAN, Information System for Notifiable Diseases) and Sistema Nacional de Informações Tóxico-Farmacológicas (SINITOX, National System of Toxic-Pharmacological Information) databases. Data of accidents caused by venomous animals between 2012 and 2015 were collected from the Amazonas 60 municipalities. The variables analyzed were: year of highest incidence, municipality with the highest incidence, age of the victims, sex of the victim, animal responsible for the accident, time interval between the accident and therapeutics and deaths. Results: During the years 2012 to 2015, a total of 9,349 cases of accidents involving venomous animals were reported in Amazonas state, with most victims registered in Manaus (1,331 cases). Most of the victims present 20 to 39 years-old and were male. The snakes were responsible for the most accidents, followed by scorpions. Most of the victims reach the hospital and start the therapy between 1 to 3 hours after the accident. The deaths in the state present less than 20 cases per year. Conclusion: This study expands the knowledge about the epidemiological profile of venomous animal accidents in Amazonas state, which is crucial for quantifying the disease burden, contributing to evidence-based healthcare planning, and evaluating effectiveness and relative contribution of primary, secondary and tertiary preventative measures for reducing these accidents and their complications in the region

Experimental Lachesis muta rhombeata envenomation and effects of soursop (Annona muricata) as natural antivenom

Abstract\ud \ud Background\ud In the Atlantic forest of the North and Northeast regions of Brazil, local population often uses the fruit juice and the aqueous extract of leaves of soursop (Annona muricata L.) to treat Lachesis muta rhombeata envenomation. Envenomation is a relevant health issue in these areas, especially due to its severity and because the production and distribution of antivenom is limited in these regions. The aim of the present study was to evaluate the relevance of the use of soursop leaf extract and its juice against envenomation by Lachesis muta rhombeata.\ud \ud \ud Methods\ud We evaluated the biochemical, hematological and hemostatic parameters, the blood pressure, the inflammation process and the lethality induced by Lachesis muta rhombeata snake venom. We also assessed the action of the aqueous extract of leaves (AmL) and juice (AmJ) from A. muricata on the animal organism injected with L. m. rhombeata venom (LmrV) in the laboratory environment.\ud \ud \ud Results\ud LmrV induced a decrease of total protein, albumin and glucose; and increase of creatine kinase, aspartate aminotransferase, and urea concentrations. It provoked hemoconcentration followed by reduction of hematocrit, an increase in prothrombin time and partial thromboplastin time and a decrease of the blood pressure. LmrV induced the release of interleukin-6, an increase in neutrophils and changes in the serum protein profile, characteristic of the acute inflammatory process. LD50 values were similar for the groups injected with LmrV and treated or untreated with AmJ and AmL. Both treatments play a role on the maintenance of blood glucose, urea and coagulation parameters and exert a protective action against the myotoxicity. However, they seem to worsen the hypotension caused by LmrV.\ud \ud \ud Conclusion\ud The treatments with AmJ and AmL present some beneficial actions, but they might intensify some effects of the venom. Therefore, additional studies on A. muricata are necessary to enable its use as natural antivenom for bushmaster snakebite.The authors are grateful to Dr. Marcelo Dias Baruffi, Luisa Helena Dias Costa,\ud Luciana Prado Turin, and Laboratory of Clinical Analysis of School of\ud Pharmaceutical Sciences of Ribeirão Preto for assistance in clinical analysis. This\ud study was supported by the following grants: the São Paulo Research\ud Foundation (FAPESP, grant no. 2005/54855–0 and doctoral scholarship to FAC\ud 2012/13590–8), the National Council for Scientific and Technological\ud Development (CNPq, masters scholarship to CMC 143472/2011–9) and\ud Research Support Center in Animal Toxins (NAP-TOXAN-USP, grant no. 12-\ud 125432.1.3). Thanks are also due to the Center for the Study of Venoms and\ud Venomous Animals (CEVAP) of UNESP for enabling the publication of this paper\ud (CAPES, grant no\ud . 23038.006285/2011–21, AUXPE – Toxinologia – 1219/2011)

Isolation, molecular and functional characterization of a new toxin present in the Tityus serrulatus scorpion venom

O escorpião Tityus serrulatus (Ts) é o responsável pela maioria casos de envenenamento escorpiônicos do Brasil. Embora sua peçonha seja constituída de inúmeros componentes, as neurotoxinas apresentam maior relevância por interagirem especificamente com canais para sódio (Nav) ou potássio (Kv) dependentes de voltagem. Até o momento, já foram descritas 20 neurotoxinas (Ts1 -> Ts20) na peçonha do Ts. No entanto, através de análises ômicas, estima-se que este número seja bem superior. Toxinas que interagem seletivamente com canais iônicos são utilizadas como ferramentas farmacológicas, pois permitem a identificação de canais específicos e a determinação de seus papéis fisiológicos. Adicionalmente, estas toxinas podem ser utilizadas para o desenvolvimento de novos medicamentos para tratar doenças relacionadas a canais iônicos. Considerando o elevado potencial biotecnológicos desta classe de moléculas, o presente trabalho isolou (através de 3 etapas cromatográficas) e caracterizou uma nova toxina da peçonha de Ts, denominada Ts19 Frag-II. A nova toxina demonstrou possuir 49 resíduos de aminoácidos e massa molecular de 5534,54012 Da. Classificada como ?-KTx, especula-se que a Ts19 Frag-II seja produzida a partir de uma modificação pós-transducional, denominada neste estudo de post-splitting, de um transcrito da Ts19. A caracterização funcional da Ts19 Frag-II foi realizada utilizando diferentes ensaios de atividade biológica. Uma extensa avaliação eletrofisiológica em canais iônicos (16 Kvs e 5 Navs) expressos em oócitos de X. leavis demonstrou que a toxina é capaz de bloquear seletivamente canais para potássio do tipo Kv1.2 (IC50 = 544 ± 32 nM). Ensaios in vivo (camundongos C57BL/6) de dor revelaram que a Ts19 Frag-II (2 e 4?g) não é capaz de induzir comportamento nociceptivo espontâneo ou mecânico em camundongos, tanto pela administração intraplantar quanto pela via intratecal. Ensaios in vivo (camundongos BALB/c) também demonstraram que a nova toxina (4 e 8?g) induz aumento dos níveis séricos de ureia, ALT, ?-globulina, IL-6, TNF-?, IL-17A e NO, além de diminuir a quantidade de ?-globulinas. Adicionalmente, utilizando ensaios in vitro de cultura celular de linfócitos T CD4+, demonstrou-se que a Ts19 Frag-II (2 ?g) foi capaz de diminuir a diferenciação de células Th17, assim como suprimir sua função (diminuiu a produção de IL-17 e IL-22). Assim, no presente estudo foi realizado o isolamento e a caracterização molecular e funcional de uma nova toxina de Ts, a qual apresentou atividade neurotóxica e pró-inflamatória, podendo contribuir significativamente para a gravidade do quadro de envenenamento ocasionado pelo escorpião Ts. Adicionalmente, sua seletividade para canais Kv1.2 faz com que Ts19 Frag-II possa ser utilizada como ferramenta de estudo deste canal iônicoThe scorpion Tityus serrulatus (Ts) is responsible for most cases of scorpion envenomations in Brazil. Although its venom consist of many components, neurotoxins present major relevance because their specific interaction with voltage-gated sodium (Nav) or potassium (Kv) channels. So far, 20 neurotoxins have been described (Ts1 -> Ts20) in the Ts venom. However, omics analysis indicate that this number is much higher. Toxins that interact selectively with ion channels are used as pharmacological tools, as they allow the identification of specific channels and the determination of their physiological roles. Additionally, these toxins may be used for the development of new drugs for treating disorders related to ion channels. Considering the high biotechnology potential of this class of molecules, this study isolated (by 3 chromatographic steps) and characterized a new toxin from Ts venom, named Ts19 Frag-II. The novel toxin presented 49 amino acid residues and a molecular mass of 5534.54012 Da. Classified as ? - KTx, it is speculated that the Ts19 Frag-II is produced from a post- translational modification, referred in this study as post- splitting, a transcript of Ts19. The functional characterization of Ts19 Frag-II was performed using different biological assays. The extensive electrophysiological study on ion channels (16 Kvs and 5 Navs) expressed in oocytes of X. leavis showed that the toxin is able to selectively block the potassium channel Kv1.2 (IC50 = 544 ± 32 nM). In vivo assays (C57BL/6 mice) of nociception showed that Ts19 Frag-II (2 and 4?g) is not able to induce spontaneous or mechanical nociceptive behavior in mice, both by intraplantar as by intrathecal administration. In vivo assays (BALB/c mice) also demonstrated that the novel toxin (4 and 8?g) increased serum levels of urea, ALT, ?-globulin, IL-6, TNF-?, IL-17A and NO, besides decreasing ?-globulins. In addition, using in vitro assays of CD4+ T-lymphocyte cell culture, it was demonstrated that Ts19 Frag-II (2 ug) was able to decrease the differentiation of Th17 cells, as well as it suppresses Th17 function (decreased IL-17 and IL-22 production). Therefore, the present study isolated and performed the molecular and functional characterization of a new toxin from Ts, which presented neurotoxic and pro-inflammatory activity and could contribute significantly to the severity of the envenoming caused by the Ts scorpion. Moreover, based on its selectivity for Kv1.2 channels, this toxin could be used as a tool to study this type of ion channe

New fractionation procedure of Tityus serrulatus venom and electrophysiological characterization of toxins Ts6 and Ts7

No Brasil, a espécie Tityus serrulatus (Ts) é a responsável pela maioria dos acidentes de envenenamento com escorpiões, bem como pela maior incidência de acidentes ocasionados por animais peçonhentos. Isso ocorre devido ao fato desta espécie possuir somente fêmeas, realizando uma reprodução assexuada (partenogênese), facilitando assim sua proliferação. Atualmente, existem 16 diferentes toxinas descritas provenientes da peçonha de Ts, sendo a Ts1 a mais abundante na peçonha solúvel. Dentre estas toxinas, as neurotoxinas com ação em canais para sódio e potássio são as que despertam maior interesse da comunidade científica, devido aos seus efeitos no envenenamento e especificidades por canais iônicos. As neurotoxinas com ação em canais para potássio são compostas por uma alfa-hélice e três fitas-beta antiparalelas, e são constituídas por 23-43 resíduos de aminoácidos. Essas estão classificadas em quatro famílias (?-, ?-, g- e k-KTx). A família ?-KTx é a de maior relevância e está dividida em 21 subfamílias. Estas toxinas com alta especificidade para diferentes subtipos de canais para sódio e potássio são de extrema importância, pois podem ser utilizadas como ferramentas terapêuticas específicas para células-alvo. Até o momento, nosso grupo realizava o isolamento dessas toxinas utilizando como primeira etapa de purificação a cromatografia da peçonha em coluna de CM-Celulose-52, segundo protocolo descrito por Arantes e colaboradores (1989). O presente trabalho padronizou um novo método de fracionamento inicial da peçonha utilizando a mesma coluna, porém incorporando o uso de CLAE (Cromatografia Liquida de Alta Eficiência), onde foi possível observar um perfil cromatográfico semelhante ao anterior (XIII Frações), porém com maior reprodutibilidade e praticidade. Algumas frações do método anteriormente descrito foram subdivididas em duas (VIA-VIB, VIIIA-VIIIB, IXA-IXB e XIA-XIB), demonstrando que o novo procedimento também apresenta melhor resolução dos componentes da peçonha. Utilizando o novo método, foram purificadas as toxinas Ts6 e Ts7. Os efeitos dessas toxinas foram avaliados em 14 diferentes tipos de canais para potássio (Kv1.1, Kv1.2, Kv1.3, Kv1.4, Kv1.5, Kv1.6, Kv2.1, Kv3.1, Kv4.3, Kv7.1, Kv7.2, Kv7.4, hERG e Shaker), expressos em células de oócitos de Xenopus laevis, através da técnica de voltage-clamp com dois microeletrodos. A toxina Ts6 (1?M) demonstrou ter ação em 11 tipos de canais (Kv1.1, Kv1.2, Kv1.3, Kv1.5, Kv1.6, Kv4.3, Kv7.1, Kv7.2, Kv7.4, hERG e Shaker), porém nos canais Kv1.2, Kv1.3 e Shaker sua ação bloqueadora foi mais intensa. Através de experimentos de dose-resposta foi possível comprovar tal seletividade, demonstrando que a toxina Ts6 atua em quantidades extremamente baixas em ambos os canais (IC50 Kv1.2 = 6,19 ± 0,35 nM /IC50 Kv1.3 = 0,55 ± 0,20 nM). A toxina Ts7 (1?M) demonstrou ter ação em 11 tipos de canais para K+ (Kv1.1, Kv1.2, Kv1.3, Kv1.4 Kv1.5, Kv1.6, Kv2.1, Kv3.1, Kv7.1, hERG e Shaker), porém a ação de bloqueio em vários subtipos de canais não apresentou diferenças significativas, mostrando baixa seletividade entre os canais analisados. Este trabalho foi de Resumo ii extrema importância por melhorar a reprodutibilidade, praticidade e resolução do método de fracionamento da peçonha de Ts, bem como por fornecer uma avaliação eletrofisiológica criteriosa das toxinas Ts6 e Ts7 em diferentes subtipos de canais para potássio. O presente estudo demonstra a potencial aplicação da toxina Ts6, seletiva para canais Kv 1.3, para o tratamento de doenças autoimunes. Além disso, indica o uso das toxinas Ts6 e Ts7 como ferramentas para o estudo de características estruturais e funcionais de canais para potássio.In Brazil, Tityus serrulatus (Ts) species is the responsible for the most scorpion accidents and also for the major incidence of accidents caused by venomous animals. About 16 different toxins of Ts venom have been listed so far, being Ts1 the major one. Among these toxins, the neurotoxins with action on sodium and potassium channels are the most interest in the scientific community, due to their effect in the envenomation and ion channel specificity. The neurotoxins with action on potassium channels are composed of an ?-helix and three ?-strands formed by 23-43 amino acid residues. They are classified into four families (?-, ?-, g- and ?- KTx). The ?-KTx family is the most relevant and is divided into 21 subfamilies. These toxins with high specificity for different subtypes of sodium and potassium channels are very important, because they can be used as therapeutic tools to specific target cells. Until now, the fractionation of these toxins was done using a CM-Cellulose-52 column, according to the protocol of Arantes and co-workers (1989). The present work standardized a new method of isolation using the same column, but incorporated the use of HPLC (High Performance Liquid Chromatography), in which was observed a chromatographic profile such as the previous one (XIII Fractions), however with high resolution and more practical. Some fraction of the previous method were divided in two subfractions (VIA-VIB, VIIIA-VIIIB, IXA-IXB e XIA-XIB), showing that the new method also present high resolution. Using the new method, it was isolated the Ts6 and Ts7 toxin. The effects of these toxins were evaluated in 14 different types of potassium channels (Kv1.1, Kv1.2, Kv1.3, Kv1.4, Kv1.5, Kv1.6, Kv2.1, Kv3.1, Kv4.3, Kv7.1, Kv7.2, Kv7.4, hERG and Shaker), which were expressed in Xenopus laevis oocytes using the voltage-clamp technique with twomicroelectrodes. The Ts6 toxin (1?M) shows to act on 11 types of potassium channels (Kv1.1, Kv1.2, Kv1.3, Kv1.5, Kv1.6, Kv4.3, Kv7.1, Kv7.2, Kv7.4, hERG and Shaker), but the blocking of Kv1.2 and Kv1.3 was significantly more intense. Using dose-response experiments, it was possible to confirm this selectivity, in which Ts6 demonstrates to act in both channels in extremely low quantities (IC50 Kv1.2 = 6,19 ± 0,35 nM /IC50 Kv1.3 = 0,55 ± 0,20 nM). The Ts7 toxin (1?M) shows to act on 11 types of potassium channels (Kv1.1, Kv1.2, Kv1.3, Kv1.5, Kv1.6, Kv4.3, Kv7.1, Kv7.2, Kv7.4, hERG and Shaker), but the blocking action on multiple subtypes channels showed no significant differences, showing low selectivity among the channels analyzed. This work was important to improve and facilitate the method of fractionation of Ts venom, as well as evaluate the electrophysiology properties of the toxins Ts6 and Ts7 of interacting with different types of potassium channels. These studies will be essential for future applications of these toxins as drugs to treat channelpathies or as tools to study potassium channels structurally and functionally

Tityus serrulatus envenoming in non-obese diabetic mice: a risk factor for severity

Abstract Background In Brazil, accidents with venomous animals are considered a public health problem. Tityus serrulatus (Ts), popularly known as the yellow scorpion, is most frequently responsible for the severe accidents in the country. Ts envenoming can cause several signs and symptoms classified according to their clinical manifestations as mild, moderate or severe. Furthermore, the victims usually present biochemical alterations, including hyperglycemia. Nevertheless, Ts envenoming and its induced hyperglycemia were never studied or documented in a patient with diabetes mellitus (DM). Therefore, this is the first study to evaluate the glycemia during Ts envenoming using a diabetic animal model (NOD, non-obese diabetic). Methods Female mice (BALB/c or NOD) were challenged with a non-lethal dose of Ts venom. Blood glucose level was measured (tail blood using a glucose meter) over a 24-h period. The total glycosylated hemoglobin (HbA1c) levels were measured 30 days after Ts venom injection. Moreover, the insulin levels were analyzed at the glycemia peak. Results The results demonstrated that the envenomed NOD animals presented a significant increase of glycemia, glycosylated hemoglobin (HbA1c) and insulin levels compared to the envenomed BALB/c control group, corroborating that DM victims present great risk of developing severe envenoming. Moreover, the envenomed NOD animals presented highest risk of death and sequelae. Conclusions This study demonstrated that the diabetic victims stung by Ts scorpion should be always considered a risk group for scorpion envenoming severity

Isolation and characterization of Ts19 Fragment II, a new long-chainpotassium channel toxin from Tityus serrulatus venom

Ts19 Fragment II (Ts19 Frag-II) was first isolated from the venom of the scorpion Tityus serrulatus (Ts). It is aprotein presenting 49 amino acid residues, three disulfide bridges, Mr5534 Da and was classified as a newmember of class (subfamily) 2 of the -KTxs, the second one described for Ts scorpion. The -KTx familyis composed by two-domain peptides: N-terminal helical domain (NHD), with cytolytic activity, and aC-terminal CS domain (CCD), with Kv blocking activity. The extensive electrophysiological screening(16 Kv channels and 5 Nav channels) showed that Ts19 Frag-II presents a specific and significant blockingeffect on Kv1.2 (IC50value of 544 ± 32 nM). However, no cytolytic activity was observed with this toxin.We conclude that the absence of 9 amino acid residues from the N-terminal sequence (compared to Ts19Frag-I) is responsible for the absence of cytolytic activity. In order to prove this hypothesis, we synthesizedthe peptide with these 9 amino acid residues, called Ts19 Frag-III. As expected, Ts19 Frag-III showed tobe cytolytic and did not block the Kv1.2 channel. The post-translational modifications of Ts19 and itsfragments (I–III) are also discussed here. A mechanism of post-translational processing (post-splitting) issuggested to explain Ts19 fragments production. In addition to the discovery of this new toxin, this reportprovides further evidence for the existence of several compounds in the scorpion venom contributing tothe diversity of the venom arsenal

Beyond hemostasis: a snake venom serine protease with potassium channel blocking and potential antitumor activities

Snake venom serine proteases (SVSPs) are complex and multifunctional enzymes, acting primarily on hemostasis. In this work, we report the hitherto unknown inhibitory effect of a SVSP, named collinein-1, isolated from the venom of Crotalus durissus collilineatus, on a cancer-relevant voltage-gated potassium channel (hEAG1). Among 12 voltage-gated ion channels tested, collinein-1 selectively inhibited hEAG1 currents, with a mechanism independent of its enzymatic activity. Corroboratively, we demonstrated that collinein-1 reduced the viability of human breast cancer cell line MCF7 (high expression of hEAG1), but does not affect the liver carcinoma and the non-tumorigenic epithelial breast cell lines (HepG2 and MCF10A, respectively), which present low expression of hEAG1. In order to obtain both functional and structural validation of this unexpected discovery, where an unusually large ligand acts as an inhibitor of an ion channel, a recombinant and catalytically inactive mutant of collinein-1 (His43Arg) was produced and found to preserve its capability to inhibit hEAG1. A molecular docking model was proposed in which Arg79 of the SVSP 99-loop interacts directly with the potassium selectivity filter of the hEAG1 channel.status: publishe