Immune response to snake envenoming and treatment with antivenom; complement activation, cytokine production and mast cell degranulation.
BACKGROUND: Snake bite is one of the most neglected public health issues in poor rural communities worldwide. In addition to the clinical effects of envenoming, treatment with antivenom frequently causes serious adverse reactions, including hypersensitivity reactions (including anaphylaxis) and pyro...
Published in: | PLoS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2013
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0002326 https://doaj.org/article/38975a96e0e44b29b6343b6c51d860ea |
id |
ftdoajarticles:oai:doaj.org/article:38975a96e0e44b29b6343b6c51d860ea |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:38975a96e0e44b29b6343b6c51d860ea 2023-05-15T15:11:43+02:00 Immune response to snake envenoming and treatment with antivenom; complement activation, cytokine production and mast cell degranulation. Shelley F Stone Geoffrey K Isbister Seyed Shahmy Fahim Mohamed Chandana Abeysinghe Harendra Karunathilake Ariaranee Ariaratnam Tamara E Jacoby-Alner Claire L Cotterell Simon G A Brown 2013-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0002326 https://doaj.org/article/38975a96e0e44b29b6343b6c51d860ea EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3723557?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002326 https://doaj.org/article/38975a96e0e44b29b6343b6c51d860ea PLoS Neglected Tropical Diseases, Vol 7, Iss 7, p e2326 (2013) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2013 ftdoajarticles https://doi.org/10.1371/journal.pntd.0002326 2022-12-31T00:58:47Z BACKGROUND: Snake bite is one of the most neglected public health issues in poor rural communities worldwide. In addition to the clinical effects of envenoming, treatment with antivenom frequently causes serious adverse reactions, including hypersensitivity reactions (including anaphylaxis) and pyrogenic reactions. We aimed to investigate the immune responses to Sri Lankan snake envenoming (predominantly by Russell's viper) and antivenom treatment. METHODOLOGY/PRINCIPAL FINDINGS: Plasma concentrations of Interleukin (IL)-6, IL-10, tumor necrosis factor α (TNFα), soluble TNF receptor I (sTNFRI), anaphylatoxins (C3a, C4a, C5a; markers of complement activation), mast cell tryptase (MCT), and histamine were measured in 120 Sri Lankan snakebite victims, both before and after treatment with antivenom. Immune mediator concentrations were correlated with envenoming features and the severity of antivenom-induced reactions including anaphylaxis. Envenoming was associated with complement activation and increased cytokine concentrations prior to antivenom administration, which correlated with non-specific systemic symptoms of envenoming but not with coagulopathy or neurotoxicity. Typical hypersensitivity reactions to antivenom occurred in 77/120 patients (64%), satisfying criteria for a diagnosis of anaphylaxis in 57/120 (48%). Pyrogenic reactions were observed in 32/120 patients (27%). All patients had further elevations in cytokine concentrations, but not complement activation, after the administration of antivenom, whether a reaction was noted to occur or not. Patients with anaphylaxis had significantly elevated concentrations of MCT and histamine. CONCLUSIONS/SIGNIFICANCE: We have demonstrated that Sri Lankan snake envenoming is characterized by significant complement activation and release of inflammatory mediators. Antivenom treatment further enhances the release of inflammatory mediators in all patients, with anaphylactic reactions characterised by high levels of mast cell degranulation but not further complement ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 7 7 e2326 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Shelley F Stone Geoffrey K Isbister Seyed Shahmy Fahim Mohamed Chandana Abeysinghe Harendra Karunathilake Ariaranee Ariaratnam Tamara E Jacoby-Alner Claire L Cotterell Simon G A Brown Immune response to snake envenoming and treatment with antivenom; complement activation, cytokine production and mast cell degranulation. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND: Snake bite is one of the most neglected public health issues in poor rural communities worldwide. In addition to the clinical effects of envenoming, treatment with antivenom frequently causes serious adverse reactions, including hypersensitivity reactions (including anaphylaxis) and pyrogenic reactions. We aimed to investigate the immune responses to Sri Lankan snake envenoming (predominantly by Russell's viper) and antivenom treatment. METHODOLOGY/PRINCIPAL FINDINGS: Plasma concentrations of Interleukin (IL)-6, IL-10, tumor necrosis factor α (TNFα), soluble TNF receptor I (sTNFRI), anaphylatoxins (C3a, C4a, C5a; markers of complement activation), mast cell tryptase (MCT), and histamine were measured in 120 Sri Lankan snakebite victims, both before and after treatment with antivenom. Immune mediator concentrations were correlated with envenoming features and the severity of antivenom-induced reactions including anaphylaxis. Envenoming was associated with complement activation and increased cytokine concentrations prior to antivenom administration, which correlated with non-specific systemic symptoms of envenoming but not with coagulopathy or neurotoxicity. Typical hypersensitivity reactions to antivenom occurred in 77/120 patients (64%), satisfying criteria for a diagnosis of anaphylaxis in 57/120 (48%). Pyrogenic reactions were observed in 32/120 patients (27%). All patients had further elevations in cytokine concentrations, but not complement activation, after the administration of antivenom, whether a reaction was noted to occur or not. Patients with anaphylaxis had significantly elevated concentrations of MCT and histamine. CONCLUSIONS/SIGNIFICANCE: We have demonstrated that Sri Lankan snake envenoming is characterized by significant complement activation and release of inflammatory mediators. Antivenom treatment further enhances the release of inflammatory mediators in all patients, with anaphylactic reactions characterised by high levels of mast cell degranulation but not further complement ... |
format |
Article in Journal/Newspaper |
author |
Shelley F Stone Geoffrey K Isbister Seyed Shahmy Fahim Mohamed Chandana Abeysinghe Harendra Karunathilake Ariaranee Ariaratnam Tamara E Jacoby-Alner Claire L Cotterell Simon G A Brown |
author_facet |
Shelley F Stone Geoffrey K Isbister Seyed Shahmy Fahim Mohamed Chandana Abeysinghe Harendra Karunathilake Ariaranee Ariaratnam Tamara E Jacoby-Alner Claire L Cotterell Simon G A Brown |
author_sort |
Shelley F Stone |
title |
Immune response to snake envenoming and treatment with antivenom; complement activation, cytokine production and mast cell degranulation. |
title_short |
Immune response to snake envenoming and treatment with antivenom; complement activation, cytokine production and mast cell degranulation. |
title_full |
Immune response to snake envenoming and treatment with antivenom; complement activation, cytokine production and mast cell degranulation. |
title_fullStr |
Immune response to snake envenoming and treatment with antivenom; complement activation, cytokine production and mast cell degranulation. |
title_full_unstemmed |
Immune response to snake envenoming and treatment with antivenom; complement activation, cytokine production and mast cell degranulation. |
title_sort |
immune response to snake envenoming and treatment with antivenom; complement activation, cytokine production and mast cell degranulation. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2013 |
url |
https://doi.org/10.1371/journal.pntd.0002326 https://doaj.org/article/38975a96e0e44b29b6343b6c51d860ea |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 7, Iss 7, p e2326 (2013) |
op_relation |
http://europepmc.org/articles/PMC3723557?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002326 https://doaj.org/article/38975a96e0e44b29b6343b6c51d860ea |
op_doi |
https://doi.org/10.1371/journal.pntd.0002326 |
container_title |
PLoS Neglected Tropical Diseases |
container_volume |
7 |
container_issue |
7 |
container_start_page |
e2326 |
_version_ |
1766342536554610688 |