Abstract
BackgroundThrombosis and coagulopathy are the commonest hematological manifestations of envenomation of Russell’s viper venom (RVV). Factor X is activated by a factor X-activating enzyme from Russell’s viper venom (RVV-X) to start the coagulation cascade. We established an animal model with local ischemic effects induced by RVV. We tried to treat RVV envenomation with antiplatelets and anticoagulants without recourse to antivenom.MethodsRVV was injected into the foot pad of mice. We observed the effects at different intervals and compared local changes in ischemia with drug treatment after 30 min.ResultsA combination of aspirin plus tirofiban could prevent the ischemic change induced by RVV. The antithrombotic effects of single-use of aspirin or tirofiban were better than single-use of heparin or clopidogrel.ConclusionThe aspirin + tirofiban group had a better outcome with respect to prevention of tissue ischemia and gangrene. This indicates that the activation and aggregation of platelets is the major cause of thrombosis induced by RVV.
Highlights
Thrombosis and coagulopathy are the commonest hematological manifestations of envenomation of Russell’s viper venom (RVV)
Thrombosis occludes vessels, which leads to local tissue ischemia; the subsequent tissue necrosis is suspected to be the leading cause of multiple-organ damage
We constructed an animal model with measurement of local changes in cyanosis, gangrene, mummification, and tissue necrosis after injection of a sub-lethal dose of RVV into the foot pad of mice to mimic the thrombosis caused by RVV
Summary
Thrombosis and coagulopathy are the commonest hematological manifestations of envenomation of Russell’s viper venom (RVV). We established an animal model with local ischemic effects induced by RVV. The effects of Russell’s viper venom (RVV) can lead to many different severe conditions such as coagulopathy, thrombotic microangiopathy [2], stroke [3], renal failure [4], generalized increase in capillary permeability, and rhabdomyolysis and neurotoxicity. These effects can vary among the different subspecies [5, 6]. We used the model to test aspirin, clopidogrel, tirofiban and heparin for the prevention of venom-induced vessel occlusion and tissue necrosis
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