Abstract
Pain—acute, chronic and debilitating—is the most feared neurotoxicity resulting from a survivable venomous snake bite. The purpose of this review is to present in a novel paradigm what we know about the molecular mechanisms responsible for pain after envenomation. Progressing from known pain modulating peptides and enzymes, to tissue level interactions with venom resulting in pain, to organ system level pain syndromes, to geographical level distribution of pain syndromes, the present work demonstrates that understanding the mechanisms responsible for pain is dependent on “location, location, location”. It is our hope that this work can serve to inspire the molecular and epidemiologic investigations needed to better understand the neurotoxic mechanisms responsible for these snake venom mediated diverse pain syndromes and ultimately lead to agent specific treatments beyond anti-venom alone.
Highlights
IntroductionA primordial fear shared by humankind is often heralded by the sudden onset of intense pain in a limb—the beginning of envenomation and neurotoxicity from a snake bite
Review of the Mechanisms of SnakeA primordial fear shared by humankind is often heralded by the sudden onset of intense pain in a limb—the beginning of envenomation and neurotoxicity from a snake bite
The site of pain in reference to the bite can be classified as either local(e.g., (e.g.,atator oradjacent adjacenttotothe thebite bitesite) remote.ItItcan canbe bepostulated postulatedthat thatififantivenom antivenom local treatmentattenuates attenuatespain painin inaaremote remotesite sitesuch suchas asthe theabdomen, abdomen, thenthe thepain painisisbeing being treatment caused by the elaboration of small molecular weight compounds derived from snake venom enzymatic activity (e.g., Phospholipase A2 (PLA2) ) that is inactivated by the antivenom as opposed to irreversible damage of neural structures by such enzymes
Summary
A primordial fear shared by humankind is often heralded by the sudden onset of intense pain in a limb—the beginning of envenomation and neurotoxicity from a snake bite. This is only the onset of what may be a complex experience composed of fear, injury to limb and potentially loss of life. Given the complex and seemingly unpredictable outcome in the matter of snake venom induced pain, it would be important to understand the molecular mechanisms underlying this experience that subsequently dictate appropriate treatments. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
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