The effect of physiological levels of South African puff adder (Bitis arietans) snake venom on blood cells: an in vitro model.

Etheresia Pretorius,Morné A Strydom,Janette Bester,Sthembile Mbotwe

doi:10.1038/srep35988

Etheresia Pretorius, Morné A Strydom + Show 2 more

Open Access

https://doi.org/10.1038/srep35988

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Journal: Scientific reports	Publication Date: Oct 24, 2016
Citations: 16	License type: CC BY 4.0

Affiliation: University of Pretoria

Abstract

A significant burden of illness is caused globally by snakebites particularly by the puff adder, Bitis arietans. Presently there is no reliable and rapid method to confirm envenomation on blood chemistry; although coagulation parameters like prothrombin time, partial thromboplastin time, international normalized ratio and also serum electrolytes are tested. Here, we found that direct in vitro exposure of physiological relevant whole venom levels to human healthy blood (N = 32), caused significant physiological changes to platelet activity using a hematology analyzer, and measuring occlusion time, as well as lyses time, with the global thrombosis test (GTT). Disintegrated platelets were confirmed by scanning electron microscopy (SEM). We also confirmed the pathologic effects on erythrocytes (RBCs) (visible as eryptotic RBCs), by looking at both light microscopy and SEM. Thromboelastography showed that no clot formation in whole blood could be induced after addition of whole venom. We propose further clinical studies to investigate the use of light microscopy smears and hematology analyzer results immediately after envenomation, as a possible first-stage of clinical confirmation of envenomation.

Highlights

The effect of physiological levels of South African puff adder (Bitis arietans) snake venom on blood cells: an in vitro model
In 2010, it was noted that the burden of human suffering caused by snake bite remains unrecognized, invisible, and unheard by the global public health community, and forgotten by development agencies and governments[3]
We observed changes in platelet numbers, as measured by a standard hematology analyzer, Platelet numbers were significantly decreased for all individuals after venom exposure (P < 0.0001)

Summary

Introduction

The effect of physiological levels of South African puff adder (Bitis arietans) snake venom on blood cells: an in vitro model. A significant burden of illness is caused globally by snakebites by the puff adder, Bitis arietans. We found that direct in vitro exposure of physiological relevant whole venom levels to human healthy blood (N = 32), caused significant physiological changes to platelet activity using a hematology analyzer, and measuring occlusion time, as well as lyses time, with the global thrombosis test (GTT). A significant burden of illness is caused globally by snakebites, in tropical and subtropical regions as South Asia, South-east Asia, and sub-Sahara Africa[1]. The puff adder, Bitis arietans, is indigenous to sub-Saharan Africa and parts of the Middle East and is responsible for a significant amount of morbidity and mortality in these regions. The Arg-Gly-Asy-containing peptide (Arietin), inhibited aggregation of platelets because it blocks aggregation through the interference of fibrinogen binding to fibrinogen receptors on the platelet surface[9]

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