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The presence of cardiac shunts in ectothermic tetrapods is thought to be consistent with active vascular modulations for proper hemodynamic support. Local control of blood flow modulates tissue perfusion and thus systemic conductance (Gsys) is assumed to increase with body temperature (Tb) to accommodate higher aerobic demand. However, the general increase of Gsys presses for a higher right-to-left (R-L) shunt, which reduces arterial oxygen concentration. In contrast, Tb reduction leads to a Gsys decrease and a left-to-right shunt, which purportedly increases pulmonary perfusion and plasma filtration in the respiratory area. This investigation addressed the role of compensatory vascular adjustments in the face of the metabolic alterations caused by Tb change in the South American rattlesnake (Crotalus durissus). Cardiovascular recordings were performed in decerebrated rattlesnake preparations at 10, 20 and 30°C. The rise in Tb increased metabolic demand, and correlated with an augmentation in heart rate. Although cardiac output increased, systemic stroke volume reduced while pulmonary stroke volume remained stable. Although that resulted in a proportionally higher increase in pulmonary blood flow, the R-L shunt was maintained. While the systemic compliance of large arteries was the most relevant factor in regulating arterial systemic blood pressure, peripheral conductance of pulmonary circulation was the major factor influencing the final cardiac shunt. Such dynamic adjustment of systemic compliance and pulmonary resistance for shunt modulation has not been demonstrated before and contrasts with previous knowledge on shunt control.

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Mexico has the highest diversity of snake species in the world, following Australia when considering just venomous snakes. Specifically, in Sonora, the second largest state in the country, more than 15 highly venomous species occur, including the northern black-tailed rattlesnake (Crotalus molossus). This specie's venom has not been as thoroughly researched in contrast with other Mexican vipers, nevertheless some studies report its biological activity and even pharmacological potential with antibacterial and cytotoxic activity. In this study we identified the main protein components from a pool of C. molossus venom through a gel-free proteomics approach, reporting ∼140 proteins belonging to the SVMP (38.76%), PLA2 (28.75%), CTL (11.93%), SVSP (6.03%) and LAAO (5.67%) toxin families. To study its biological activities, we evaluated its hemolytic, antibacterial, and cytotoxic activity in red blood cells, Gram positive and negative bacteria and a luminal A breast carcinoma cell line (T47D), respectively, in vitro. We report that concentrations <100 µg/mL are potentially not hemolytic and reduced the bacteria viability of E. coli and S. aureus with an IC50 of 10.27 and 11.51 µg/mL, respectively. Finally, we determined the C. molossus venom as cytotoxic against the T47D breast carcinoma cell line, with an IC50 of 1.55 µg/mL. We suggest that the evaluated cytotoxicity was due to a high abundance of SVMPs and PLA2s, since it's been reported that they affect the extracellular matrix and membrane permeation. This may provide a useful tool for pharmaceutical screening in the future.

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Macrophage plasticity is a fundamental feature of the immune response since it favors the rapid and adequate change of the functional phenotype in response to the pathogen or the microenvironment. Several studies have shown that Crotoxin (CTX), the major toxin of the Crotalus durissus terrificus snake venom, has a long-lasting antitumor effect both in experimental models and in clinical trials. In this study, we show the CTX effect on the phenotypic reprogramming of macrophages in the mesenchymal tumor microenvironment or those obtained from the peritoneal cavity of healthy animals. CTX (0.9 or 5 µg/animal subcutaneously) administered concomitantly with intraperitoneal inoculation of tumor cells (1 × 107/0.5 mL, injected intraperitoneally) of Ehrlich Ascitic Tumor (EAT) modulated the macrophages phenotype (M1), accompanied by increased NO• production by cells from ascites, and was evaluated after 13 days. On the other hand, in healthy animals, the phenotypic profile of macrophages was modulated in a dose-dependent way at 0.9 µg/animal: M1 and at 5.0 µg/animal: M2; this was accompanied by increased NO• production by peritoneal macrophages only for the dose of 0.9 µg/animal of CTX. This study shows that a single administration of CTX interferes with the phenotypic reprogramming of macrophages, as well as with the secretory state of cells from ascites, influencing events involved with mesenchymal tumor progression. These findings may favor the selection of new therapeutic targets to correct compromised immunity in different systems.

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Macrophage plasticity is a fundamental feature of the immune response since it favors the rapid and adequate change of the functional phenotype in response to the pathogen or the microenvironment. Several studies have shown that Crotoxin (CTX), the major toxin of the Crotalus durissus terrificus snake venom, has a long-lasting antitumor effect both in experimental models and in clinical trials. In this study, we show the CTX effect on the phenotypic reprogramming of macrophages in the mesenchymal tumor microenvironment or those obtained from the peritoneal cavity of healthy animals. CTX (0.9 or 5 μg/animal subcutaneously) administered concomitantly with intraperitoneal inoculation of tumor cells (1 × 107/0.5 mL, injected intraperitoneally) of Ehrlich Ascitic Tumor (EAT) modulated the macrophages phenotype (M1), accompanied by increased NO• production by cells from ascites, and was evaluated after 13 days. On the other hand, in healthy animals, the phenotypic profile of macrophages was modulated in a dose-dependent way at 0.9 μg/animal: M1 and at 5.0 μg/animal: M2; this was accompanied by increased NO• production by peritoneal macrophages only for the dose of 0.9 μg/animal of CTX. This study shows that a single administration of CTX interferes with the phenotypic reprogramming of macrophages, as well as with the secretory state of cells from ascites, influencing events involved with mesenchymal tumor progression. These findings may favor the selection of new therapeutic targets to correct compromised immunity in different systems.

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The reproductive cycle of Crotalus durissus is markedly seasonal and synchronous between individuals. The start of vitellogenesis occurs at the end of the summer and coincides with copulation. However, given that the copulation is dissociated from ovulation, sperm storage is obligatory in females. In viperids, sperm storage in the female reproductive tract is reported to occur in two regions: (1) the posterior infundibulum, which presents sperm storage glands; and (2) the nonglandular uterus where sperm is stored in crypts by means of the uterine muscular twisting (UMT). The mechanisms that allow the survival of sperm in the female reproductive tract of snakes are still unknown. In this study, we investigated five regions of the reproductive tract of C. durissus, searching for the presence of spermatozoa and sperm storage structures in different oviductal portions. Additionally, we used histological techniques to verify the occurrence of hypertrophy of the infundibular and uterine glands during the processes of vitellogenesis, as well as histochemical techniques to investigate the nature of the secretion produced in the nonglandular uterus and posterior infundibulum. Storage sperm were observed in the nonglandular uterus and although the posterior infundibulum had storage receptacles, sperm were not observed in that region. Both sperm storage regions presented granules testing positive for acidic and neutral polysaccharides, in vitellogenic and previtellogenic females. This presence of guaranteeing conditions for sperm storage. Histochemical analysis revealed the possible storage capacity of sperm in the nonglandular uterus. In addition, the UMT was observed in all the females with storage sperm, which assures the maintenance of sperm in the nonglandular uterus until ovulation.

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Snakebite is a neglected tropical disease that causes extensive mortality and morbidity in rural communities. Antivenim sera are the currently approved therapy for snake bites; however, they have some therapeutic limitations that have been extensively documented. Recently, small molecule toxin inhibitors have received significant attention as potential alternatives or co-adjuvant to immunoglobulin-based snakebite therapies. Thus, in this study, we evaluated the inhibitory effects of the phospholipase A2 inhibitor varespladib and the metalloproteinase inhibitor CP471474 and their synergistic effects on the lethal, edema-forming, hemorrhagic, and myotoxic activities of Bothrops asper and Crotalus durissus cumanensis venoms from Colombia. Except for the preincubation assay of the lethal activity with B. asper venom, the mixture showed the best inhibitory activity. Nevertheless, the mix did not display statistically significant differences to varespladib and CP471474 used separately in all assays. In preincubation assays, varespladib showed the best inhibitory activity against the lethal effect induced by B. asper venom. However, in independent injection assays, the mix of the compounds partially inhibited the lethal activity of both venoms (50%). In addition, in the assays to test the inhibition of edema-forming activity, the mixture exhibited the best inhibitory activity, followed by Varespladib, but without statistically significant differences (p > 0.05). The combination also decreased the myotoxic activity of evaluated venoms. In these assays, the mix showed statistical differences regarding CP471474 (p < 0.05). The mixture also abolished the hemorrhagic activity of B. asper venom in preincubation assays, with no statistical differences to CP471474. Finally, the mixture showed inhibition in studies with independent administration in a time-dependent manner. To propose a mode of action of varespladib and CP471474, molecular docking was performed. PLA2s and SVMPs from tested venoms were used as targets. In all cases, our molecular modeling results suggested that inhibitors may occupy the substrate-binding cleft of the enzymes, which was supported by specific interaction with amino acids from the active site, such as His48 for PLA2s and Glu143 for the metalloproteinase. In addition, varespladib and CP471474 also showed interaction with residues from the hydrophobic channel in PLA2s and substrate binding subsites in the SVMP. Our results suggest a synergistic action of the mixed inhibitors and show the potential of varespladib, CP471474, and their mixture to generate new treatments for snakebite envenoming with application in the field or as antivenom co-adjuvants.

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The most enigmatic group of rattlesnakes is the long-tailed rattlesnake group, consisting of three species: Crotalus ericsmithi, Crotalus lannomi and Crotalus stejnegeri. These species have been the least studied rattlesnakes in all aspects, and no study on the characterization of their venoms has been carried out to date. Our main objective was to investigate the proteomic composition, as well as some of the biochemical and toxic activities of these venoms, and their neutralization by commercial antivenom. The venom proteome of C. ericsmithi mainly contains metalloproteinases (SVMP; 49.3%), phospholipases A2 (PLA2; 26.2%), disintegrins (Dis; 12.6%), and snake venom serine proteases (SVSP; 6.8%), while C. lannomi venom mainly consists of SVMP (47.1%), PLA2 (19.3%), Dis (18.9%), SVSP (6%) and l-amino acid oxidase (LAAO; 2.6%). For these venoms high lethality was recorded in mice, the most potent being that of C. lannomi (LD50 of 0.99 µg/g body weight), followed by C. ericsmithi (1.30 µg/g) and finally C. stejnegeri (1.79 µg/g). The antivenoms Antivipmyn® from SILANES and Fabotherapic polyvalent antiviperin® from BIRMEX neutralized the lethal activity of the three venoms. Although this group of snakes is phylogenetically related to the C. viridis group, no neurotoxic components (crotoxin or crotoxin-like proteins) common in rattlesnakes were found in their venoms. This study expands current knowledge on the venoms of understudied snake species of the Mexican herpetofauna.

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Hybridization is defined as the interbreeding of individuals from two populations distinguishable by one or more heritable characteristics. Snake hybridization represents an interesting opportunity to analyze variability and how genetics affect the venom components between parents and hybrids. Snake venoms exhibit a high degree of variability related to biological and biogeographical factors. The aim of this work is to analyze the protein patterns and enzymatic activity of some of the main hemotoxic enzymes in snake venoms, such as serine proteases (trypsin-like, chymotrypsin-like, and elastase-like), metalloproteases, hyaluronidases, and phospholipase A2. The lethal dose of 50 (LD50) of venom from the Crotalus aquilus (Cabf) and Crotalus polystictus (Cpbm) parents and their hybrids in captivity was determined, and phenetic analysis is also conducted, which showed a high similarity between the hybrids and C. polystictus. The protein banding patterns and enzymatic activity analyze by zymography resulted in a combination of proteins from the parental venoms in the hybrids, with variability among them. In some cases, the enzymatic activity is higher in the hybrids with a lower LD50 than in the parents, indicating higher toxicity. These data show the variability among snake venoms and suggest that hybridization is an important factor in changes in protein concentration, peptide variability, and enzymatic activity that affect toxicity and lethality.

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Crotalus scutulatus (Mohave rattlesnake) is a clinically significant pit viper broadly distributed across much of the arid southwestern United States and mainland Mexico. Identification of C scutulatus is a concern among emergency medical service and emergency department personnel owing to its reputation for severe envenomations and difficulty in visually differentiating between C scutulatus and other species, primarily Crotalus atrox (western diamond-backed rattlesnake). We contrast distinctive characteristics of C scutulatus, C atrox, and 3 other sympatric species: Crotalus molossus, Crotalus ornatus, and Crotalus viridis (western and eastern black-tailed rattlesnakes and prairie rattlesnake, respectively). Greenish coloration eliminates C atrox but does not confirm C scutulatus. Obvious coarse and fine speckling of the dorsal pattern and a pale postocular stripe intersecting the mouth characterize C atrox. Dorsal speckling is insignificant or absent in the other species, whereas the pale postocular stripe passes above the mouth in C scutulatus and C viridis and is absent in C molossus and C ornatus. Tails boldly ringed with alternating black and white or contrasting shades of gray are shared by C atrox and C scutulatus, respectively, but a lack of boldly ringed tails characterizes the other species. The proximal rattle segment is yellow and black, or entirely yellow, in C scutulatus but black in the others. The most reliable visual identifications are based on evaluations of multiple traits, all of which are variable to some extent. Traits such as tail ring width and the size and number of crown scales have frequently been overemphasized in the past.

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The potential biotechnological and biomedical applications of the animal venom components are widely recognized. Indeed, many components have been used either as drugs or as templates/prototypes for the development of innovative pharmaceutical drugs, among which many are still used for the treatment of human diseases. A specific South American rattlesnake, named Crotalus durissus terrificus, shows a venom composition relatively simpler compared to any viper or other snake species belonging to the Crotalus genus, although presenting a set of toxins with high potential for the treatment of several still unmet human therapeutic needs, as reviewed in this work. In addition to the main toxin named crotoxin, which is under clinical trials studies for antitumoral therapy and which has also anti-inflammatory and immunosuppressive activities, other toxins from the C. d. terrificus venom are also being studied, aiming for a wide variety of therapeutic applications, including as antinociceptive, anti-inflammatory, antimicrobial, antifungal, antitumoral or antiparasitic agent, or as modulator of animal metabolism, fibrin sealant (fibrin glue), gene carrier or theranostic agent. Among these rattlesnake toxins, the most relevant, considering the potential clinical applications, are crotamine, crotalphine and gyroxin. In this narrative revision, we propose to organize and present briefly the updates in the accumulated knowledge on potential therapeutic applications of toxins collectively found exclusively in the venom of this specific South American rattlesnake, with the objective of contributing to increase the chances of success in the discovery of drugs based on toxins.

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Introdução: Os acidentes ofídicos são eventos negligenciados em países tropicais e em desenvolvimento, incluindo o Brasil. Serpentes do gênero Crotalus são aquelas que produzem os quadros de maior letalidade no país. Objetivos: Abordar os principais aspectos do acidente por Crotalus, com ênfase na biologia das serpentes, na condução clínica dos eventos mórbidos e nas propriedades terapêuticas da peçonha destes animais. Métodos: Revisão da literatura com estratégia de busca definida, a partir da utilização das bases PubMed, LILACS e SciELO. Resultados: A inoculação da peçonha crotálica produz sinais locais discretos, mas repercussões sistêmicas podem ocorrer, especialmente alterações neurológicas e insuficiência renal aguda. A avaliação laboratorial é importante para auxiliar na distinção de outros acidentes ofídicos e para estimar a gravidade do quadro. O soro anticrotálico precisa ser administrado o mais brevemente possível, a partir da estimativa da quantidade de peçonha inoculada. A maior parte dos agravos ocorre no período chuvoso, acometendo principalmente homens jovens que trabalham na zona rural. A adoção de medidas de proteção e a educação em saúde são estratégias pertinentes para a prevenção e a redução do número de casos. As peçonhas de Crotalus possuem ações antimicrobianas, antiagregantes plaquetárias e aplicabilidade em oftalmologia (estrabismo). Conclusão: O conhecimento dos diferentes aspectos dos acidentes crotálicos é essencial para a adequada abordagem diagnóstica e terapêutica de tais condições mórbidas. As propriedades farmacológicas de componentes da peçonha crotálica deverão ser melhor investigadas nos próximos anos, dadas as possibilidades de utilização para o tratamento de diferentes enfermidades humanas

Introduction: Ophidian accidents are neglected events in tropical and in developing countries, including Brazil. Serpents of the Crotalus genus (rattlesnakes) are those that produce the highest case-fatality in the country. Purpose: to address the main aspects of the accident caused by Crotalus, with emphasis on the snakes biology, the clinical approach to snake bites and the therapeutic properties of the venom of these animals. Methods: literature review with a defined search strategy, using the PubMed, LILACS and SciELO databases. Results: Inoculation of crotalic venom produces discrete local signs, but systemic repercussions can occur, especially neurological alterations and acute renal failure. Laboratory evaluation is important to help distinguish from other ophidian accidents and to estimate the severity of the condition. Anticrotalic serum must be administered as soon as possible, based on the estimated amount of inoculated venom. Most of the morbid events occur in the rainy season (higher temperature), mainly affecting young men who work in rural areas. The adoption of protective measures and health education, aimed at the population most commonly involved, are relevant strategies for preventing and reducing the number of cases. In addition, crotalic venoms have antimicrobial actions, antiplatelets functions and ophthalmological applicability (strabismus). Conclusion: Knowledge of the different aspects of crotalic injuries is essential for an adequate diagnostic and therapeutic approach to such morbid conditions. The pharmacological properties of crotalic venom components should be better investigated in the next few years, given the possibilities of their use for the treatment of different human diseases.

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Snakebites are a global public health issue, being considered by the World Health Organization a neglected tropical disease. In Brazil, the second snake that most accidents is the rattlesnake, Crotalus durissus, which has a high lethality rate. A greater understanding of how species ecology, for example reproductive biology, can relate to the occurrence and epidemiology of accidents is important for health. Since this knowledge can provide important data for the development of prevention and combat measures, as well as environmental education strategies. In this study, retrospective data contained in the entry forms of the Laboratory of Zoological Collections on crotalic accidents seen at the Hospital Vital Brazil, whose patients brought the specimens that caused the bites, were analyzed. Some specimens of rattlesnakes were dissected and statistical calculations were performed to investigate the correlation between the ecology and epidemiology of the cases. It could be observed that several epidemiological characteristics coincide with previous works. The results of this study showed that the seasonality of accidents may be related not only to human activity, but also to reproductive events of the species, such as: the high occurrence of accidents in autumn, coinciding with the period of mating and combat between males, in spring and summer, coinciding with the period of gestation and parturition in females, leading to greater exposure of snakes and, consequently, greater probability of encounter between humans and animals. The frequency of accidents with offspring in relation to adults is probably related to other characteristics of the natural history, such as feeding, since reproductive events do not influence the activity and exposure of this ontogenetic stage. Therefore, this study shows the importance of investigating the specimens that cause bites, as well as the ecology of snakebites, requiring further studies to investigate this species, as well as other snakes that cause accidents from a new ecological perspective.

Os acidentes ofídicos são uma questão de saúde pública a nível global, sendo considerada pela Organização Mundial da Saúde uma doença tropical negligenciada. No Brasil, a segunda serpente que mais causa acidentes é a cascavel, Crotalus durissus, a qual possui um elevado índice de letalidade. Uma maior compreensão sobre como a ecologia da espécie, por exemplo a biologia reprodutiva, pode se relacionar com a ocorrência e a epidemiologia dos acidentes é importante para a saúde. Uma vez que esse conhecimento pode trazer dados importantes para o desenvolvimento de medidas de prevenção e combate, assim como estratégias de educação ambiental. Neste trabalho, foram analisados dados retrospectivos dos acidentes crotálicos atendidos no Hospital Vital Brazil, contidos nos livros de registros da Coleção, dos quais os pacientes trouxeram os exemplares causadores das picadas. Alguns exemplares da espécie foram dissecados e foram realizadas cálculos estatísticos para investigar a correlação entre a ecologia e a epidemiologia dos casos. Pôde-se observar que várias características epidemiológicas coincidem com trabalhos anteriores. Os resultados deste estudo mostraram que a sazonalidade dos acidentes pode estar relacionada não só a atividade humana, como também a eventos reprodutivos da espécie, tais como: a elevada ocorrência de acidentes no outono coincidindo com o período de acasalamento e combate entre machos, na primavera e verão coincidindo com o período de gestação e parturição nas fêmeas, levando a uma maior exposição das serpentes e, consequentemente, maior probabilidade de encontro entre humanos e animais. A frequência de acidentes com filhotes em relação aos adultos, provavelmente, está relacionada a outras características da história natural, como a alimentação, visto que os eventos reprodutivos não influenciam na atividade e exposição desse estágio ontogenético. Portanto, esse trabalho mostra a importância da investigação de exemplares causadores das picadas, como também a ecologia dos acidentes ofídicos, sendo necessário mais estudos que investiguem essa espécie, como também as outras serpentes causadoras de acidentes sob uma nova perspectiva ecológica.

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Systemic envenomation by Crotalus durissus terrificus (South American rattlesnake) can cause coagulopathy, rabdomyolysis, acute kidney injury, and peripheral neuromuscular blockade, the latter resulting in flaccid paralysis. Previous studies have shown that plant products such as tannic acid and theaflavin can protect against the neuromuscular blockade caused by C. d. terrificus venom in vitro. In this work, we used mouse-isolated phrenic nerve-diaphragm preparations to examine the ability of caffeic acid, chlorogenic acid, and quercetin to protect against C. d. terrificus venom-induced neuromuscular blockade in vitro. In addition, the ability of tannic acid to protect against the systemic effects of severe envenomation was assessed in rats. Preincubation of venom with caffeic acid (0.5 mg/mL), chlorogenic acid (1 mg/mL), or quercetin (0.5 mg/mL) failed to protect against venom (10 µg/mL)-induced neuromuscular blockade. In rats, venom (6 mg kg-1, i.p.) caused death in ~8 h, which was prevented by preincubation of venom with tannic acid or the administration of antivenom 2 h post-venom, whereas tannic acid given 2 h post-venom prolonged survival (~18.5 h) but did not prevent death. Tannic acid (in preincubation protocols or given 2 h post-venom) had a variable effect on blood creatinine and urea and blood/urine protein levels and prevented venom-induced leukocytosis. Tannic acid attenuated the histological lesions associated with renal damage in a manner similar to antivenom. The protective effect of tannic acid appeared to be mediated by interaction with venom proteins, as assessed by SDS-PAGE. These findings suggest that tannic acid could be a potentially useful ancillary treatment for envenomation by C. d. terrificus.

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The Baja California Peninsula has over 250 islands and islets with many endemic species. Among them, rattlesnakes are the most numerous but also one of the least studied groups. The study of island rattlesnake venom could guide us to a better understanding of evolutionary processes and the description of novel toxins. Crotalus helleri caliginis venom samples were analyzed to determine possible ontogenetic variation with SDS-PAGE in one and two dimensions and with RP-HPLC. Western Blot, ELISA, and amino-terminal sequencing were used to determine the main components of the venom. The biological and biochemical activities demonstrate the similarity of C. helleri caliginis venom to the continental species C. helleri helleri, with both having low proteolytic and phospholipase A2 (PLA2) activity but differing due to the absence of neurotoxin (crotoxin-like) in the insular species. The main components of the snake venom were metalloproteases, serine proteases, and crotamine, which was the most abundant toxin group (30-35% of full venom). The crotamine was isolated using size-exclusion chromatography where its functional effects were tested on mouse phrenic nerve-hemidiaphragm preparations in which a significant reduction in muscle twitch contractions were observed. The two Mexican antivenoms could neutralize the lethality of C. helleri caliginis venom but not the crotamine effects.

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Crotalus durissus ruruima is a rattlesnake subspecies mainly found in Roraima, the northernmost state of Brazil. Envenomings caused by this subspecies lead to severe clinical manifestations (e.g. respiratory muscle paralysis, rhabdomyolysis, and acute renal failure) that can lead to the victim's death. In this review, we comprehensively describe C. d. ruruima biology and the challenges this subspecies poses for human health, including morphology, distribution, epidemiology, venom cocktail, clinical envenoming, and the current and future specific treatment of envenomings by this snake. Moreover, this review presents maps of the distribution of the snake subspecies and evidence that this species is responsible for some of the most severe envenomings in the country and causes the highest lethality rates. Finally, we also discuss the efficacy of the Brazilian horse-derived antivenoms to treat C. d. ruruima envenomings in Roraima state.

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Crotamine is a paralyzing toxin (MW: ~5 kDa) found in different proportions in some rattlesnake venoms (up to 62%). Mexican pit viper antivenoms have shown low immunoreactivity against crotamine, which is an urgent quality to be improved. The objective of this work was to evaluate the ability of a novel recombinant fusion protein composed of sphingomyelinase D and crotamine, and two whole venoms from Crotalus molossus nigrescens and C. oreganus helleri to produce neutralizing antibodies against crotamine. These immunogens were separately used for immunization procedures in rabbits. Then, we generated three experimental antivenoms to test their cross-reactivity via western-blot against crotamine from 7 species (C. m. nigrescens, C. o. helleri, C. durissus terrificus, C. scutulatus salvini, C. basiliscus, C. culminatus and C. tzabcan). We also performed pre-incubation neutralization experiments in mice to measure the neutralizing potency of each antivenom against crotamine induced hind limb paralysis. Our antivenoms showed broad recognition across crotamine from most of the tested species. Also, neutralization against crotamine paralysis symptom was successfully achieved by our three antivenoms, albeit with different efficiencies. Our results highlight the use of crotamine enriched venoms and our novel recombinant fusion protein as promising immunogens to improve the neutralizing potency against crotamine for the improvement of Mexican antivenoms.

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Crotalus durissus ruruima is a rattlesnake subspecies mainly found in Roraima, the northernmost state of Brazil. Envenomings caused by this subspecies lead to severe clinical manifestations (e.g. respiratory muscle paralysis, rhabdomyolysis, and acute renal failure) that can lead to the victim’s death. In this review, we comprehensively describe C. d. ruruima biology and the challenges this subspecies poses for human health, including morphology, distribution, epidemiology, venom cocktail, clinical envenoming, and the current and future specific treatment of envenomings by this snake. Moreover, this review presents maps of the distribution of the snake subspecies and evidence that this species is responsible for some of the most severe envenomings in the country and causes the highest lethality rates. Finally, we also discuss the efficacy of the Brazilian horse-derived antivenoms to treat C. d. ruruima envenomings in Roraima state.

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The aim of this study was to evaluate the clinical-epidemiological factors associated with victims of rattlesnake envenoming in the state of Roraima, Brazil. In this location, rattlesnake accidents are caused by the subspecies Crotalus durissus ruruima. This is a prospective observational study carried out at the General Hospital of Roraima from april 2017 until july 2018. A total of 37 alleged rattlesnake victims had their medical records evaluated. However only one of them proved to be by C. d. ruruima. All individuals were residents from the savannas (lavrados) of Roraima. The town of Bonfim on the border between Brazil and Guyana had the highest occurrence of rattlesnake bites. The most affected group were males aged 13-20 years and farmers. The highest number of incidents occurred during daytime and lower limbs (feet) were the most major affected part of the body. Tourniquets were used as first aid after snake envenoming in 32.4% of victims. Out of 37 patients, 16.2% were classified as severe cases of snakebite envenoming and in 5.4% dry bites seem to have occurred. Among the symptomatic patients, 100% presented local manifestations and 70.3% presented systemic manifestations. The clinical setting showed local effects such as pain and edema while the systemic effects were blurred vision, myalgias, myasthenic facies, palpebral ptosis, muscle weakness and headache. Laboratory results of aspartate aminotransferase (62.2%), creatine phosphokinase (51.3%), lactic dehydrogenase (37.8%), urea level (32.4%) and serum creatinine (29.7%) were increased significantly in relation to the reference standards. In 16.2% of the cases, the victims presented acute kidney injury. Patients were treated with anticrotalic serum in 70.3% of the cases and antibotropic + anticrotalic serum in 24.3%. The victims of C. d. ruruima in Roraima showed a local symptomatology similar to Bothrops envenoming, while systemic symptoms and laboratory analysis proved kidney and muscular injuries, similar to envenoming by Crotalus d. terrificus in Brazil.

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Snakebite in Mexico is commonly treated with an antivenom which uses Bothrops asper and Crotalus simus venoms as immunogens. Current taxonomic recommendations for the C. simus species complex suggest a novel endemic species from Mexico: Crotalus mictlantecuhtli. The aim of this report was to evaluate the immunogenic properties of C. mictlantecuhtli venom and its potential to generate polyclonal antibodies capable of neutralizing other pitviper venoms. We generated an experimental anti-Crotalus mictlantecuhtli serum, using the rabbit model, to test recognition and neutralizing capacity against the homologous venom as well as venoms from C. atrox, C.basiliscus, C. durissus terrificus, C. scutulatus salvini, C. tzabcan and Ophryacus sphenophrys. Pre-incubation neutralization experiments using our experimental serum showed positive results against venoms containing crotoxin, while venoms from two non-neurotoxic pit-vipers were not neutralized. Rescue experiments in mice showed that, when intravenously injected (i.v.), C. mictlantecuhtli venom is not neutralized by a maximum dose of Antivipmyn® and the experimental serum after 5 min of envenomation, albeit mice envenomated intraperitoneally (i.p.) and rescued i.v. with Antivipmyn® survived even at 50 min after envenomation. Our results highlight the importance of using the highly neurotoxic C. mictlantecuhtli venom to increase antivenom effectiveness against Mexican neurotoxic pitvipers.

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The Baja California Peninsula possesses a mosaic of ecoregions that offers a wide variety of environments for the species that here inhabit. Here we report biological variations in. Crotalus ruber lucasensis venom from arid, semiarid and tropical eco-regions. Lethal (1.4-6.8 mg/kg), edematogenic (0.3-0.5 µg) and defibrinogenating (from non-detectable to 20 µg) activities were found to have significant differences among eco-regions.

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