Cardiovascular alterations caused by Bothrops alternatus venom: studys in vivo and in vitro

Author(s)

Lourdes Dias

• Document type: Doctoral Thesis
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2009-07-13

Examining board members

Stephen Hyslop; Ida Sigueko Sano Martins; Ruy Ribeiro Campos; Wilson Nadruz Junior; Miguel Arcanjo Areas

• Advisor: Stephen Hyslop

Abstract

Bothrops snake venoms cause hypotension, but the hemodynamic and cardiac alterations associated with this phenomenon have not been extensively investigated. In this study, we examined the cardiovascular changes caused by Bothrops alternatus (urutu) venom in anesthetized dogs and examined the cardiotoxicity of the venom in rat isolated rat atria. In isofluorane-anesthetized dogs, venom (0.3 mg/kg, i.v.) caused immediate hypotension that was maximal within 5 min followed by a slow recovery to levels not significantly different from pre-venom values after 2 h; no recovery was seen with a venom dose of 1 mg/kg. The hypotension was accompanied by an abrupt decrease in cardiac output, left and right ventricular systolic work, and systolic indices and volume that persisted without recovery until the end of the experiment. There were no significant changes in heart rate, ECG, pulmonary hemodynamics, blood gas levels (pO2, pCO2, HCO3, SBCe and SBEc) and metabolic parameters (blood pH, lactate, glucose and creatine kinase); however, a slight, significant increase in lactate dehydrogenase was seen soon after venom. There were no histological alterations in cardiac tissue, but microaneurysms and epithelial desquamation were seen in renal tubules. Circulating venom decreased rapidly after i.v. administration, but was still detectable after 240 min. Venom (0.5, 1.0 and 2.0 mg/ml) did not affect the beating rate of rat isolated right atria but significantly reduced the contractile force (maximal reduction of ~76%) and markedly increased the release of creatine kinase (CK) and CK-MB. Histological analysis revealed extensive myonecrosis. Venom dialysis (1.0 mg/ml; membrane nominal MW cut-off = 2000 Da) against 0.9% NaCl (24 h, 4°C) did not affect the decrease in contractile force whereas heating (100°C, 20 min) abolished the venom-induced reduction; CK and CK-MB release was also unaltered by dialysis but attenuated by heating. The decrease in atrial contractility was unaffected by atropine, atenolol, propranolol, cimetidine or indomethacin, but was attenuated by L-NAME, an inhibitor of nitric oxide synthase, indicating a possible role for nitric oxide in the venom-induced response. These results show that in dogs B. alternatus produces marked cardiovascular alterations involving a direct cardiac action, with little role for metabolic changes. The venom is also toxic to rat atria, probably as a result of venom proteolytic and/or phospholipase A2 activity. (AU)