Venenos e toxinas de serpentes do gênero Bothrops com ação na resposta inflamatória: implicações no tratamento de reações locais

Abstract

Snakebite is one of the neglected diseases in public health and affects many people's lives worldwide. It impacts the quality of life of populations, mainly poor people and rural areas, constantly exposed to the risk of being affected by this accident. It may cause coagulation disorders and induce acute inflammatory and hemorrhagic activity. It can cause local pain, edema, local hemorrhage, blister formation, and necrosis and may progress to tissue loss, physical disability, or amputation. The main toxins present in Bothrops venom are metalloproteases, phospholipases A2, and serine proteases, which act in isolation and synergistically, triggering an inflammatory response, tissue damage, and hemostatic disorders. Antivenom therapy is the only effective treatment for envenoming by venomous snakebites, and it has a remarkable ability to neutralize systemic effects. However, when it comes to local damage, the antivenom does not have such an effective action, since the mediators of the inflammatory process act quickly after the accident, and the antivenom does not act on endogenous inflammatory mediators that have already been released or on the already damaged tissue. Therefore, it is necessary to study complementary therapies to antivenom therapy so that recovery after snakebite is a more effective outcome. Complementary therapies are diverse and encouraging. Studies with specific toxin inhibitors, natural or synthetic, are promising and have shown potential for improvement in treating local lesions induced by snakebites. The field of study for treating these accidents is encouraging but lacks more investment and further clinical studies to confirm these data and reach the health system.