Bleeding and Thrombosis: Insights into Pathophysiology of <i>Bothrops</i> Venom-Related Hemostasis Disorders
Toxins from <i>Bothrops</i> venoms targeting hemostasis are responsible for a broad range of clinical and biological syndromes including local and systemic bleeding, incoagulability, thrombotic microangiopathy and macrothrombosis. Beyond hemostais disorders, toxins are also involved in t...
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doaj-c3d0f2386f774fe6bff62e19b544ae2a2021-09-09T13:48:58ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672021-09-01229643964310.3390/ijms22179643Bleeding and Thrombosis: Insights into Pathophysiology of <i>Bothrops</i> Venom-Related Hemostasis DisordersSébastien Larréché0Jean-Philippe Chippaux1Lucie Chevillard2Simon Mathé3Dabor Résière4Virginie Siguret5Bruno Mégarbane6INSERM, UMRS-1144, Paris University, 75006 Paris, FranceMERIT, IRD, Paris University, 75006 Paris, FranceINSERM, UMRS-1144, Paris University, 75006 Paris, FranceINSERM, UMRS-1144, Paris University, 75006 Paris, FranceClinical Toxicology Unit, Critical Care Department, University Hospital of Martinique, Fort de France, 97200 Martinique, FranceINSERM, UMRS-1140, Paris University, 75006 Paris, FranceINSERM, UMRS-1144, Paris University, 75006 Paris, FranceToxins from <i>Bothrops</i> venoms targeting hemostasis are responsible for a broad range of clinical and biological syndromes including local and systemic bleeding, incoagulability, thrombotic microangiopathy and macrothrombosis. Beyond hemostais disorders, toxins are also involved in the pathogenesis of edema and in most complications such as hypovolemia, cardiovascular collapse, acute kidney injury, myonecrosis, compartmental syndrome and superinfection. These toxins can be classified as enzymatic proteins (snake venom metalloproteinases, snake venom serine proteases, phospholipases A<sub>2</sub> and L-amino acid oxidases) and non-enzymatic proteins (desintegrins and C-type lectin proteins). Bleeding is due to a multifocal toxicity targeting vessels, platelets and coagulation factors. Vessel damage due to the degradation of basement membrane and the subsequent disruption of endothelial cell integrity under hydrostatic pressure and tangential shear stress is primarily responsible for bleeding. Hemorrhage is promoted by thrombocytopenia, platelet hypoaggregation, consumption coagulopathy and fibrin(ogen)olysis. Onset of thrombotic microangiopathy is probably due to the switch of endothelium to a prothrombotic phenotype with overexpression of tissue factor and other pro-aggregating biomarkers in association with activation of platelets and coagulation. Thrombosis involving large-caliber vessels in <i>B. lanceolatus</i> envenomation remains a unique entity, which exact pathophysiology remains poorly understood.https://www.mdpi.com/1422-0067/22/17/9643snake venomhemorrhagemicrothrombithrombocytopeniacoagulopathy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sébastien Larréché Jean-Philippe Chippaux Lucie Chevillard Simon Mathé Dabor Résière Virginie Siguret Bruno Mégarbane |
spellingShingle |
Sébastien Larréché Jean-Philippe Chippaux Lucie Chevillard Simon Mathé Dabor Résière Virginie Siguret Bruno Mégarbane Bleeding and Thrombosis: Insights into Pathophysiology of <i>Bothrops</i> Venom-Related Hemostasis Disorders International Journal of Molecular Sciences snake venom hemorrhage microthrombi thrombocytopenia coagulopathy |
author_facet |
Sébastien Larréché Jean-Philippe Chippaux Lucie Chevillard Simon Mathé Dabor Résière Virginie Siguret Bruno Mégarbane |
author_sort |
Sébastien Larréché |
title |
Bleeding and Thrombosis: Insights into Pathophysiology of <i>Bothrops</i> Venom-Related Hemostasis Disorders |
title_short |
Bleeding and Thrombosis: Insights into Pathophysiology of <i>Bothrops</i> Venom-Related Hemostasis Disorders |
title_full |
Bleeding and Thrombosis: Insights into Pathophysiology of <i>Bothrops</i> Venom-Related Hemostasis Disorders |
title_fullStr |
Bleeding and Thrombosis: Insights into Pathophysiology of <i>Bothrops</i> Venom-Related Hemostasis Disorders |
title_full_unstemmed |
Bleeding and Thrombosis: Insights into Pathophysiology of <i>Bothrops</i> Venom-Related Hemostasis Disorders |
title_sort |
bleeding and thrombosis: insights into pathophysiology of <i>bothrops</i> venom-related hemostasis disorders |
publisher |
MDPI AG |
series |
International Journal of Molecular Sciences |
issn |
1661-6596 1422-0067 |
publishDate |
2021-09-01 |
description |
Toxins from <i>Bothrops</i> venoms targeting hemostasis are responsible for a broad range of clinical and biological syndromes including local and systemic bleeding, incoagulability, thrombotic microangiopathy and macrothrombosis. Beyond hemostais disorders, toxins are also involved in the pathogenesis of edema and in most complications such as hypovolemia, cardiovascular collapse, acute kidney injury, myonecrosis, compartmental syndrome and superinfection. These toxins can be classified as enzymatic proteins (snake venom metalloproteinases, snake venom serine proteases, phospholipases A<sub>2</sub> and L-amino acid oxidases) and non-enzymatic proteins (desintegrins and C-type lectin proteins). Bleeding is due to a multifocal toxicity targeting vessels, platelets and coagulation factors. Vessel damage due to the degradation of basement membrane and the subsequent disruption of endothelial cell integrity under hydrostatic pressure and tangential shear stress is primarily responsible for bleeding. Hemorrhage is promoted by thrombocytopenia, platelet hypoaggregation, consumption coagulopathy and fibrin(ogen)olysis. Onset of thrombotic microangiopathy is probably due to the switch of endothelium to a prothrombotic phenotype with overexpression of tissue factor and other pro-aggregating biomarkers in association with activation of platelets and coagulation. Thrombosis involving large-caliber vessels in <i>B. lanceolatus</i> envenomation remains a unique entity, which exact pathophysiology remains poorly understood. |
topic |
snake venom hemorrhage microthrombi thrombocytopenia coagulopathy |
url |
https://www.mdpi.com/1422-0067/22/17/9643 |
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