Clinical and Pharmacological Investigation of Myotoxicity in Sri Lankan Russell's Viper (Daboia russelii) Envenoming

摘要: Background Sri Lankan Russell’s viper (Daboia russelii) envenoming is reported to cause myotoxicity and neurotoxicity, which are different the effects of by most other populations vipers. This study aimed investigate evidence in envenoming, response antivenom toxins responsible for myotoxicity. Methodology Findings Clinical features were assessed authenticated bite patients admitted a Sri teaching hospital. Toxins isolated using high-performance liquid chromatography. In-vitro venom was investigated chick biventer nerve-muscle preparations. Of 245 enrolled patients, 177 (72.2%) had local myalgia 173 (70.6%) muscle tenderness. Generalized tenderness present 35 (14.2%) 29 (11.8%) respectively. Thirty-seven high (>300 U/l) serum creatine kinase (CK) concentrations samples 24h post-bite (median: 666 U/l; maximum: 1066 U/l). Peak CK not associated (Spearman’s correlation; p = 0.48). The differed without (median 58 U/l), compared those with (137 generalised signs/symptoms (107 0.049). Venom caused concentration-dependent inhibition direct twitches cervicis preparation, completely abolishing after 3 h even at 80 μg/ml. Indian polyvalent did prevent in-vitro recommended concentrations. Two phospholipase A2 molecular weights 13kDa, U1-viperitoxin-Dr1a (19.2% venom) U1-viperitoxin-Dr1b (22.7% venom), concentration dependently inhibited preparation. At μM, abolished twitches, while 70% twitch force 3h. Removal both from whole resulted no myotoxicity. Conclusion The shows that mild non-life threatening, due two PLA2 weak myotoxic properties.