Inactivation of venom PLA2 alleviates myonecrosis and facilitates muscle regeneration in envenomed mice: A time course observation

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Abstract

Snake venom is a complex cocktail of toxins which induces a series of clinical and pathophysiological manifestations in victims, including severe local tissue damage and systemic alterations. Deinagkistrodon acutus (D. acutus) ranks among the “big four” life-threatening venomous species in China, whose venom possesses strong myotoxicity and hematotoxicity that often lead to permanent disability or muscle atrophy. Varespladib, an inhibitor of mammalian phospholipase A2 (PLA2), has been recently reproposed as an effective antidote against snakebite envenomation. The present study aimed at evaluating the protective role of varespladib on muscle regeneration in envenomed mice. Mice were grouped and subjected to inoculation with D. acutus venom or a mixture of venom and varespladib or control vehicle in the gastrocnemius muscle. Local injuries including hemorrhage, myonecrosis, ulceration, and systemic damages including general dysfunction, visceral failure, and inflammatory responses were observed at 1, 3, 7, 14, and 21 days. The results indicated that most of the muscle myonecrosis and hemorrhage were alleviated by varespladib. Besides, the pretreated mice recovered rapidly with lesser atrophy and muscle fibrosis. In conclusion, the findings of the present study suggested that varespladib is an effective antidote that could neutralize D. acutus venom and allow for earlier and improved rehabilitation outcome.

Figures

  • Figure 1. Macroscopic observation of overall signs and gastrocnemius muscle edema during the rehabilitation process. (A) The envenomed status of mice inoculated with D. acutus venom i.m. was tightly related with varespladib. Severe subcutaneous hemorrhage, paralytic hind leg, and skin ulceration developed in the venom group (day 1). Muscle contraction recovery, hemorrhage clearance, skin scabs and heals appeared serially during the rehabilitation process; (B) Morphological changes in gastrocnemius muscle. The envenomed muscle exhibited hemorrhage and edema during the early stage, atrophy was observed in the reg nerative period; (C) Variation in gastrocnemius muscl width. ∆m = width subtraction of the right limb t the left limb. Data wer presented as means ± SD (n = 3). * p V nom vs. Venom + Var (p < 0.05), “a” p < 0.05 Venom vs. Vehicle, “b” p < 0.05 Venom + Var vs. ehicle, “c” p < 0.05 V nom vs. Venom day 1, “d” p < 0.05 Venom + Var vs. Venom + Var day 1, Varespla ib was bbreviated as Var.
  • Figure 2. Variation in seru CK, AST, LD 1, and TBIL during a ti e course rehabilitation of envenomed mice. (A) Creatine kinase increased significantly at day 1, indicating an immediate muscle necrosis. Varespladib significantly prevented muscle degeneration; (B,C) were serum AST and LDH1 levels, significant increase occurred at the initial 7 days; (D) Total bilirubin, a biomarker of erythrocyte degradation, increased substantially at the 3rd day, the time of hemorrhage removal and absorption. Results were presented as means ± SD (n = 3). * p Venom vs. Venom + Var (p < 0.05), ** p < 0.01, *** p < 0.001,“a” p < 0.05 Venom vs. Vehicle, “b” p < 0.05 Venom + Var vs. Vehicle, “c” p < 0.05 Venom vs. Venom day 1, “d” p < 0.05 Venom + Var vs. Venom + Var day 1.
  • Figure 3. Histological examination of gastrocnemius muscle during necrosis and repair. (A) Hematoxylin-eosin (HE) staining of the gastrocnemius muscle. Photos of day 1 to day 3 were characterized by severe myonecrosis (asterisk), massive erythrocytes (arrow) and inflammatory cell (pentastar) infiltration. Evident basophilic myotubes were observed on day 7 (A3), and centrallylocated nuclei muscle fibers (triangle) appeared simultaneously. The gastrocnemius muscle that was pretreated with varespladib showed reduced necrosis, low inflammatory reaction, better and earlier re-arrangement of myofibers; (B) Sirius red staining. Collagen was stained in red with a subsequent increase in its deposition accompanied by muscle regeneration. Slight fibrosis was noticed in varespladib pretreated mice. Muscle sections were examined at 200× magnification.
  • Figure 4. Gene expression profile of muscle regeneration. (A,B) Molecular markers of M1 and M2 macrophages, CD68 and CD163 exhibited their maximum expression at day 3 and day 7; (C,D) show the relative expression of Myogenin and MyoD, which represented the progression of muscle regeneration; (E) NGF expression was significantly increased in the venom group, indicating major nerve repair during the early stage of envenomation; (F) The bifacial variation of Ang-1 expression indicated early initiation of microvascular repair in the varespladib group, and a deferred repair in the venom group. Results were presented as means ± SD (n = 3). * p: Venom vs. Venom + Var (p < 0.05), ** p < 0.01, *** p < 0.001, “a” p < 0.05 Venom vs. Vehicle, “b” p < 0.05 Venom + Var vs. Vehicle, “c” p < 0.05 Venom vs. Venom day 1, “d” p < 0.05 Venom + Var vs. Venom + Var day 1, “e” p < 0.05 Vehicle vs. Vehicle day 1.
  • Table 1. Primers used for mRNA analysis.

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Xiao, H., Li, H., Zhang, D., Li, Y., Sun, S., & Huang, C. (2018). Inactivation of venom PLA2 alleviates myonecrosis and facilitates muscle regeneration in envenomed mice: A time course observation. Molecules, 23(8). https://doi.org/10.3390/molecules23081911

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