Proteomic characteristics of six snake venoms from the Viperidae and Elapidae families in China and their relation to local tissue necrosis.

Patients envenomed by snakes from the Viperidae and Elapidae families in China often have varying degrees of local tissue necrosis. Due to the relative clinical characteristics of local tissue necrosis and ulceration following envenoming, this study has analyzed the proteome of six snake venoms from the Viperidae and Elapidae family, and the toxin profiles of each snake were compared and correlated with the clinical manifestations that follow cytotoxic envenoming. Deinagkistrodon acutus and Naja atra envenomation induce severe ulceration, which is absent in Bungarus multicinctus envenomation and mild in the other three vipers. It is interesting to note that the proportion of c-type lectins (CTL) (20.63%) in Deinagkistrodon acutus venom was relatively high, which differs from the venom of other vipers. In addition, three-fingered toxin (3FTx) (2.15%) is present in the venom of Deinagkistrodon acutus, but has not been detected in the remaining three vipers. Snake venom metalloprotease (SVMP) (34.4%-44.7%), phospholipase A2 (PLA2) (9.81%-40.83%), and snake venom serine protease (SVSP) (9.44%-16.2%) represent the most abundant families of toxin in Viperidae venom. The Elapidae venom proteome was mainly composed of neurotoxins and cytotoxins, including 3FTx (39.28%-60.08%) and PLA2 (8.24%-58.95%) toxins, however, the proportion of CRISPS (26.36%) in Naja atra venom was relatively higher compared to Bungarus multicinctus venom. Significant differences in SVMP, SVSP, and 3FTx expression levels exist between the Viperidae and the Elapidae family. The main toxins responsible for the development of tissue necrosis and ulcerations following Viperidae envenoming are hematotoxins (SVSMP, SVSP) and myotoxins (PLA2). Deinagkistrodon acutus venom contains high levels of CTL and traces of 3FTx, leading to more severe local necrosis. However, Naja atra venom can also cause severe local necrosis through the effects of myotoxin (3FTx, CRISP, PLA2). Bungarus multicinctus venom does not contain myotoxins, resulting in pure systemic neurological manifestations no obvious necrosis of local tissue in patients.

[Imbalance of T helper 1 cells/T helper 2 cells accelerated T-cell-mediated endothelium injury in patients with acute coronary syndromes].

OBJECTIVE: To observe the T helper 1 and T helper 2 (Th1/Th2) balance and possible association to vascular endothelial cells injury in patients with acute coronary syndromes (ACS). METHODS: Forty patients with ACS and 18 patients with stable angina pectoris (SAP) were included in this study. The concentrations of T helper 1/T helper 2 subsets related cytokines in plasma were evaluated by ELISA Kits. Cytotoxic activity of peripheral blood mononuclear cells (PBMCs) or PBMCs depleted CD(+) T cells against human umbilical vein endothelial cells (HUVECs) were evaluated by Cr51 cytotoxicity assay. RESULTS: Concentrations of T helper 1 related cytokines IFN-gamma and IL-2 were significantly higher [IFN-gamma: (131.2 +/- 42.2) ng/L vs. (47.6 +/- 20.2) ng/L; IL-2: (83.7 +/- 21.3) ng/L vs. (46.2 +/- 16.7) ng/L, all P < 0.05] while T helper 2 related cytokine IL-10 concentration was significantly lower [(16.7 +/- 4.3) ng/L vs. (27.5 +/- 5.5) ng/L, P < 0.05] in patients with ACS compared to those in SAP patients. Cytotoxic activity of PBMCs against HUVECs in patients with ACS was also significantly higher than that in patients with SAP (28.84% +/- 4.20% vs. 20.28% +/- 2.71%, P < 0.05). CONCLUSIONS: In patients with ACS, Th1 related cytokines were significantly upregulated while Th2 related cytokines were significantly downregulated. This imbalance of Th1/Th2 accelerated PBMCs mediated endothelium injury in patients with ACS.