Electronic and Tobacco Cigarettes Alter Polyunsaturated Fatty Acids and Oxidative Biomarkers.

[Figure: see text].

Diesel exhaust particle extract elicits an oxPAPC-like transcriptomic profile in macrophages across multiple mouse strains.

Air pollution is a prominent cause of cardiopulmonary illness, but uncertainties remain regarding the mechanisms mediating those effects as well as individual susceptibility. Macrophages are highly responsive to particles, and we hypothesized that their responses would be dependent on their genetic backgrounds. We conducted a genome-wide analysis of peritoneal macrophages harvested from 24 inbred strains of mice from the Hybrid Mouse Diversity Panel (HMDP). Cells were treated with a DEP methanol extract (DEPe) to elucidate potential pathways that mediate acute responses to air pollution exposures. This analysis showed that 1247 genes were upregulated and 1383 genes were downregulated with DEPe treatment across strains. Pathway analysis identified oxidative stress responses among the most prominent upregulated pathways; indeed, many of the upregulated genes included antioxidants such as Hmox1, Txnrd1, Srxn1, and Gclm, with NRF2 (official gene symbol: Nfe2l2) being the most significant driver. DEPe induced a Mox-like transcriptomic profile, a macrophage subtype typically induced by oxidized phospholipids and likely dependent on NRF2 expression. Analysis of individual strains revealed consistency of overall responses to DEPe and yet differences in the degree of Mox-like polarization across the various strains, indicating DEPe × genetic interactions. These results suggest a role for macrophage polarization in the cardiopulmonary toxicity induced by air pollution.

Who are the most affected by Bothrops snakebite envenoming in Brazil? A Clinical-epidemiological profile study among the regions of the country.

Snakebite envenoming represents an important Neglected Tropical Disease (NTD) that mainly affects tropical and subtropical developing countries according to the World Health Organization (WHO). As a priority issue in the tropics, it is estimated that accidental encounter between snakes and humans is the leading cause of morbidity and mortality among all NTDs in the world. In Brazil, an extremely diverse country with continental dimensions, snakebite envenoming is the second leading cause of reported human envenoming. Treating the disease has been an unprecedented challenge for Brazilian Health Systems for decades. Despite access to Antivenom therapy and distributing it free of charge across the country, Brazil faces numerous issues regarding the notification process and accurate treatment targeting for at-risk populations. Thus, this study aimed to identify the temporal epidemiological dynamics of accidents caused by Bothrops snakes in Brazil, the country's major group of venomous snakes, based on secondary information from the online database provided by The Brazilian Notifiable Diseases Information System (SINAN). For this purpose, reported Bothrops snakebites between 2012 and 2021 were counted, then the data were analyzed. We looked at the frequency, occurrence, mortality rates, case fatality rate (CFR), age and gender distribution, and the time lapse between the incident and the initiation of Antivenom therapy. The data were also organized considering regional variations of the country. Throughout the studied period, a total of 202,604 cases of envenoming caused by Bothrops spp. were notified, resulting in 766 fatalities. These accidents were found to occur in variable proportions across different regions in Brazil, with notable concentrations observed in the North, Northeast, and Southeast regions. The epidemiological profile of patients varied greatly between the regions, revealing that snake envenoming is much more a social, economic, and ecological problem than a medical one. In conclusion, our study provides an overview of the clinical and epidemiological profile of envenoming by Bothrops snakes in Brazil. Notably, this is the first study to present such information in a country as vast and diverse as Brazil, encompassing a comparative analysis of its regions using SINAN data, that proves to be a very useful national tool to improve the control and management of envenoming.

Antiophidic potential of chlorogenic acid and rosmarinic acid against Bothrops leucurus snake venom.

Bothrops leucurus is responsible for most cases of snakebite in Northeast Brazil; however, this species is not included in the pool of venoms used in antivenom production in Brazil. The serotherapy has logistical and effectiveness limitations, which stimulates the search for therapeutic alternatives. Chlorogenic acid and rosmarinic acid present several biological activities, but their antiophidic potential has been poorly explored. Thus, the aim of this approach was to evaluate the potential inhibitory effects of these compounds on B. leucurus venom. Initially, the enzymatic inhibition of toxins was evaluated in vitro. Then, anti-hemorrhagic, anti-myotoxic, and anti-edematogenic assays were performed in vivo, as well analysis of several biochemical markers and hemostatic parameters. In addition, the interaction of inhibitors with SVMP and PLA2 was investigated by docking analysis. Results revealed that compounds inhibited in vitro the enzymatic activities and venom-induced edema, with a decrease in both myeloperoxidase and interleukin quantification. The inhibitors also attenuated the hemorrhagic and myotoxic actions and mitigated changes in serum biochemical and hemostatic markers, as well as decreased lipid peroxidation in liver and kidney tissues. Docking analysis revealed attractive interactions of both inhibitors with the zinc-binding site of SVMP and, in the case of PLA2, chlorogenic acid showed a similar inhibition mechanism to that described for rosmarinic acid. The results evidenced the antiophidic potential of both compounds, which showed higher efficiency than antivenom serum. Thus, both inhibitors are promising candidates for future adjuvants to be used to complement antivenom serotherapy.

Antibiofilm Activity of Acidic Phospholipase Isoform Isolated from Bothrops erythromelas Snake Venom.

INTRODUCTION: Bacterial resistance is a worldwide public health problem, requiring new therapeutic options. An alternative approach to this problem is the use of animal toxins isolated from snake venom, such as phospholipases A2 (PLA2), which have important antimicrobial activities. Bothropserythromelas is one of the snake species in the northeast of Brazil that attracts great medical-scientific interest. Here, we aimed to purify and characterize a PLA2 from B. erythromelas, searching for heterologous activities against bacterial biofilms. METHODS: Venom extraction and quantification were followed by reverse-phase high-performance liquid chromatography (RP-HPLC) in C18 column, matrix-assisted ionization time-of-flight (MALDI-ToF) mass spectrometry, and sequencing by Edman degradation. All experiments were monitored by specific activity using a 4-nitro-3-(octanoyloxy) benzoic acid (4N3OBA) substrate. In addition, hemolytic tests and antibacterial tests including action against Escherichiacoli, Staphylococcusaureus, and Acinetobacterbaumannii were carried out. Moreover, tests of antibiofilm action against A. baumannii were also performed. RESULTS: PLA2, after one purification step, presented 31 N-terminal amino acid residues and a molecular weight of 13.6564 Da, with enzymatic activity confirmed in 0.06 µM concentration. Antibacterial activity against S. aureus (IC50 = 30.2 µM) and antibiofilm activity against A. baumannii (IC50 = 1.1 µM) were observed. CONCLUSIONS: This is the first time that PLA2 purified from B. erythromelas venom has appeared as an alternative candidate in studies of new antibacterial medicines.

[Epidemiology of accidents by venomous animals and distribution of antivenon: state of art and world status]. / Epidemiologia dos acidentes por animais peçonhentos e a distribuição de soros: estado de arte e a situação mundial.

Accidents by venomous animals are discussed under the historical perspective of state actions. Considered as neglected diseases, they cause social and economic losses in the working age population from rural areas of poor countries, as few of them have public health policies for adequate prophylaxis and treatment; in fact, the largest life losses occur in Africa and Asia. The 46 world producers of antivenin do not meet the global needs, making access to treatment difficult, even in countries with own production. Notification systems lead to inaccurate surveillance surveys and antivenin needs. Despite mandatory notification, Brazil lacks robust databases with full open access in order to allow the timely distribution of antivenin for quality care of these patients. Progress has been made in diagnostic testing, but its application in poor areas is not feasible due to high costs. Improvements in quality antivenin production through good laboratory practices and manufacturing minimize unsatisfactory results of treatments carried out with products of dubious origin. Antivenin development using biotechnology and well-designed clinical trials are key for the treatment of envenoming by agents phylogenetically related from different regions (continental or universal antivenins). International partnerships are fundamental, besides regulatory stocks, similarly to those adopted for vaccines, to supply world demand. The qualification of antivenin will certainly minimize treatment mistakes. Government support to research is a driving force and the most efficient tool for preserving life and avoiding social security surcharges, particularly in developing countries.

Acidentes por animais peçonhentos são discutidos sob perspectiva histórica de ações de estado. Considerados doenças negligenciadas eles causam prejuízos sociais e econômicos, em pessoas em idade produtiva de regiões rurais em países pobres. Poucos países dispõem de políticas públicas de saúde para profilaxia e tratamento adequados e as maiores perdas ocorrem na África e Ásia. Os 46 produtores mundiais de soros não suprem as necessidades globais e acesso ao tratamento é difícil, mesmo em países com produção própria. Sistemas de Notificação produzem levantamentos imprecisos sobre necessidades de soro e apesar da notificação compulsória. O Brasil carece de bancos de dados robustos de amplo acesso, que permita uma distribuição do soro em tempo seguro para o atendimento de qualidade. Muito se avançou em testes diagnóstico, porém sua aplicação em áreas pobres é inviabilizada pelos custos. Melhorias na qualidade de produção dos soros, via boas práticas laboratoriais e fabris, minimizam resultados insatisfatórios de tratamentos com produtos de origem e ação duvidosa. Desenvolvimento de soros empregando Biotecnologia e Ensaios Clínicos bem desenhados, são chave para tratamento de envenenamentos por agentes aparentados em diferentes regiões (soros continentais ou universais). Parcerias internacionais são fundamentais, além de estoques reguladores, semelhantes aos adotados em vacinas, para suprir a demanda mundial. A qualificação dos soros antivenenos certamente minimizará equívocos de uso. Apoio governamental à pesquisa é alavanca propulsora e a ferramenta mais eficiente de preservação da vida, evitando sobrecargas social e previdenciária principalmente em países em desenvolvimento.

Accidentes por animales venenosos se discuten desde una perspectiva histórica de acciones de estado. Consideradas enfermedades olvidadas, causan perjuicios sociales y económicos, en personas en edad productiva de regiones rurales en países pobres. Pocos países disponen de políticas públicas de salud para profilaxis y tratamiento adecuados y las mayores pérdidas ocurren en África y Asia. Los 46 productores mundiales de sueros no suplen las necesidades globales y el acceso al tratamiento es difícil, incluso en países con producción propia. Los sistemas de notificación generan levantamientos imprecisos sobre las necesidades de suero ya pesar de la notificación obligatoria, Brasil carece de bases de datos robustas de amplio acceso, permitiendo la llegada del suero en tiempo seguro para la atención de calidad. Se ha avanzado mucho en pruebas diagnósticas, pero su aplicación en áreas pobres es inviabilizada por los costos. Mejoras en la calidad de producción de los sueros, a través de buenas prácticas de laboratorio y fabril, minimizan resultados insatisfactorios de tratamientos con productos de origen y acción dudosa. El desarrollo de sueros empleando Biotecnología y Ensayos Clínicos bien diseñados, son clave para el tratamiento de envenenamientos por agentes emparentados en diferentes regiones (sueros continentales o universales). Las alianzas internacionales son fundamentales, además de stocks reguladores, similares a los adoptados en vacunas, para suplir la demanda mundial. La pre cualificación de los sueros antivenenos ciertamente minimizará equívocos de uso. El apoyo gubernamental a la investigación es la palanca propulsora y la herramienta más eficiente de preservación de la vida, evitando sobrecargas social y previsional principalmente en países en desarrollo.

An overview of Bothrops erythromelas venom.

This review discusses studies on the venom of Bothrops erythromelas published over the past 36 years. During this period, many contributions have been made to understand the venomous snake, its venom, and its experimental and clinical effects better. The following chronological overview is based on 29 articles that were published between 1979 and 2015, with emphasis on diverse areas. The complexity of this task demands an integration of multidisciplinary research tools to study toxinology. This science is in need of renewed conceptual and experimental platforms aimed at obtaining a profound understanding of the highly complex pathophysiology of snakebite envenoming and toxins isolated from snakes.

Venomics and antivenomics of Bothrops erythromelas from five geographic populations within the Caatinga ecoregion of northeastern Brazil.

The Caatinga lancehead, Bothrops erythromelas, is a medically relevant species, responsible for most of the snakebite accidents in most parts of its distribution range in northeastern Brazil. The spectrum and geographic variability of its venom toxins were investigated applying a venomics approach to venom pools from five geographic areas within the Caatinga ecoregion. Despite its wide habitat, populations of B. erythromelas from Ceará, Pernambuco, Juazeiro, Paraiba, and Ilha de Itaparica exhibit highly conserved venom proteomes. Mirroring their compositional conservation, the five geographic venom pools also showed qualitatively and quantitatively overlapping antivenomic profiles against antivenoms generated in Vital Brazil (BR) and Clodomiro Picado (CR) Institutes, using different venoms in the immunization mixtures. The paraspecificity exhibited by the Brazilian SAB and the Costa Rican BCL antivenoms against venom toxins from B. erythromelas indicates large immunoreactive epitope conservation across genus Bothrops during the last ~14 million years, thus offering promise for the possibility of generating a broad-spectrum bothropic antivenom. Biological Significance Accidental snakebite envenomings represent an important public health hazard in Brazil. Ninety per cent of the yearly estimated 20-30,000 snakebite accidents are caused by species of the Bothrops genus. Bothrops erythromelas, a small, moderately stocky terrestrial venomous snake, is responsible for most of the snakebite accidents in its broad distribution range in the Caatinga, a large ecoregion in northeastern Brazil. To gain a deeper insight into the spectrum of medically important toxins present in the venom of the Caatinga lancehead, we applied a venomics approach to define the proteome and geographic variability of adult B. erythromelas venoms from five geographic regions. Although intraspecific compositional variation between venoms among specimens from different geographic regions has long been appreciated by herpetologists and toxinologists as a general feature of highly adaptable and widely distributed snake species, the five B. erythromelas populations investigated exhibit highly conserved venom proteomes. The overall toxin profile of the Caatinga lancehead's venom explains the local and systemic effects observed in envenomations by B. erythromelas. The five geographic venom pools sampled also showed qualitatively and quantitatively overlapping antivenomic profiles against antivenoms generated using different bothropic venoms in the immunization mixtures. The large immunoreactive epitope conservation across genus Bothrops offers promise for the generation of a broad-spectrum bothropic antivenom.

Epidemiologia dos acidentes por animais peçonhentos e a distribuição de soros: estado de arte e a situação mundial / Epidemiology of accidents by venomous animals and distribution of antivenon: state of art and world status / Epidemiología de accidentes por animales venenosos y distribución de suero: estado de arte y situación mundial

RESUMO Acidentes por animais peçonhentos são discutidos sob perspectiva histórica de ações de estado. Considerados doenças negligenciadas eles causam prejuízos sociais e econômicos, em pessoas em idade produtiva de regiões rurais em países pobres. Poucos países dispõem de políticas públicas de saúde para profilaxia e tratamento adequados e as maiores perdas ocorrem na África e Ásia. Os 46 produtores mundiais de soros não suprem as necessidades globais e acesso ao tratamento é difícil, mesmo em países com produção própria. Sistemas de Notificação produzem levantamentos imprecisos sobre necessidades de soro e apesar da notificação compulsória. O Brasil carece de bancos de dados robustos de amplo acesso, que permita uma distribuição do soro em tempo seguro para o atendimento de qualidade. Muito se avançou em testes diagnóstico, porém sua aplicação em áreas pobres é inviabilizada pelos custos. Melhorias na qualidade de produção dos soros, via boas práticas laboratoriais e fabris, minimizam resultados insatisfatórios de tratamentos com produtos de origem e ação duvidosa. Desenvolvimento de soros empregando Biotecnologia e Ensaios Clínicos bem desenhados, são chave para tratamento de envenenamentos por agentes aparentados em diferentes regiões (soros continentais ou universais). Parcerias internacionais são fundamentais, além de estoques reguladores, semelhantes aos adotados em vacinas, para suprir a demanda mundial. A qualificação dos soros antivenenos certamente minimizará equívocos de uso. Apoio governamental à pesquisa é alavanca propulsora e a ferramenta mais eficiente de preservação da vida, evitando sobrecargas social e previdenciária principalmente em países em desenvolvimento.(AU)

ABSTRACT Accidents by venomous animals are discussed under the historical perspective of state actions. Considered as neglected diseases, they cause social and economic losses in the working age population from rural areas of poor countries, as few of them have public health policies for adequate prophylaxis and treatment; in fact, the largest life losses occur in Africa and Asia. The 46 world producers of antivenin do not meet the global needs, making access to treatment difficult, even in countries with own production. Notification systems lead to inaccurate surveillance surveys and antivenin needs. Despite mandatory notification, Brazil lacks robust databases with full open access in order to allow the timely distribution of antivenin for quality care of these patients. Progress has been made in diagnostic testing, but its application in poor areas is not feasible due to high costs. Improvements in quality antivenin production through good laboratory practices and manufacturing minimize unsatisfactory results of treatments carried out with products of dubious origin. Antivenin development using biotechnology and well-designed clinical trials are key for the treatment of envenoming by agents phylogenetically related from different regions (continental or universal antivenins). International partnerships are fundamental, besides regulatory stocks, similarly to those adopted for vaccines, to supply world demand. The qualification of antivenin will certainly minimize treatment mistakes. Government support to research is a driving force and the most efficient tool for preserving life and avoiding social security surcharges, particularly in developing countries.(AU)

RESUMEN Accidentes por animales venenosos se discuten desde una perspectiva histórica de acciones de estado. Consideradas enfermedades olvidadas, causan perjuicios sociales y económicos, en personas en edad productiva de regiones rurales en países pobres. Pocos países disponen de políticas públicas de salud para profilaxis y tratamiento adecuados y las mayores pérdidas ocurren en África y Asia. Los 46 productores mundiales de sueros no suplen las necesidades globales y el acceso al tratamiento es difícil, incluso en países con producción propia. Los sistemas de notificación generan levantamientos imprecisos sobre las necesidades de suero ya pesar de la notificación obligatoria, Brasil carece de bases de datos robustas de amplio acceso, permitiendo la llegada del suero en tiempo seguro para la atención de calidad. Se ha avanzado mucho en pruebas diagnósticas, pero su aplicación en áreas pobres es inviabilizada por los costos. Mejoras en la calidad de producción de los sueros, a través de buenas prácticas de laboratorio y fabril, minimizan resultados insatisfactorios de tratamientos con productos de origen y acción dudosa. El desarrollo de sueros empleando Biotecnología y Ensayos Clínicos bien diseñados, son clave para el tratamiento de envenenamientos por agentes emparentados en diferentes regiones (sueros continentales o universales). Las alianzas internacionales son fundamentales, además de stocks reguladores, similares a los adoptados en vacunas, para suplir la demanda mundial. La pre cualificación de los sueros antivenenos ciertamente minimizará equívocos de uso. El apoyo gubernamental a la investigación es la palanca propulsora y la herramienta más eficiente de preservación de la vida, evitando sobrecargas social y previsional principalmente en países en desarrollo.(AU)

An overview of Bothrops erythromelas venom

Abstract This review discusses studies on the venom of Bothrops erythromelas published over the past 36 years. During this period, many contributions have been made to understand the venomous snake, its venom, and its experimental and clinical effects better. The following chronological overview is based on 29 articles that were published between 1979 and 2015, with emphasis on diverse areas. The complexity of this task demands an integration of multidisciplinary research tools to study toxinology. This science is in need of renewed conceptual and experimental platforms aimed at obtaining a profound understanding of the highly complex pathophysiology of snakebite envenoming and toxins isolated from snakes.

Humoral immune response of patients bitten by the snake Bothrops erythromelas.

INTRODUCTION: Snake envenomings are a health problem in rural areas of tropical and subtropical countries, but little is known regarding the immune response presented by bitten individuals. The IgM production of patients bitten by Bothrops erythromelas snake was analyzed to identify the effectiveness of treatment in this type of envenomation. METHODS: Bothrops erythromelas venom was submitted to electrophoresis and transferred to a nitrocellulose sheet, following incubation with patients' sera. RESULTS: A 38 KDa protein was detected before and 24 h after therapy. CONCLUSIONS: The result suggests that this protein could be used as a marker for individuals envenomed by Bothrops. erythromelas.

Humoral immune response of patients bitten by the snake Bothrops erythromelas / Resposta imune humoral em pacientes picados pela serpente Bothrops erythromelas

INTRODUCTION: Snake envenomings are a health problem in rural areas of tropical and subtropical countries, but little is known regarding the immune response presented by bitten individuals. The IgM production of patients bitten by Bothrops erythromelas snake was analyzed to identify the effectiveness of treatment in this type of envenomation. METHODS: Bothrops erythromelas venom was submitted to electrophoresis and transferred to a nitrocellulose sheet, following incubation with patients' sera. RESULTS: A 38 KDa protein was detected before and 24 h after therapy. CONCLUSIONS: The result suggests that this protein could be used as a marker for individuals envenomed by Bothrops. erythromelas.

INTRODUÇÃO: Envenenamentos ofídicos consistem problema de saúde pública em áreas rurais de países tropicais e subtropicais, mas pouco sabe-se sobre a resposta imune apresentada pelos indivíduos picados, por isso a avaliação da produção de IgM por pacientes picados por Bothrops erythromelas identificando a eficácia do tratamento nesse tipo de envenenamento. MÉTODOS: O veneno de Bothrops erythromelas foi submetido a eletroforese e transferido para nitrocelulose, seguindo incubação com soro de pacientes. RESULTADOS: Foi observada proteína de 38KDa antes e 24 horas após o tratamento. CONCLUSÕES: Os resultados sugerem que essa proteína poderia ser utilizada como marcador para indivíduos envenenados pela serpente Bothrops erythromelas.

A expressão dos demônios de Morin / The expression of the demons of Morin

O objetivo deste texto é promover um diálogo com a autobiografia intelectual de Edgar Morin, com os três temas de maior relevância na sua obra "Meus demônios": a epistemologia, a ética e a política; e destacar a importância do pensamento complexo no processo de produzir saúde. A postura de indagação contínua faz Morin refletir sobre a provisoriedade das "verdades" e "conclusões". Sobretudo, que o conhecimento nunca é total, mas multidimensional. Propõe-se a construir um conhecimento que religa, que é inacabado e inacabável. Trabalha com o conceito de auto-ética, com a urgência de "constituição" de uma identidade humanitária, de uma consciência planetária, da idéia de terra pátria. Na política assinala a necessidade de uma consciência de resistência entre os homens, em todos os tempos e áreas, a forças mentais, ideológicas, culturais e históricas que possam suscitar erros e desta forma reforça a crença na necessidade imperiosa de repensar a política. A lógica do pensamento complexo de Morin tem iluminado muitas das discussões no campo da saúde, uma vez que nesse campo os fenômenos envolvendo o processo saúde e doença apresentam múltiplas dimensões, o que nos faz refletir sobre a complexidade do conceito de necessidades de saúde.

This paper aims to promote a dialogue with the Edgar Morin's intellectual autobiography, with the three greatest relevant subjects in his work "My demons": the epistemology, the ethics and the politics; and to enhance the importance of the complex thought in the process of producing health. The continuous investigating attitude makes Morin reflect on the provisionment of the "truths" and "conclusions". Mainly that the knowledge is never total, but multidimensional. The knowledge is proposed to be constructed which re-links, which is unaccomplished and unaccomplishable. It works with the concept of auto-ethics, the urgency of "constitution" of a humanitarian identity, a planetary conscience, the native land idea. In the politics it designates the necessity of a conscience of resistance among men, in all the times and areas, the mental, ideological, cultural and historical forces that can rouse errors and thus it strengthens the belief in the imperious necessity to rethink the politics. The logic of the complex thought of Morin has illuminated many of the arguments in the health field, since in that the phenomena that involve the health and illness process presents multiple dimensions, what makes us reflect on the complexity of the concept of health necessities.

Avaliação da resposta imune relacionada a ação dos venenos das serpentes Bothrops erythromelas e Crotalus durissus cascavella / Evaluation of the immune response associated to poison action of snakes bothrops erythromelas and crotalus durissus cascavella

Acidentes causados por serpentes, especialmente nos países tropicais e subtropicais, ainda constituem grave problema de saúde pública. Este estudo objetivou avaliar aspectos da resposta imune em vítimas de envenenamento por Bothrops erythromelas (jararaca) antes e após tratamento soroterápico. Além disso, em cultura de esplenócitos de camundongos BALB/c foram determinadas citotoxicidade, produção de óxido nítrico, de citocinas (IL-10, IFN-gama, IL-2, IL-6) e a viabilidade celular na presença do veneno de B. erythromelas. Os aspectos clínicos e epidemiológicos de pacientes picados por B. erythromelas e a resposta imune humoral dos mesmos foram avaliados antes, 12 e 24 horas após soroterapia. IFN-gama, IL-10 e óxido nítrico foram quantificados em sobrenadantes de culturas desses pacientes, além de marcadores de superfície celular. Níveis séricos de quimiocinas e citocinas também foram avaliados. Em cultura de esplenócitos, assim como em sobrenadantes de cultura de pacientes acometidos por envenenamento botrópico, o veneno de B. erythromelas induziu uma resposta imunomoduladora através de citocinas (IFN-gama e IL-6) e produção de óxido nítrico, apresentando um perfil pró-inflamatório. No soro de pacientes foi identificada uma proteína de 38 kDa, sugerindo um marcador no envenenamento por essa espécie. A clínica e a epidemiologia dos acidentes por B. erythromelas mostram aspectos similares aos acidentes ofídicos ocorridos no Brasil. A variação nos marcadores de superfície celular observados pode estar relacionada a aspectos que vão da quantidade inoculada de veneno ao tratamento do paciente. Os niveis séricos de citocinas Th1/Th2, além de quimiocinas mostraram um perfil semelhante para todos os tipos de envenenamento humano. Portanto, o presente estudo permitiu compreender os aspectos relacionados à evolução clínica de pacientes acometidos por envenenamento por B. erythromelas na região Nordeste.