ACUTE-PHASE REACTIONS, INCLUDING CYTOKINES, IN PATIENTS BITTEN BY BOTHROPS AND CROTALUS SNAKES IN BRAZIL

B. BARRAVIERA(1,2), B. LOMONTE(3), A. TARKOWSKI(5), L. Å. HANSON(5), D.A. MEIRA(1)

(1)Department  of  Tropical  Diseases  of  the  School of  Medicine of  Botucatu, State of São Paulo, Brazil; (2)Center for the Study of Venoms and Venomous Animals - CEVAP-UNESP, State of  São Paulo, Brazil; (3)Instituto Clodomiro Picado, Facultad de Microbiologia, Universidad de  Costa Rica, San José, Costa Rica; (4)Department of Clinical Immunology, and (5)Rheumatology, University of Göteborg, Sweden.

ABSTRACT. Thirty-one patients bitten by venomous snakes in Botucatu area  (State of São Paulo - Brazil), sixteen by Bothrops spp. and fifteen by Crotalus durissus terrificus, were studied.  The group comprised twenty-nine males and two females, ranging from fourteen to sixty-three years of age (mean 33 ± 15).  Leukocytosis with neutrophilia and lymphopenia, increase of mucoproteins and C-reactive protein, decrease of total serum protein and albumin, were observed on the first day after the accident.  In addition, increased serum levels of the cytokines IL-6 and IL-8, but not of IL-1ß and TNF-alfa, were observed.  The alterations were generally more intense in patients bitten by Crotalus durissus terrificus than by Bothrops spp.  It is concluded that these snakebite envenomations closely resemble an acute trauma, inducing a typical acute-phase response.

KEY WORDS: snake venom, acute-phase reactions, cytokines, C-reactive protein, inflammation.

CORRESPONDENCE TO:

B. BARRAVIERA - Caixa Postal 576 - CEP 18.618-000 - Botucatu - São Paulo - Brasil. bbarraviera@laser.com.br