USE OF AN ELISA ASSAY TO EVALUATE VENOM, ANTIVENOM, IgG AND IgM HUMAN ANTIBODY LEVELS IN SERUM AND CEREBROSPINAL FLUID FROM PATIENTS BITTEN BY Crotalus durissus terrificus IN BRAZIL

B. BARRAVIERA(1,2), A. SARTORI(2,3) , M. F. PEREIRA DA SILVA(3), R. KANENO(2,3), M. T. S. PERAÇOLI(2,3).

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 Department of Microbiology and Immunology of the Institute of Biosciences of Botucatu, State of São Paulo, Brazil.

ABSTRACT: A sandwich-type ELISA technique for specific and sensitive detection of Crotalus durissus terrificus venom antigens, horse-antivenom, human IgG and IgM antibodies was set up. Sixteen patients, 13 males and 3 females aged between 13 to 63 years  (mean 33 ± 15) bitten by Crotalus durissus terrificus snakes were studied. Of the 15 patients, 6 had previously received anti-Crotalus venom  and no seric venom  was detected. For the other 9 patients studied, the venom levels ranged from 2 to 108 ng/ml according to the severity of each case. Seric antivenom  was detected up to 44 days after  the bite. IgM human antibody levels against Crotalus venom were higher between 3 and 18 days after  specific treatment. IgG human antibody levels against Crotalus venom were detected between 30 and 90 days after envenoming. Venom and antivenom levels in cerebrospinal fluid were not observed 24 h after the bite. This suggests that neither the venom nor the antivenom is capable of crossing the  blood-brain barrier. In addition, when either the venom or the antivenom is presented to the immune system cells an immune response is prepared.

KEY WORDS: Enzyme-linked immunosorbent assay, Crotalus durissus terrificus, venom, antivenom, antibodies, cerebrospinal fluid.

CORRESPONDENCE TO:

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