title: The effect of physiological levels of South African puff adder (Bitis arietans) snake venom on blood cells: an in vitro model.
abstract: A significant burden of illness is caused globally by snakebites particularly by the puff adder, Bitis arietans. Presently there is no reliable and rapid method to confirm envenomation on blood chemistry; although coagulation parameters like prothrombin time, partial thromboplastin time, international normalized ratio and also serum electrolytes are tested. Here, we found that direct in vitro exposure of physiological relevant whole venom levels to human healthy blood (N = 32), caused significant physiological changes to platelet activity using a hematology analyzer, and measuring occlusion time, as well as lyses time, with the global thrombosis test (GTT). Disintegrated platelets were confirmed by scanning electron microscopy (SEM). We also confirmed the pathologic effects on erythrocytes (RBCs) (visible as eryptotic RBCs), by looking at both light microscopy and SEM. Thromboelastography showed that no clot formation in whole blood could be induced after addition of whole venom. We propose further clinical studies to investigate the use of light microscopy smears and hematology analyzer results immediately after envenomation, as a possible first-stage of clinical confirmation of envenomation.
authors: Department of Physiology, University of Pretoria, South Africa.
authors: Morné A
authors: MA
authors: Strydom
authors: Department of Physiology, University of Pretoria, South Africa.
authors: Janette
authors: J
authors: Bester
authors: Department of Physiology, University of Pretoria, South Africa.
authors: Sthembile
authors: S
authors: Mbotwe
authors: Department of Physiology, University of Pretoria, South Africa.
authors: Etheresia
authors: E
authors: Pretorius
mesh_terms: D000818:Animals; D001777:Blood Coagulation / Q000187:drug effects; D001792:Blood Platelets / Q000187:drug effects* / Q000473:pathology*; D004912:Erythrocytes / Q000187:drug effects* / Q000473:pathology*; D006801:Humans; D008855:Microscopy, Electron, Scanning; D008962:Models, Theoretical; D012909:Snake Bites / Q000473:pathology; D012910:Snake Venoms / Q000633:toxicity*; D017819:Viperidae
chemical_list: D012910:Snake Venoms