An infarct‐like myocardial lesion experimentally induced in wistar rats with Africanized bee venom

Ferreira, Dirceu B.; Costa, R. S.; Oliveira, José Alberto; Muccillo, Gerson

doi:10.1002/path.1711770114

Cited by 26 publications

(19 citation statements)

References 28 publications

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“…The presence of different molecules in the venom, including phospholipase A2, hyaluronidase, melittin, apamine [37][38][39][40] , and, most recently, a serine protease-like protein studied by Lima et al 41 , may contribute to skin necrosis at the sting site. Such necrosis has frequently occurred and has been reported by most studies in Brazil [33][34][35][36][37][38][39][40][41][42][43][44][45] . The presence of rhabdomyolysis characterized by fiber eosinophilia, vacuolization, and absence of nuclei can be seen in Figure 1B.…”

Section: Anatomopathological Examinationmentioning

confidence: 99%

Africanized honeybee stings: how to treat them

Almeida

Olivo

Mendes

et al. 2011

Rev. Soc. Bras. Med. Trop.

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Introduction:In 1956, Africanized honeybees (AHB) migrated from Brazil to other regions of the Western Hemisphere, including South, Central, and North America, except for Canada. Despite being productive, they are highly aggressive and cause fatal accidents. This study aimed to evaluate patients at the Clinical Hospital of Botucatu Medical School (HC-FMB) and to propose treatment guidelines. Methods: From 2005 to 2006, the clinical and laboratorial aspects of 11 patients (7 male and 4 female) and the anatomopathological aspects of one patient who had died in 2003 were analyzed. Results: The age of the surviving patients varied from 5 to 87 years, with a mean of 42.5 years. The majority of accidents occurred in the afternoon, and the number of stings ranged from 20 to 500. The principal signs and symptoms were pain and local inflammatory signs, nausea, tachycardia, and vomiting. Biochemical findings presented increased levels of creatine phosphokinase, lactate dehydrogenase, and aspartate/alanine aminotransferase. An 11-year-old male patient died upon entering the attic of a two-storey building where he was attacked by a swarm, receiving more than 1,000 stings. He was sent to HC-FMB where he was treated, but he died 24h later. Observed at the autopsy were erythematous-purpuric skin lesions besides necrosis at the sting locations, rhabdomyolysis, focal myocardial necrosis, tubular hydropic degeneration and focal tubular acute necrosis of the kidneys, myoglobinuria, and centrolobular necrosis in the liver. Conclusions: Accidents caused by multiple AHB stings always constitute a medical emergency. As there is no specific antivenom, we have developed guidelines, including first aid, drugs, and the proper removal of stingers.

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Section: Anatomopathological Examinationmentioning

confidence: 99%

Africanized honeybee stings: how to treat them

Almeida

Olivo

Mendes

et al. 2011

Rev. Soc. Bras. Med. Trop.

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“…Previous studies from our laboratory carried out on Wistar rats have demonstrated electrocardiographic (ECG) 2 and enzymatic 7 changes and morphological lesion of the AMI type 8 , showing a possible direct toxic action of the venom on cardiac muscle. Using monkey cardiomyocytes in culture 21 , it was demonstrated that previous treatment of bee venom with anti-melittin antibody eliminated the cardiotoxicity, suggesting that this lesion may be mainly due to melittin.…”

Section: Discussionmentioning

confidence: 98%

“…Several factors are hypothesized to participate in the pathogenesis of ATN: 1) a direct toxic effect of ABV on renal tubules, especially proximal tubules 12,23,24 ; 2) a toxic effect of myoglobin and hemoglobin on the tubules 7,24 ; 3) an ischemic effect mediated by AVB or by substances released in the organism, or by a fall in cardiac output due to AMI-like lesions 8 with a consequent fall in MAP reducing renal plasma flow, and 4) a stress-potentiating effect acting, for example, on NAD release in the myocardium 7 aggravating the cardiac ischemic component and consequently renal perfusion.…”

Section: Discussionmentioning

confidence: 99%

“…Rhabdomyonecrosis 1 , a greater release of cardiac noradrenaline (NAD) 7 and lesion of the acute myocardial infarction (AMI) type have been demonstrated 8 , as well as ARF due to ATN, with characteristics suggestive of both ischemic and toxic etiology. On the basis of previous experiments showing that ABV produces serious damage to the kidney and the heart, the aim of the present study was to evaluate the time course of the cardiovascular changes occurring in response to intravenous injection of ABV in awake rats.…”

Section: Introductionmentioning

confidence: 99%

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Cardiovascular profile after intravenous injection of Africanized bee venom in awake rats

Guimarães

Costa

Machado

et al. 2004

Rev. Inst. Med. trop. S. Paulo

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SUMMARYThe manifestations caused by Africanized bee stings depend on the sensitivity of the victim and the toxicity of the venom. Previous studies in our laboratory have demonstrated cardiac changes and acute tubular necrosis (ATN) in the kidney of rats inoculated with Africanized bee venom (ABV). The aim of the present study was to evaluate the changes in mean arterial pressure (MAP) and heart rate (HR) over a period of 24 h after intravenous injection of ABV in awake rats. A significant reduction in basal HR as well as in basal MAP occurred immediately after ABV injection in the experimental animals. HR was back to basal level 2 min after ABV injection and remained normal during the time course of the experiment, while MAP returned to basal level 10 min later and remained at this level for the next 5 h. However, MAP presented again a significant reduction by the 7 th and 8 th h and returned to the basal level by the 24 th h. The fall in MAP may contribute to the pathogenesis of ATN observed. The fall in MAP probably is due to several factors, in addition to the cardiac changes already demonstrated, it is possible that the components of the venom themselves or even substances released in the organism play some role in vascular beds.

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“…Rarely, direct myocardial necrotizing effect of large amounts of venom released during multiple bee stings has also been postulated as a cause of myocardial damage. 2,4,5 Two variants of Kounis syndrome have been described. 4 Type I variant includes normal coronary arteries without predisposing factors for coronary artery disease and Type II variant includes patients with culprit but quiescent pre-existing …”

Section: S179mentioning

confidence: 99%