Wasp venom and acute kidney injury: The mechanisms and therapeutic role of renal replacement therapy

Gong, Jianhua; Yuan, Hai; Gao, Zhao; Hu, Fengqi

doi:10.1016/j.toxicon.2019.03.008

Cited by 36 publications

(38 citation statements)

References 50 publications

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“…Wasp venom contains a variety of bioactive components, such as enzymes (including phospholipase, hyaluronic acid), amines (including histamine, serotonin, catecholamine), peptides (including wasp venom peptide, wasp kinin) [16]. Phospholipase damages the cell membrane by attacking the phospholipid structure, which has a toxic effect on skeletal muscle and erythrocyte membrane, leading to rhabdomyolysis and intravascular hemolysis [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

“…Phospholipase damages the cell membrane by attacking the phospholipid structure, which has a toxic effect on skeletal muscle and erythrocyte membrane, leading to rhabdomyolysis and intravascular hemolysis [17][18][19]. Wasp venom peptide can also cause muscle necrosis and cell apoptosis [16,20]. Venom induced rhabdomyolysis leads to a release of muscle enzymes such as creatine kinase and muscle protein such as myoglobin, free hemoglobin (from red blood cells) in the intravascular circulation [21].…”

Section: Discussionmentioning

confidence: 99%

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Gross Hematuria in Patients with Wasp Sting: A Retrospective Study

Wang¹,

Wang²,

Singh³

et al. 2020

Preprint

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Background: Wasp sting is common in the world, and gross hematuria after wasp sting has been reported in Asia to occur before AKI. Gross hematuria is often used by clinicians as a sign indicated for intensive care and blood purification treatment. However, there is no study on the clinical characteristics and prognosis of wasp sting patients complicated with gross hematuria. Methods: The demographic characteristics and clinical data of 363 patients with wasp sting admitted to Suining Central Hospital from January 2016 to December 2018 were retrospectively analyzed. At admission, the poisoning severity score was used as the criterion for severity classification. According to the presence of gross hematuria, the patients were divided into gross hematuria group and non-gross hematuria group. Multivariate logistic regression analysis was performed to explore the risk factors for gross hematuria.Results: Of the 363 wasp sting patients, 219 were male and 144 were female, mean age was 55.9±16.3 years. 51 (14%) had gross hematuria, 39(10.7%) had Acute Kidney Injury(AKI), 105 (28.9%) had rhabdomyolysis, 61(16.8%) had hemolysis, 56 (15.4%) had Multiple Organ Dysfunction Syndrome (MODS), 13 (3.6%) had Acute Respiratory Distress Syndrome (ARDS), 45(12.4%) went on to receive renal replacement therapy, and 14 (3.9%) died. Patients with gross hematuria group had significantly higher poisoning severity scores when admitted to the hospital than those without gross hematuria group (2.2±0.5 vs. 1.1±0.3, P<0.001).Conclusion: Gross hematuria is one of the early clinical symptoms of severe wasp sting patients. AKI incidence and mortality of patients with gross hematuria are significantly increased. Prompt treatment should be taken for wasp sting patients complicated with gross hematuria. The poisoning severity score can be used for early assessment of the severity of wasp sting patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gross Hematuria in Patients with Wasp Sting: A Retrospective Study

Wang¹,

Wang²,

Singh³

et al. 2020

Preprint

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“…12 In addition to specific signs and symptoms directly related to the venom toxic components, patients bitten by wasps may develop a systemic inflammatory response syndrome. 4,8,9 There is also evidence of acute-phase reaction with hyperthermia or hypothermia, leukocytosis, neutrophilia, lymphopenia, eosinophilia, some clotting disorders, and protein imbalance with the increase in CRP and decrease in total proteins. 13,14 Increasing evidence from animal studies and clinical experience showed that the involvement of the inflammatory cascade and release of cytokines play a major role in the pathogenesis of wasp stings.…”

Section: Discussionmentioning

confidence: 99%

“…The wasp venom contains several active substances, including melittin with hemolytic and vasoactive properties, histamine, hyaluronidase, apamin, phospholipase A 2 , and acid phosphatase. 4 In fact, in addition to acute renal failure (ARF), hepatocyte damage, intravascular hemolysis, rhabdomyolysis, thrombocytopenia, coagulopathy, cardiovascular, and neurological abnormalities are the severe complications caused by wasp venom. [1][2][3][4][5][6][7] Furthermore, inflammatory reaction activated by wasp venom was another difficult problem to be dealt with.…”

Section: Introductionmentioning

confidence: 99%

“…4 In fact, in addition to acute renal failure (ARF), hepatocyte damage, intravascular hemolysis, rhabdomyolysis, thrombocytopenia, coagulopathy, cardiovascular, and neurological abnormalities are the severe complications caused by wasp venom. [1][2][3][4][5][6][7] Furthermore, inflammatory reaction activated by wasp venom was another difficult problem to be dealt with. The wasp venom can induce the excessive release of pro-/anti-inflammatory mediators, such as tumor necrosis factor (TNF-α), interleukin-1 (IL-1), IL-6, and IL-8.…”

Section: Introductionmentioning

confidence: 99%

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Hemoperfusion plus continuous veno-venous hemofiltration in the treatment of patients with multiple organ failure after wasp stings

Wang

Huang

et al. 2019

Int J Artif Organs

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Purpose: This study aimed to evaluate the clinical effects of hemoperfusion plus continuous veno-venous hemofiltration in the treatment of patients with multiple organ failure after wasp stings and investigate its impacts on cytokines. Methods: A total of 12 patients with multiple organ failure after wasp stings admitted to Xijing Hospital were included in the present study between January 2017 and January 2019. All patients received hemoperfusion plus continuous veno-venous hemofiltration treatment in addition to conventional treatment after admission. Procedure of treatment was conducted as the following: hemoperfusion (2 h/day) and followed by continuous veno-venous hemofiltration (22 h/day) for at least 5 days. Patients’ clinical features, serum laboratory tests, and hemodynamic variables were monitored. The blood samples were taken to measure the changes of plasma cytokines. Results: All 12 patients survived in the observation period. After hemoperfusion plus continuous veno-venous hemofiltration treatment, there were significant improvements in indicators of liver function, renal function, state of consciousness, and mediators in blood circulation, including alanine transaminase, aspartate transaminase, creatine kinase, blood urea nitrogen, serum creatinine, myoglobin, C-reactive protein, and so on. In these patients, acid–base metabolism returned to normal levels; Acute Physiology and Chronic Health Evaluation II score, Simplified Acute Physiology Score II score, and Sequential Organ Failure Assessment score lowered markedly. Furthermore, the plasma levels of interleukin 1β, interleukin 4, interleukin 6, interleukin 8, and interleukin 10 in these patients were significantly decreased; no significant change was shown in the level of tumor necrosis factor α. Conclusion: Our results revealed that hemoperfusion plus continuous veno-venous hemofiltration was effective in the management of patients with multiple organ failure after wasp sting via the non-specific removal of the wasp venom and inflammatory cytokines.

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STING deficiency protects against wasp venom-induced acute kidney injury

Liu

Lü

et al. 2023

Inflamm. Res.

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Wasp venom and acute kidney injury: The mechanisms and therapeutic role of renal replacement therapy

Cited by 36 publications

References 50 publications

Gross Hematuria in Patients with Wasp Sting: A Retrospective Study

Gross Hematuria in Patients with Wasp Sting: A Retrospective Study

Hemoperfusion plus continuous veno-venous hemofiltration in the treatment of patients with multiple organ failure after wasp stings

STING deficiency protects against wasp venom-induced acute kidney injury

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