Thromb Haemost 2004; 92(02): 369-383
DOI: 10.1160/TH04-02-0120
Platelets and Blood Cells
Schattauer GmbH

Platelet dysfunction during Bothrops jararaca snake envenomation in rabbits

Marcelo Larami Santoro
1   Laboratory of Pathophysiology, Institute Butantan, São Paulo, Brazil
,
Ida Sigueko Sano-Martins
1   Laboratory of Pathophysiology, Institute Butantan, São Paulo, Brazil
› Author Affiliations
Financial support: This investigation was supported by FAPESP (Proc. 98/04188-2).
Further Information

Publication History

Received 23 February 2004

Accepted after resubmission 11 May 2004

Publication Date:
30 November 2017 (online)

Summary

Despite being well established that snake envenomation causes blood coagulation and fibrinolysis disturbances, scant information is available about blood platelet disorders. Herein we show that experimentally Bothrops jararaca-envenomed rabbits presented thrombocytopenia, hypofibrinogenemia, elevation of von Willebrand factor plasma levels, platelet hypoaggregation in platelet rich plasma and whole blood, normoaggregation in washed platelet suspensions, decreased platelet ATP secretion, normal plasma levels of platelet factor 4, and constant intraplatelet serotonin levels. Furthermore, by flow cytometric analyses, platelets displayed a significant decrease in the expression of a GPIIb-IIIa epitope recognized by P2 monoclonal antibody (p< 0.05) and an increased expression of a ligandinduced binding site (LIBS-1) of GPIIIa (p< 0.05), but total GPIIb-IIIa expression, evaluated with specific polyclonal antibodies, was normal. Fibrinogen and fibrin(ogen) degradation product (FfDP) expression on platelet surface showed no significant alteration. Nonetheless, significant elevations of platelet P-selectin were noticed on circulating platelets. The percentage of circulating reticulated platelets and the survival time of biotinylated platelets of envenomed rabbits were not statistically different from control animals. We suggest that thrombin engendered by procoagulating components of B. jararaca venom has an essential role in the pathogenesis of platelet and coagulation disorders in this experimental model. Increased expression of P-selectin in the experimental group demonstrates that platelets of envenomed rabbits are indeed activated in circulation, and that decreased fibrinogen or increased FfDP levels are not the primary cause of platelet dysfunction. These results imply the existence of an inhibitor in plasma that interferes with platelet aggregation in bothropic envenomation.

 
  • References

  • 1 Chippaux JP. Snake-bites: appraisal of the global situation. Bull World Health Organ 1998; 76: 515-524.
  • 2 Brasil. Manual de diagnóstico e tratamento de acidentes por animais peçonhentos. Brasília, Ministério da Saúde, Fundação Nacional de Saúde/Coordenação de Controle de Zoonoses e Animais Peçonhentos. 1998
  • 3 Jorge MT, Ribeiro LA. Acidentes por serpentes peçonhentas no Brasil. Rev Assoc Med Bras 1990; 36: 66-77.
  • 4 Kamiguti AS, Cardoso JLC, Theakston RDG. et al. Coagulopathy and haemorrhage in human victims of Bothrops jararaca envenoming in Brazil. Toxicon 1991; 29: 961-972.
  • 5 Maruyama M, Kamiguti AS, Cardoso JLC. et al. Studies on blood coagulation and fibrinolysis in patients bitten by Bothrops jararaca (jararaca). Thromb Haemost 1990; 63: 449-453.
  • 6 Cardoso JLC, Fan HW, França FOS. et al. Randomized comparative trial of three antivenoms in the treatment of envenoming by lance-headed vipers (Bothrops jararaca) in São Paulo, Brazil. Q J Med 1993; 86: 315-325.
  • 7 Kamiguti AS, Matsunaga S, Spir M. et al. Alterations of the blood coagulation system after accidental human inoculation by Bothrops jararaca venom. Braz J Med Biol Res 1986; 19: 199-204.
  • 8 Sano-Martins IS, Santoro ML, Morena P. et al. Hematological changes induced by Bothrops jararaca venom in dogs. Braz J Med Biol Res 1995; 28: 303-312.
  • 9 Santoro ML, Sano-Martins IS, Chamone DAF. In vivo platelet activation induced by Bothrops jararaca venom in rabbits. Platelets 1994; 05: 162-170.
  • 10 Sano-Martins IS, Santoro ML, Castro SCB. et al. Platelet aggregation in patients bitten by the Brazilian snake Bothrops jararaca. Thromb Res 1997; 87: 183-195.
  • 11 van Oost BA, van Hien-Hagg IH, Timmermans APM. et al. The effect of thrombin on the density distribution of blood platelets: detection of activated platelets in the circulation. Blood 1983; 62: 433-438.
  • 12 Milani R, Jorge MT, Ferraz de Campos FP. et al. Snake bites by the jararacuçu (Bothrops jararacussu): clinicopathological studies of 29 proven cases in São Paulo State, Brazil. Q J Med 1997; 90: 323-334.
  • 13 Kouyoumdjian JA, Polizelli C, Lobo SMA. et al. Fatal extradural haematoma after snake bite (Bothrops moojeni). Trans R Soc Trop Med Hyg 1991; 85: 552.
  • 14 Fujimura Y, Titani K, Usami Y. et al. Isolation and chemical characterization of two structurally and functionally distinct forms of botrocetin, the platelet coagglutinin isolated from the venom of Bothrops jararaca. Biochemistry 1991; 30: 1957-1964.
  • 15 Santoro ML, Barbaro KC, Da Rocha TRF. et al. Simultaneous isolation of platelet factor 4 and glycoprotein IIb-IIIa complex from rabbit platelets, and characterization of specific chicken antibodies to assay them. J Immunol Meth 2004; 284: 55-72.
  • 16 Jakobsen E, Kierulf P. A modified β-alanine precipitation procedure to prepare fibrinogen free of antithrombin-III and plasminogen. Thromb Res 1973; 03: 145-159.
  • 17 Franco RS, Lee KN, Barker-Gear R. et al. Use of bi-level biotinylation for concurrent measurement of in vivo recovery and survival in two rabbit platelet populations. Transfusion 1994; 34: 784-789.
  • 18 Bath PMW. The routine measurement of platelet size using sodium citrate alone as the anticoagulant. Thromb Haemost 1993; 70: 687-690.
  • 19 Holmsen H, Dangelmaier CA. Measurement of secretion of serotonin. Meth Enzymol 1989; 169: 205-210.
  • 20 Ratnoff OD, Menzie C. A new method for the determination of fibrinogen in small samples of plasma. J Lab Clin Med 1951; 37: 216-320.
  • 21 Richards EM, Baglin TP. Quantitation of reticulated platelets: methodology and clinical application. Br J Haematol 1995; 91: 445-451.
  • 22 International Committee for Standardization in Hematology. Recommended methods for radioisotope platelet survival studies. Blood 1977; 50: 1137-1144.
  • 23 Leytin V, Mody M, Semple JW. et al. Quantitation of platelet activation status by analyzing P-selectin expression. Biochem Biophys Res Commun 2000; 273: 565-570.
  • 24 Leytin V, Mody M, Semple JW. et al. Flow cytometric parameters for characterizating platelet activation by measuring P-selectin (CD62) expression: theoretical consideration and evaluation in thrombin-treated platelet populations. Biochem Biophys Res Commun 2000; 269: 85-90.
  • 25 Cardinal DC, Flower RJ. The eletronic aggregomenter: a novel device for assessing platelet behavior in blood. J Pharmacol Methods 1980; 03: 135-158.
  • 26 Knöfler R, Weissbach G, Kuhlisch E. Critical evaluation of the quantification of ATP release reaction in whole blood. Thromb Res 1996; 84: 157-165.
  • 27 Santoro ML, Sousa-e-Silva MC, Gonçalves LR. et al. Comparison of the biological activities in venoms from three subspecies of the South American rattlesnake (Crotalus durissus terrificus, C. durissus cascavella and C. durissus collilineatus). Comp Biochem Physiol C Pharmacol Toxicol Endocrinol 1999; 122: 61-73.
  • 28 Born GVR. Aggregation of blood platelets by adenosine diphosphate and its reversal. Nature 1962; 194: 927-929.
  • 29 Luna MG. Manual of histologic staining methods of the Armed Forces Institute of Pathology. New York: McGraw-Hill; 1968
  • 30 Gatter KC, Cordell JL, Turley H. et al. The immunohistological detection of platelets, megakaryocytes and thrombi in routinely processed specimens. Histopathology 1988; 13: 257-267.
  • 31 Kleinbaum DG, Kupper LL, Muller KE. et al. Applied regression analysis and other multivariate methods. 3 ed. Pacific Grove; Duxbury: 1998
  • 32 Markland FS. Snake venoms and the hemostatic system. Toxicon 1998; 36: 1749-1800.
  • 33 Santoro ML, Sano-Martins IS. Different clotting mechanisms of Bothrops jararaca venom on human and rabbit plasmas. Toxicon 1993; 31: 733-742.
  • 34 Stocker K. Defibrinogenation with thrombinlike snake venom enzymes. In: Markwardt F. Fibrinolytics and antifibrinolytics. Handbook of Experimental Pharmacology. vol. 46 Berlin: Springer-Verlag; 1978: 451-484.
  • 35 Stocker K, Meier J. Thrombin-like snake venom enzymes. In: Pirkle H, Markland FS. Hemostasis and Animal Venoms. New York: Marcel Dekker; 1988: 67-84.
  • 36 Dempfle CE, Argiriou S, Kucher K. et al. Analysis of fibrin formation and proteolysis during intravenous administration of ancrod. Blood 2000; 96: 2793-2802.
  • 37 Egberg N, Ljungquist A. On fibrin distribution in organs of dogs during defibrination with the thrombin-like enzyme from Bothrops atrox. Thromb Res 1973; 03: 191-207.
  • 38 Kelen EMA, Rosenfeld G, Vainzof M. et al. Experimental defibrination with bothropase. A study on the fibrinolytic mechanism in vivo. Haemostasis 1978; 07: 35-45.
  • 39 Amorim MdF, De Mello RF, Saliba F. Envenenamento botrópico e crotálico. Contribuição para o estudo experimental comparado das lesões. Mem Inst Butantan 1951; 23: 63-108.
  • 40 Myint-Lwin DAWarrell, Phillips RE. et al. Bites by Russell’s viper (Vipera russelli siamensis) in Burma: haemostatic, vascular, and renal disturbances and response to treatment. Lancet 1985; 02: 1259-1264.
  • 41 Schaeffer RCJ, Chilton SM, Hadden TJ. et al. Pulmonary fibrin microembolism with Echis carinatus venom in dogs: effects of a synthetic thrombin inhibitor. J Appl Physiol 1984; 57: 1824-1828.
  • 42 Shimamura K, Oka K, Nakazawa M. et al. Distribution patterns of microthrombi in disseminated intravascular coagulation. Arch Pathol Lab Med 1983; 107: 543-547.
  • 43 Nahas L, Kamiguti AS, Rzeppa HW. et al. Effects of heparin on the coagulant action of snake venoms. Toxicon 1975; 13: 457-463.
  • 44 Bergentz SE, Ljungqvist U, Lewis DH. The distribution of platelets, fibrin, and erythrocytes in various organs following thrombin infusion: an experimental study in dogs with and without antifibrinolytic therapy. Surgery 1972; 71: 190-195.
  • 45 Chiu PJS, Tetzloff GG, Foster C. et al. Characterization of in vitro and in vivo platelet responses to thrombin and thrombin receptor-activating peptides in guinea pigs. Eur J Pharmacol 1997; 321: 129-135.
  • 46 Konstam MA, Brockway BA, Aronovitz MJ. et al. Kinetics of pulmonary platelet deposition and clearance during thrombin-induced microembolism in rabbits. Exp Lung Res 1989; 15: 867-879.
  • 47 Mustard JF, Rowsell HC, Murphy EA. Platelet economy (platelet survival and turnover). Br J Haematol 1966; 12: 1-24.
  • 48 Toh CH, Hoogendoorn H, Giles AR. The generation of thrombin in vivo induces the selective loss of high molecular weight multimers of von Willebrand factor and the reversible sequestration of platelets. Br J Haematol 1993; 85: 751-760.
  • 49 Michelson AD, Barnard MR, Hechtman HB. et al. In vivo tracking of platelets: circulating degranulated platelets rapidly lose surface Pselectin but continue to circulate and function. Proc Natl Acad Sci USA 1996; 93: 11877-82.
  • 50 Reimers H-J, Kinlough-Rathbone RL, Cazenave JP. et al. In vitro and in vivo functions of thrombin-treated platelets. Thromb Haemost 1976; 35: 151-166.
  • 51 Reimers HJ, Packham MA, Kinlough-Rathbone RL. et al. Effect of repeated treatment of rabbit platelets with low concentrations of thrombin on their function, metabolism and survival. Br J Haematol 1973; 25: 675-689.
  • 52 Kornalík F, Forty’nova J, Táborská E. et al. Thrombocytopenia in defibrination syndrome induced by Echis carinatus venom coagulase. Acta Univ Carol Med Monogr 1972; 53: 433-439.
  • 53 Gyongyossy-Issa MIC, Miranda J, Devine DV. Generation of reticulated platelets in response to whole blood donation or plateletpheresis. Transfusion 2001; 41: 1234-1240.
  • 54 Stohlawetz P, Stiegler G, Jilma B. et al. Measurement of the levels of reticulated platelets after plateletpheresis to monitor activity on thrombopoiesis. Transfusion 1998; 38: 454-458.
  • 55 Brinkhous KM, Read MS, Reddick RL. et al. Pathophysiology of platelet-aggregating von Willebrand factor: applications of the venom coagglutinin vWF assay. Ann NY Acad Sci 1981; 370: 191-204.
  • 56 Sanders WE, Read MS, Reddick RL. et al. Thrombotic thrombocytopenia with von Willebrand factor deficiency induced by botrocetin - an animal model. Lab Invest 1988; 59: 443-452.
  • 57 Sanders WE, Reddick RL, Nichols TC. et al. Thrombotic thrombocytopenia induced in dogs and pigs. The role of plasma and platelet vWF in animal models of thrombotic thrombocytopenic purpura. Arterioscler Thromb Vasc Biol 1995; 15: 793-800.
  • 58 Sakariassen KS, Holme PA, Ørvim U. et al. Shear-induced platelet activation and platelet microparticle formation in native human blood. Thromb Res 1998; 92 Suppl. S33-S41.
  • 59 Sims PJ, Wiedmer T, Esmon CT. et al. Assembly of the prothrombinase complex is linked to vesiculation of the platelet plasma membrane. Studies in Scott syndrome: an isolated defect in platelet procoagulant activity. J Biol Chem 1989; 264: 17049-57.
  • 60 Michelson AD, Benoit SE, Kroll MH. et al. The activation-induced decrease in the platelet surface expression of hte glycoprotein Ib-X complex is reversible. Blood 1994; 83: 3562-3573.
  • 61 Ruf A, Patscheke H. Flow cytometric detection of activated platelets: comparison of determining shape change, fibrinogen binding, and P-selectin expression. Semin Thromb Hemost 1995; 21: 146-151.
  • 62 Barradas MA, Gill DS, Fonseca VA. et al. Intraplatelet serotonin in patients with diabetes mellitus and peripheral vascular disease. Eur J Clin Invest 1988; 18: 399-404.
  • 63 Mezzano D, Tagle R, Panes O. et al. Hemostatic disorder of uremia: the platelet defect, main determinant of the prolonged bleeding time, is correlated with indices of activation of coagulation and fibrinolysis. Thromb Haemost 1996; 76: 312-321.
  • 64 Shuttleworth RD, O’Brien JR. Intraplatelet serotonin and plasma 5-hydroxyindoles in health and disease. Blood 1981; 57: 505-509.
  • 65 Reimers HJ, Allen DJ, Feurskin IA. et al. Transport and storage of serotonin by thrombin-treated platelets. J Cell Biol 1975; 65: 359-372.
  • 66 Wojenski CM, Schick PK. Development of storage granules during megakaryocyte maturation: accumulation of adenine nucleotides and capacity for serotonin sequestration. J Lab Clin Med 1993; 121: 479-485.
  • 67 Rucinski B, Knight LC, Niewiarowski S. Clearance of human platelet factor 4 by liver and kidney: its alteration by heparin. Am J Physiol 1986; 251: H800-H07.
  • 68 Wang C, Deny C, Li G. [Experimental study of Chinese Agkistrodon acutus venom in activation of rabbit platelets in vivo]. Hua Hsi I Ko Ta Hsueh Pao 1994; 25: 38-40.
  • 69 Kurata M, Ishizuka N, Matsuzawa M. et al. A comparative study of whole-blood platelet aggregation in laboratory animals: its species differences and comparison with turbidimetric method. Comp Biochem Physiol C Pharmacol Toxicol Endocrinol 1995; 112: 359-365.
  • 70 Ingerman-Wojenski CM, Silver MJ. A quick method for screening platelet dysfunctions using the whole blood lumi-agregometer. Thromb Haemost 1984; 51: 154-156.
  • 71 Ingerman-Wojenski CM, Smith JB, Silver MJ. Difficulty in detecting inhibition of platelet aggregation by the impedance method. Thromb Res 1982; 28: 427-432.
  • 72 Greenberg JP, Packham MA, Guccione MA. et al. Survival of rabbit platelets treated in vitro with chymotrypsin, plasmin, trypsin, or neuraminidase. Blood 1979; 53: 916-927.
  • 73 Fujimura Y, Ikeda Y, Miura S. et al. Isolation and characterization of jararaca GPIb-BP, a snake venom antagonist specific to platelet glycoprotein Ib. Thromb Haemost 1995; 74: 743-750.
  • 74 Michelson AD, Barnard MR. Thrombininduced changes in platelet membrane glycoproteins Ib, IX, and IIb-IIIa complex. Blood 1987; 70: 1673-1678.
  • 75 Rosenfeld G, Kelen EMA, Nahas L. Regeneration of fibrinogen after defibrination by bothropic venom in man and in dogs. Relationships with clotting and bleeding time. Revista Clínica de São Paulo 1958; 34: 36-44.
  • 76 Chang MC, Huang TF. The antiplatelet activity of ancrod on administration to rabbits. J Lab Clin Med 1995; 125: 508-516.
  • 77 Yang X, Sun L, Gabbeta J. et al. Platelet activation with combination of ionophore A23187 and a direct protein kinase C activator induces normal secretion in patients with impaired receptor mediated secretion and abnormal signal transduction. Thromb Res 1997; 88: 317-328.
  • 78 Scarborough RM, Rose JW, Naughton MA. et al. Characterization of the integrin-specificities of disintegrins isolated from American pit viper venoms. J Biol Chem 1993; 268: 1058-1065.
  • 79 Coelho ALJ, De Freitas MS, Oliveira-Carvalho AL. et al. Effects of jarastatin, a novel snake venom disintegrin, on neutrophil migration and actin cytoskeleton dynamics. Exp Cell Res 1999; 251: 379-387.
  • 80 Beviglia L, Poggi A, Rossi C. et al. Mouse antithrombotic assay, inhibition of platelet thromboembolism by disintegrins. Thromb Res 1993; 71: 301-315.
  • 81 Shebuski RJ, Ramjit DR, Sitko GR. et al. Prevention of canine coronary artery thrombosis with echistatin, a potent inhibitor of platelet aggregation from the venom of the viper, Echis carinatus. Thromb Haemost 1990; 64: 576-581.
  • 82 Dennis MS, Henzel WJ, Pitt RM. et al. Platelet glycoprotein IIb-IIIa protein antagonists from snake venoms: evidence for a family of platelet-aggregation inhibitors. Proc Natl Acad Sci USA 1989; 87: 2471-2475.
  • 83 Sheu JR, Huang TF. Ex-vivo and in-vivo antithrombotic effect of triflavin, an RGDcontaining peptide. J Pharm Pharmacol 1994; 46: 58-62.
  • 84 Alving BM, Evatt BL, Bell WR. Stimulation of fibrinogen synthesis by thrombin in rabbits with ancrod-induced afibrinogenemia. Am J Physiol 1977; 233: H562-H67.
  • 85 Chen YL, Huang TF, Chen SW, Tsai IH. Determination of the structure of two novel echistatin variants and comparison of the ability of echistatin variants to inhibit aggregation of platelets from different species. Biochem J 1995; 305: 513-520.
  • 86 Gan ZR, Gould RJ, Jacobs JW. et al. Echistatin - a potent platelet aggregation inhibitor from the venom of the viper, Echis carinatus. J Biol Chem 1988; 263: 19827-32.
  • 87 Verhallen PFJ, Barth M. Species comparison of anti-aggregatory properties of three fibrinogen receptor-antagonists: RGDS, echistatin and the carboxiterminal duodecapeptide of the fibrinogen gamma-chain. Thromb Haemost 1991; 65: 1144.
  • 88 Harfenist EJ, Packham MA, Mustard JF. Effects of the cell adhesion peptide, Arg-Gly-Asp-Ser, on responses of washed platelets from humans, rabbits and rats. Blood 1988; 71: 132-136.
  • 89 Marques JA, George JK, Smith IJ. et al. A bar-bourin-albumin fusion protein that is slowly cleared in vivo retains the ability to inhibit platelet aggregation in vitro. Thromb Haemost 2001; 86: 902-908.
  • 90 Wencel-Drake JD. Plasma membrane GPIIb/IIIa. Evidence for a cycling receptor pool. Am J Pathol 1990; 136: 61-70.
  • 91 Wencel-Drake JD, Boudignon-Proudhon C, Dieter MG. et al. Internalization of bound fibrinogen modulates platelet aggregation. Blood 1996; 87: 602-612.
  • 92 McGregor JL, McGregor L, Bauer AS. et al. Identification of two distinct regions within the binding sites for fibrinogen and fibronectin on the IIb-IIIa human platelet membrane glycoprotein complex by monoclonal antibodies P2 and P4. Eur J Biochem 1986; 159: 443-449.
  • 93 Peter K, Schwarz M, Yiànne J. et al. Induction of fibrinogen binding and platelet aggregation as a potential intrinsic property of various glycoprotein IIb/IIIa (αIIbβ3) inhibitors. Blood 1998; 92: 3240-3249.
  • 94 Sreedhara R, Itagaki I, Hakim RM. Uremic patients have decreased shear-induced platelet aggregation mediated by decreased availability of glycoprotein IIb-IIIa receptors. Am J Kidney Dis 1996; 27: 335-364.
  • 95 Ginsberg MH, Frelinger AL, Lam SCT. et al. Analysis of platelet aggregation disorders based on flow cytometric analysis of membrane glycoprotein IIb-IIIa with conformation-specific monoclonal antibodies. Blood 1990; 76: 2017-2023.
  • 96 Frelinger AL, III Du XP, Plow EF, Ginsberg MH. Monoclonal antibodies to ligand-occupied conformers of integrin αIIbβ3 (glycoprotein IIb-IIIa) alter receptor affinity, specificity, and function. J Biol Chem 1991; 266: 17106-11.
  • 97 Frelinger III AL, Cohen I, Plow EF. et al. Selective inhibition of integrin function by antibodies specific for ligand-occupied receptor conformers. J Biol Chem 1990; 265: 6346-6352.
  • 98 Gawaz M, Fateh-Moghadam S, Pilz G. Platelet activation and interaction with leucocytes in patients with sepsis or multiple organ failure. Eur J Clin Invest 1995; 25: 843-851.