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Systemic cytokine response in children bitten by snakes in Costa Rica

dc.creatorÁvila Agüero, María L.
dc.creatorParís, María M.
dc.creatorShuxian, Hu
dc.creatorPeterson, Phillip K.
dc.creatorGutiérrez, José María
dc.creatorLomonte, Bruno
dc.creatorFaingezicht, Idis
dc.date.accessioned2017-02-02T16:35:17Z
dc.date.available2017-02-02T16:35:17Z
dc.date.issued2001-12
dc.description.abstractBACKGROUND: To characterize the host response to venom from snakes of the family Viperidae in Costa Rica, we investigated the release of cytokines: IL-1, IL-6, IL-8, TNF-alpha, MIP-1beta, and RANTES in pediatric patients who were bitten by a snake. METHODS: Patients were included in this study if they were admitted to the hospital within 24 hours of the snakebite. Blood samples were taken immediately on admission to the hospital, and then at intervals of 3, 12, and 24 hours, and on days 3, 5, and 7 after the accident. Patients received gentamicin plus clindamycin or gentamicin plus penicillin intravenously for a minimum of 3 days or longer if necessary. IL-1, IL-8, TNF-alpha, MIP-1beta, and RANTES were determined by monoclonal antibody-based ELISAs, while IL-6 was determined by bioassay. RESULTS: Eighteen patients were included in this study; 15 were bitten by Bothrops asper and three by B. lateralis. Eleven patients were male. Median (range) age was 9 (1-12) years. Nine patients had detectable serum concentrations of IL-6 (200 pg/ mL) and IL-8 (51 pg/mL) on admission, increasing to 500 pg/mL and 115 pg/mL for IL-6 and IL-8, respectively, during the first 12-24 hours. Cytokine concentrations returned to normal or undetectable ranges by 72 hours. TNF-alpha concentrations peaked at 12 hours (mean: 48 pg/mL). Low, but detectable concentrations of MIP-1beta were observed in some patients at various time intervals (48 pg/mL), whereas IL-1 was not detectable at any time point. Regulated on Activation Normal T cell Expressed and Secreted (RANTES) concentrations were evaluated in only five patients, being elevated in all of them. Patients with elevated cytokine concentrations required early fasciotomy (<24 hours after the accident) more often than those who had normal or undetectable cytokine concentrations (P < 0.05). There were no statistically significant associations between severity of envenomation, or outcome, and elevated serum cytokine concentrations (P > 0.05). CONCLUSIONS: Bothrops sp snake venoms induce clinical and pathophysiologic alterations similar to acute trauma, with release of proinflammatory cytokines. A better understanding of the role of the inflammatory response could lead to the development of new therapeutic strategies to improve the outcome in snakebitten patients.es_ES
dc.description.procedenceUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto Clodomiro Picado (ICP)es_ES
dc.identifier.citationhttp://journals.lww.com/pec-online/Abstract/2001/12000/Systemic_cytokine_response_in_children_bitten_by.6.aspx
dc.identifier.doihttps://doi.org/10.1097/00006565-200112000-00006
dc.identifier.issn0749-5161
dc.identifier.pmid11753186
dc.identifier.urihttps://hdl.handle.net/10669/29483
dc.language.isoen_USes_ES
dc.rightsacceso embargado
dc.sourcePediatric Emergency Care; Volumen 17, Número 6. 2001es_ES
dc.subjectSnake Biteses_ES
dc.subjectCytokineses_ES
dc.subjectInflammatoryes_ES
dc.subjectSystemic Responsees_ES
dc.subjectViperidaees_ES
dc.subjectSnake venomes_ES
dc.titleSystemic cytokine response in children bitten by snakes in Costa Ricaes_ES
dc.typeartículo original

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