Banca de DEFESA: ALEX AUGUSTO FERREIRA E FERREIRA

TREATMENT OF SNAKE POISONING: THERAPIES SUPPORTING CONVENTIONAL SEROTHERAPY USING PHOTOBIOMODULATION (LED) AND DEXAMETASONE

Ophidism. Photobiomodulation. LED. Serum therapy. Dexamethasone. Treatment.

Snakebite accidents are a serious and complex public health problem affecting mainly the tropical, subtropical areas of developing countries. Due to its magnitude, ophidism has been reinserted in the World Health Organization's list of Neglected Tropical Diseases. Worldwide, reported cases annually reach 2.1 million, of which 81 to 138,000 die and another 300,000 develop permanent sequelae. In Brazil, the annual average reaches 27,200 cases and in the North region this average appears in fourth place. Among the four snake genera of medical interest, the Bothrops genus is the most important, as it is responsible for about 90% of snakebites. Among the snake species of medical interest, Bothrops jararacussu and Bothrops atrox, found in the south, southeast and north, respectively, have distinct characteristics, among them the composition of the venom itself. This difference makes the clinical aspects presented by the victims of accidents with these snakes also have particularities. Treatment with ophidic serum is effective for systemic effects and ineffective against local effects. Thus, the objective of this study was to evaluate the photobiomodulation treatment with LED and/or dexamethasone associated with conventional serum therapy to treat local damage caused by envenoming by these two snake species. For this, the experimental envenoming was conducted in gastrocnemius muscle of male Swiss mice of mass between 18 and 22 grams (divided into groups of 5 animals) by intramuscular inoculation of 25 μg of B. jararacussu venom and 50 μg of B. atrox venom. After 30 minutes, the proposed treatments were administered alone or in combination. After 3 hours, blood and muscle samples were collected for myotoxicity, cytotoxicity, histological analysis and IL-1β assay. Results reaffirmed that serum therapy is not effective in treating local damage and demonstrated that LED photobiomodulation alone was able to decrease the leukocyte infiltrate in the inoculated muscle, as well as hemorrhage and myotoxicity. Dexamethasone treatment then showed good results in inhibiting myotoxicity against B. jararacussu venom and proved to be an excellent resource for the treatment of the inflammatory process against both venoms. It was concluded that the combination of serum therapy, LED and dexamethasone was very promising for the treatment of snakebites caused by the two species in question, as it will provide efficacy not only to systemic damage, but also to local damage, thus avoiding disfigurement of the affected limb.