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A Liposome Membrane Permeability Assay for Investigating the Effects of Phosphatidylinositol Phosphate Groups on Membranotropic Action of Venom PLA2
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Australian snakebite myotoxicity (ASP-23).

Christopher I Johnston1, Geoffrey K Isbister1,2

  • 1Clinical Toxicology Research Group, University of Newcastle, Newcastle, Australia.

Clinical Toxicology (Philadelphia, Pa.)
|November 6, 2020
PubMed
Summary
This summary is machine-generated.

Myotoxicity from Australian snakebites is common and can cause severe illness or death. Early antivenom treatment may reduce its severity, but creatine kinase (CK) is not a reliable early indicator.

Keywords:
Myotoxicityantivenomelapidenvenomingrhabdomyolysissnakesnakebitetoxin

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Area of Science:

  • Toxicology
  • Clinical Medicine
  • Epidemiology

Background:

  • Myotoxicity is a recognized but poorly understood complication of snake envenoming globally.
  • Australian snake envenoming presents unique challenges in characterizing myotoxicity.

Purpose of the Study:

  • To describe the clinical manifestations, complications, and antivenom effectiveness in Australian snakebite-induced myotoxicity.
  • To analyze the role of creatine kinase (CK) as a biomarker for myotoxicity.

Main Methods:

  • Prospective observational study (Australian Snakebite Project) of 1638 patients (2003-2016).
  • Included 148 patients with confirmed envenoming and biochemical evidence of myotoxicity (peak CK > 1000 U/L).
  • Analyzed patient demographics, clinical findings, pathology, treatment, and outcomes, including CK levels and time to peak.

Main Results:

  • Myotoxicity occurred in 16% of envenomed patients, most commonly from Notechis spp. (30%) and Pseudechis spp. (33% combined).
  • Median peak CK was 3323 U/L, with peak levels reached around 34 hours; elevated white cell count was common (93%).
  • Early antivenom administration (before first abnormal CK) correlated with reduced myotoxicity severity (2976 U/L vs 7590 U/L).

Conclusions:

  • Myotoxicity from Australian snakes is a significant cause of morbidity and mortality.
  • Creatine kinase (CK) is not an effective early biomarker for myotoxicity.
  • Prompt antivenom administration may mitigate the severity of snakebite-induced myotoxicity.