The ex vivo effects of Naja mossambica venom on the ultrastructure and viscoelastic properties of human blood

Abstract

Snake bites are of a major global concern that may affect any individual in all age groups, gender, geographical location and economic status. Previous research has identified the effects of venomous snake bites of various species and families and the correlation with proteins found in snake venom. There is, however, limited research on the effects of the Naja mossambica (Mozambique spitting cobra) venom on the coagulation system, particularly the haematological system and blood rheology. In order to better understand the effects of Naja mossambica venom on the coagulation system, this research aimed to study the ex vivo physiological effects of Naja mossambica venom, of concentration 0.025 ng/μL, on human blood cells and the viscoelastic properties of the coagulation system. The methods used include light microscopy (LM) and scanning electron microscopy (SEM), which provided morphological data on red blood cells (RBCs), platelets, fibrin fibres and clot structure, particularly with the SEM. In addition, Thromboelastography® (TEG®) was performed to study clot kinetics and clot formation and the Global thrombosis test® (GTT®) was performed to study platelet activity in relation to thrombin generation and thrombolysis. From the results, it was established that there was an increase in deformed RBCs, increased platelet activity, and fibrin fibres appeared loosely packed. Also, a significant difference in the clot kinetics was noted, suggesting changed fibrin mechanics. Therefore, these results suggest hypo-coagulability in individuals exposed to Naja mossambica snake venom. The hypo-coagulable state in the victims might not be to an extent of bleeding events, however, this might have implications in blood flow and wound healing. This information can also be used in future studies to improve diagnostics or management strategies for snakebite victims, and to contribute to the haemotoxic profile of venomous snakes.