Mara Fernandes Ribeiro1, Felipe Leite de Oliveira2, Aline Moreira Souza3, Thelma de Barros Machado4, Priscilla Farinhas Cardoso5, Andrea Patti6, Angélica Silveira Nascimento1, Cláudio Maurício Vieira de Souza5, Sabrina Calil Elias1. 1. Laboratory of Pharmacology; Department of Pharmacy and Pharmaceutical Administration; School of Pharmacy; Fluminense Federal University; Niterói - RJ, Brazil. 2. Laboratory for Cellular Proliferation and Differentiation; Institute of Biomedical Sciences; Federal University of Rio de Janeiro; Rio de Janeiro, RJ, Brazil. 3. Laboratory for Veterinary Clinical Pathology; Department of Pathology and Veterinary Clinics; School of Veterinary Medicine; Fluminense Federal University; Niterói - RJ, Brazil. 4. Laboratory of Physiochemical Quality Control; Department of Pharmaceutical Technology; School of Pharmacy; Fluminense Federal University; Niterói - RJ, Brazil. 5. Laboratory of Arthropods; Scientific Directorship; Vital Brazil Institute; Niterói - RJ, Brazil. 6. Biotherium; Scientific Directorship; Vital Brazil Institute; Niterói - RJ, Brazil.
Abstract
BACKGROUND: Accidents caused by spiders of the genus Loxosceles constitute an important public health problem in Brazil. The venom of Loxosceles sp induces dermonecrosis at the bite site and systemic disease in severe cases. Traditional medicine based on plant-derived products has been proven to reduce the local effects of envenomation. The present study verified the healing effects of copaiba oil on lesions induced by the venom of L. intermedia. METHODS: Cutaneous lesions were induced on the backs of rabbits by intradermal injection of L. intermedia venom. Copaiba oil was applied topically 6 hours after injection; the treatment was repeated for 30 days, after which animal skins were removed and processed for histopathological analysis. Blood samples were also collected before and 24 hours after venom inoculation to measure the hematological parameters. RESULTS: Compared to the control group, the platelet count was reduced significantly in all groups inoculated with venom, accompanied by a decreased number of heterophils in the blood. The minimum necrotic dose (MND) was defined as 2.4 μg/kg. Topical treatment with copaiba oil demonstrated a differentiated healing profile: large skin lesions were observed 10 days after venom inoculation, whereas formation of a thick crust, without scarring was observed 30 days after venom inoculation. Histopathological analysis showed no significant difference after treatment. Nevertheless, the copaiba oil treatment induced a collagen distribution similar to control skin, in marked contrast to the group that received only the spider venom injection. CONCLUSIONS: We conclude that copaiba oil may interfere in the healing process and thus propose it as a possible topical treatment for cutaneous lesions induced by L. intermedia venom.
BACKGROUND: Accidents caused by spiders of the genus Loxosceles constitute an important public health problem in Brazil. The venom of Loxosceles sp induces dermonecrosis at the bite site and systemic disease in severe cases. Traditional medicine based on plant-derived products has been proven to reduce the local effects of envenomation. The present study verified the healing effects of copaiba oil on lesions induced by the venom of L. intermedia. METHODS: Cutaneous lesions were induced on the backs of rabbits by intradermal injection of L. intermedia venom. Copaiba oil was applied topically 6 hours after injection; the treatment was repeated for 30 days, after which animal skins were removed and processed for histopathological analysis. Blood samples were also collected before and 24 hours after venom inoculation to measure the hematological parameters. RESULTS: Compared to the control group, the platelet count was reduced significantly in all groups inoculated with venom, accompanied by a decreased number of heterophils in the blood. The minimum necrotic dose (MND) was defined as 2.4 μg/kg. Topical treatment with copaiba oil demonstrated a differentiated healing profile: large skin lesions were observed 10 days after venom inoculation, whereas formation of a thick crust, without scarring was observed 30 days after venom inoculation. Histopathological analysis showed no significant difference after treatment. Nevertheless, the copaiba oil treatment induced a collagen distribution similar to control skin, in marked contrast to the group that received only the spider venom injection. CONCLUSIONS: We conclude that copaiba oil may interfere in the healing process and thus propose it as a possible topical treatment for cutaneous lesions induced by L. intermedia venom.
The venom of spiders belonging to the genus Loxosceles produces a
characteristic set of symptoms known as loxoscelism. Currently, loxoscelism has been
hypothesized to be a multifactorial process involving a direct action of venom on
the inflammatory response [1-6]. The main characteristic of envenomation is
dermonecrosis at the bite site that is manifested initially by direct and
degenerative effects of the venom components on the cell membrane, basement
membrane, and extracellular matrix resulting in drastic tissue damage [7].The early phase of loxoscelism is highlighted by local edema and erythema within 6
hours of the spider bite. Subsequently, the lesion evolves into an ecchymotic area
about 24 to 36 hours after the accident. After 5 to 7 days, the necrotic lesion
reaches maximum area and develops a dry crust; it is occasionally associated with
secondary infection. The necrotic scab falls off 2 to 3 weeks after the accident,
leaving an ulcer. The terminal evolution of loxoscelism can induce severe
intravascular hemolysis associated with acute anemia, jaundice, and hemoglobinuria
of varying degrees. Fatalities are rare, but frequently correlated with acute renal
failure [8, 9].Treatment of loxoscelism is still a controversial subject. The effectiveness of the
antivenom serum in neutralizing local effects varies in different therapeutic
approaches, especially for the skin lesion [10]. Therefore, there is no consensus as to its efficacy in reversing
the local effects, while the ideal interval between the bite and its management that
results in good recuperation from the injury. However, antivenom serum is indicated
at any time in the case of hemolysis [11,
12].The low efficacy of the treatment has been attributed to poor understanding of action
mechanisms of Loxosceles venom [13]. Several treatment protocols that have been proposed and tested for
bites by L. intermedia include dapsone, corticosteroids,
antibiotics, and antivenom. Dapsone limits neutrophil migration and infiltration at
the site of the bite [14]; corticosteroids
produce a potent anti-inflammatory effect [15]; and antibiotics prevent secondary infections [16]. However, this polytherapy is not completely effective in
reducing skin lesions and restoring the affected tissue. In many situations,
dermonecrosis is so extensive that it requires skin grafts [9].The strategies already employed to treat skin lesions include phytotherapy and
popular medicinal plant products. Indeed, the effectiveness of some herbal agents
used in traditional medicine has been evaluated and confirmed by researchers
worldwide [17, 18]. For instance, specialists in wound healing have shown
great interest in the use of copaiba oil, a popular medicine in Brazil, extracted
from trees of the genus Copaifera (Leguminosae-Caesalpinioideae
family) to treat scarring [19, 20, 21].
Its property of healing wounds and ulcers is attributed to the presence of
medicinally important active components [22].
Copaiba oil is popularly used, especially in the Amazon, as an anti-inflammatory,
healing, and antiseptic product that can be administered orally, topically, or
vaginally [19]. This oil stands out for its
therapeutic properties not only in the Amazon region, but also in northeastern
Brazil. Moreover, it is also exported owing to its broad indications for such
diseases as cystitis, bronchitis, chronic diarrhea, rheumatism, and psoriasis [23-26].Sesquiterpene hydrocarbons are the major compounds derived from
Copaifera oleoresins, the most dominant one being
β-caryophyllene, which accounts for more than 90% of the total composition [27]. Sesquiterpenes are responsible for many of
the pharmacological activities of copaiba oleoresins. However, some studies
correlate increased anti-inflammatory activity with the presence of high levels of
diterpenes [28, 29].No study exists on the potential use of plants with healing effects as therapeutic
tools for local manifestations induced by the venom of Loxosceles
sp. In this context, any scientific evidence describing the healing
effects of plant derivatives on skin lesions by loxoscelism would pave the way for
the development of topical medicines with wide applicability and benefits for those
injured by Loxosceles spiders. Thus, the present study evaluated
the healing effects of copaiba oil on dermonecrosis induced by the venom of
L. intermedia, also known as the brown spider.
Methods
L. intermedia Venom
The venom of L. intermedia was obtained from the Laboratory of
Arthropods of Instituto Vital Brazil from adult specimens of L.
intermedia. The spiders were made to fast for a week followed by
extraction of the crude venom.
Animals
Adult male albino rabbits (Oryctolagus cuniculus), weighing 2.5
± 3.0 kg, were used for in vivo tests. These were obtained from
the animal colony at the Vital Brazil Institute. All rabbits were fed food and
water ad libitum under a 12-hour light-dark cycle at 22 ± 2°C
throughout the experiment. Venom of L. intermedia was injected
intradermally into the back of rabbits to induce cutaneous lesions.
Plant Material
The Copaifera spp. oil (copaiba oil) was acquired from a pool of
individuals from eastern Amazon (2º 08' 14''-2º 12' 26'' S and 48º 47' 34''-48º
14' W, at an elevation of 16 m above sea level), state of Pará, Brazil. The oil
was extracted using the method followed by the local population: Drilling of the
trunk of the Copaifera tree and insertion of a PVC cannula,
through which the oil flows. After the extraction is finished, the hole is
sealed with the use of clay. A total of 1 mL of copaiba oil was administered
topically at the site of injury.
Gas Chromatography-Mass Spectrometry Analysis of Sesquiterpenes in
Copaifera spp. Oleoresin
The sesquiterpenes present in the Copaifera spp. oleoresin were
analyzed in a gas chromatograph coupled to a mass spectrometer (GC-MS, QP2010SE;
Shimadizu). The following chromatographic conditions were used: Rtx-5 capillary
column (30 m × 0.25 mm × 0.25 µM MMID); helium as carrier gas at a flow rate of
1.5 mL/minute, oven temperature maintained at 120°C for 2 minutes followed by an
increase of 3°C/minute to 160°C for 2 minutes. It was then increased by
8°C/minute to a final temperature of 290°C for 5 minutes; injector temperature
of 270°C; and detector temperature of 290°C, operating at 40 to 400 m/z scan
mode with electron impact of 70 eV. A volume of 1.0 µL with 1:20 split ratio was
injected into the column. The results obtained from analysis of retention times
of peaks in the sesquiterpene chromatograms were compared to the data reported
in the literature. We also compared the fragmentation spectra of sesquiterpenes
with similarity over 90% to those contained in the NIST Library 05.
Minimum Necrotic Dose Determination
To determine the minimum necrotic dose (MND), rabbits were divided into three
groups, each consisting of four rabbits. The backs of these rabbits were first
shaved, following which they were inoculated with increasing doses of venom
(1.2, 2.4, and 12.0 μg/kg. Cutaneous lesions were observed at 6, 24, and 72
hours after injection. The MND was defined as the lowest dose of venom capable
of inducing a necrotic area of at least 1 cm2 in 72 hours in 100 % of
animals.
Experimental Groups
The animals were separated into three groups (n = 4 per group)
as follows: control, venom, and venom plus topical copaiba oil treatment. Each
group underwent the same routine observation adopted for calculating the MND.
The control group received an intradermal injection of 200 µL of physiologic
saline solution (PSS). All other groups received intradermal injection of
L. intermedia venom at twice the MND determined in a final
volume of 200 µL. Topical application of copaiba oil was carried out 6 hours
after venom injection and repeated daily for 30 days. Each application using 1
mL of the product completely covered the wound area. During other days of
treatment, the remaining product was removed with saline jets, without
compromising the newly formed tissue. After washing with 0.9% saline, the
product was applied as described above. On days 3, 10, and 30 after the spider
venom inoculation and respective treatments, animals were euthanized in a
CO2 chamber, and skin samples were obtained from the lesioned
sites for histopathological analysis according to the procedures described
below.
Blood Analysis
At the beginning of the experiments, blood was collected from rabbits’ ear vein
(time 0), prior to inoculation of venom or PSS. After 24 hours, a fresh blood
sample was collected from all animals to measure hematological parameters, such
as total leukocytes and platelets, using an automatic counter (CC530-CELM).
Differential counting was performed on hematological glass slides.
Macroscopic Lesion Analysis
Macroscopic lesions were analyzed by measuring the wound area. For this,
photomicrographs of the lesions were obtained at 0 and 6 hours, and 1, 3, 10,
15, and 30 days after venom inoculation to monitor the healing process. These
images were generated using a digital camera (Sony Cyber-Shot DSC-W350, 14.1
mega pixels), which was kept at a constant distance from the tripod base. The
injury area was evaluated using the software Image-Pro (unpaid).
Histopathological Analysis and Skin Processing
Animal skins in the control group and the venom group, containing the
venom-induced lesion area, were removed and processed for histopathological
analysis. All samples were fixed in 10% paraformaldehyde in a phosphate buffer
(pH 7.4) for 48 hours and subsequently dehydrated in increasing concentrations
of ethanol. These were next embedded in paraffin, sectioned and placed on slides
(5 microns) where they were stained with hematoxylin-eosin and picrosirius
red.
Total Collagen Determination
To quantify the total collagen present in the samples, hydroxyproline was
measured using the adapted methodology recommended by the Association of
Analytical Communities (AOAC). The skin was macerated and then hydrolyzed with 1
mL of 6 M hydrochloric acid per 0.01 g of skin (maximum 0.08 g) for 4 hours at
130°C. In a separate tube, 1 mL of chloramine T and 5 μL of skin hydrolysate
were mixed and maintained at room temperature for 20 minutes. Then, 1 mL of
perchloric aldehyde (15 g of dimethylaminobenzaldehyde, 60 mL of n-propanol, 26
mL of 60 % perchloric acid, and n-propanol to complete the volume to 100 mL) was
added and stored at 60 °C for 15 minutes. Chloramine T is oxidized by
hydroxyproline to pyrrole, which, in turn, reacts with perchloric aldehyde to
form a red-purple complex, the absorbance of which could be measured at 550 nm.
The quantification of samples was performed by interpolating the absorbance
results obtained using the linear regression equation of the standard curve (y =
0.5972x + 0.0142/R = 0.99).
Statistical Analysis
Data are expressed as mean ± standard error. The Student’s t
test was employed to analyze data from the two groups. For analysis of the
various groups and temporal procedures, we used ANOVA, followed by Bonferroni’s
post-test. Linear regression was employed to design curves.
P-values < 0.05 were considered statistically
significant.
RESULTS
Analysis of Sesquiterpenes and Diterpenes Present in Copaiba Oil
The qualitative and quantitative analysis of oleoresin led to the identification
of 24 peaks of sesquiterpenes and diterpenes that represented slightly more than
50 % of the total composition (Table 1).
The major compounds found in the sample were the sesquiterpenes α-bergamotene
(7.04 %) and β-caryophyllene (11.48 %). Other compounds frequently present in
copaiba oleoresins in the range of 1 to 5% included copaene (1.61 %),
α-curcumene (4.62 %), and β-humulene (3.05 %). The major diterpenes found in the
copaiba oil were kaur-16-ene (1.4 %), kaurenoic acid (2.0 %), and cativic acid
(2.25 %) (Table 1).
Table 1.
Sesquiterpenes and Diterpenes identified in the Copaifera
oleoresin, compared with the literature and fragmentation
spectrum. It was possible to identify peaks of 24
compounds that represent little more than 50 % of the total
composition. The major compounds found were the sesquiterpenes
α-bergamotene (7.04 %) and β-caryophyllene (11.48 %). Some compounds
frequently presents in copaiba oleoresins were found at 1 to 5 %,
including Copaene (1.61 %), α-curcumene (4.62 %) and β-humulene
(3.05 %). The major diterpenes found in the copaiba oil were
Kaur-16-ene (1.4 %), kaurenoic acid (2 %) and Cativic acid (2.25
%).
Compounds
Retention Index
Composition (%)
Cyclosativene
1125
0,82
Copaene
1221
1,61
α-cedrene
1403
4,18
α-zingiberene
1451
0,40
α-cubebene
1344
1,56
δ-selinene
1481
0,47
β-Caryophyllene
1494
11,48
α-bergamotene
1430
7,04
α-guaiene
1490
1,32
β-farnesene
1440
0,75
α-caryophyllene
1579
2,48
α-curcumene
1524
4,62
β-humulene
1574
3,05
γ-cadinene
1435
0,31
δ -cadinene
1469
1,39
Bergamotol
1673
0,58
α-bisabolene
1625
0,83
Guaiol
1614
0,27
Aromadendrene
1380
0,42
α-caryophyllene
1579
0,74
β-bisabolene
1619
0,3
Kaur-16-ene
1789
1,4
Cativic acid
2016
2,25
Kaurenoic acid
2050
2
Total of identified substances
50,27
Minimum Necrotic Dose Determination (MDN)
The MDN was defined as 2.4 μg/kg, because this was the lowest venom dose capable
of inducing a necrotic area of at least 1 cm2 in 72 hours in 100 %
of animals (data not shown).
L. intermedia Venom Reduced Platelet and Heterophil
Count
A significant reduction in the number of platelets was observed in all groups
inoculated with L. intermedia venom (4.8 μg/kg) as compared
with the control group (Figure 1A).
Although the number of total leukocytes did not differ significantly between the
groups (Figure 1B), a notable reduction in
the number of heterophils in the blood of the animals inoculated with L.
intermedia venom was reported. Treatment of animals with copaiba
oil curbed the reduction in heterophil count induced by spider venom (Figure 1C). No significant difference was
observed between the groups analyzed with respect to lymphocytes (Figure 1D).
Figure 1.
Effect of treatment with copaiba oil after
Platelets (a) and heterophils (c) count
showed significant reduction after venom injection (4,8 μg/kg). The
treatment was efficient in inhibiting the decrease of heterophils in
the blood 24 hours after venom inoculation *p <0.05 / ANOVA.
However, groups inoculated with venom and treated with copaíba oil
showed no significant difference from the control group at total
leukocyte (b) and lymphocyte count (d). n
= 4 animals per experimental group.
Topical Treatment with Copaiba Oil and Effects on Cicatrization
Rabbits were evaluated for the effects of venom injected intradermally (4.8
µg/kg). Macroscopic analysis of skin lesions formed after inoculation of venom
revealed typical dermonecrosis in all animals, however with different healing
profiles. Topical application of copaiba oil induced formation of a thick but
limited crust at the site of venom inoculation, without the presence of scarring
at 30 days after venom inoculation (Figure
2A). For the animals that received topical treatment with copaiba
oil, smaller lesions with mild erythema were observed after 3 days. Ten days
after venom injection, the lesion area of the group receiving copaiba oil
treatment was larger than that of the untreated group (Figure 2B).
Figure 2.
Evolution of the lesion 30 days after Macroscopic
comparison of animals that received only the venom, compared to
those treated with copaiba oil after venom inoculation showed
lesions with smaller area and with mild erythema. The copaiba oil
induced a formation of thicker crust more delimited, without the
presence of scarring on the skin (a). Ten days after
venom injection the lesion area of the group that received the
treatment with copaiba oil was larger than the untreated group
(b). n = 4 animals per experimental group.
L. intermedia Venom Induced Local Skin Inflammation,
Muscular Necrosis, and Hemorrhaging
For histopathological evaluation, the skins were removed from rabbits 3, 10, and
30 days after venom inoculation. In control animals, PSS had no effect on
histopathological parameters on the mentioned days (Figure 3A, D, G). Animals inoculated with the venom showed
heavy bleeding, thickening of dermis and epidermis, and presence of intense
inflammatory infiltrate 30 days after injection (Figure 3B). These animals presented intravascular clots as well. The
group inoculated with venom followed by treatment with copaiba oil also showed
heavy bleeding, with inflammatory infiltrate and lesions on the epidermis (Figure 3C). On day 10 after venom injection,
a significant inflammatory infiltrate in the muscular tissue was observed (Figure 3E, F). Furthermore, treated animals showed crucial tissue redefinition
between papillary and reticular dermis (Figure
3F), an important histological aspect absent in the untreated group
(Figure 3E). At day 30 after venom
inoculation, dermis and epidermis had regained their integrity, with
regeneration of muscle tissue and persistent inflammatory infiltrate (Figure 3H). Interestingly, animals inoculated
with venom and treated with copaiba oil showed similarities with control groups,
including integrity of all layers of the skin, high number of hair follicles,
and sparse dermal inflammatory infiltrate (Figure
3G,I).
Figure 3.
Photomicrographs of the skin of rabbits 3, 10 and 30 days
after The control group presented integrity of the skin
layers (a/d/g). In the animals that received venom
injection (4.8 µg/kg) heavy bleeding in the dermis (*), epidermal
thickening (upper insert - b), the presence of intense
inflammatory infiltrate in muscle (lower insert - b)
and hypodermis tissue (#) and blood vessels with clot ( ) were
observed 3 days after inoculation (b). In animals
inoculated with venom and treated with copaiba oil, bleeding (*),
injury of the epidermis (upper insert - c) and
inflammatory infiltrates in muscle tissue (lower insert -
c) were observed 3 days after venom inoculation
(c). After 10 days, the dermal thickness was
reduced in venom group (e), but the epidermis remained
thick (upper insert - e); on the other hand, in the
treated group, dermal thickness was reduced (f), but
redefinition was detected between papillary and reticular dermis
(upper insert - f). After 30 days of regeneration of
the dermis, epidermis (upper insert - h) and muscle
tissue, marked by the presence of central nuclei (inferior insert -
h) after 30 days in the venom group
(h); the treated group also showed regeneration of
dermis, epidermis (upper insert - i) and muscle tissue
(lower insert - i), marked by an increase in the number
of hair follicles (i). n = 4 animals per experimental
group.
Copaiba Oil Treatment Reduced Collagen Production
Optical microscopy analysis did not reveal significant differences with respect
to collagen fiber deposition in all groups (Figure
4A, C). Polarized light
microscopy was employed to analyze the distribution of collagen types I (red)
and III (green) following picrosirius red staining. A large collagen deposit was
detected in the venom-inoculated group 30 days after venom injection, in
comparison with control and copaiba-treated animals (Figure 4G, I). Type I
and type III collagen fibers were frequently observed in the control group
(Figure 4J). The venom-induced
significant changes in the dermis and type I collagen fibers were predominantly
noted in this group (Figure 4K). Copaiba
oil treatment restored the mixed profile of collagen fibers, such that both red
and green stains were observed, similar to control groups (Figure 4L).
Figure 4.
Photomicrographs of collagen on skin of rabbits 3 and 30 days
after inoculation of Picrosirius red staining under optical light
reveals total collagen as red, polarized light collagen type I as
red fibers and collagen type III as green fibers. The control
animals presented normal distribution of collagen types on the skin
at 3 (a - a/d) and 30 days (a - g/j), and
did not differ in total collagen quantification by hydroxyproline
(b). The animals inoculated with venom at 4.8 µg/kg
did not differ at day 3 post-inoculation compared to the control
group (a - b/e) but showed increase of collagen
deposition at 30 days (a - h/k), quantified by
hydroxyproline (b *p<0.001 / ANOVA). The animal
group inoculated with venom and treated with copaiba oil showed no
difference at day 3 (a - c/f), but at 30 days presented
less intense increase of collagen (a - i/l), quantified
by hydroxyproline (b *p<0.05 / ANOVA). n = 4 animals
per experimental group.
Total collagen was measured by quantification of hydroxyproline. All animals
showed similar hydroxyproline levels on day 3 after venom exposure and
respective treatments. However, 30 days after venom injection, hydroxyproline
levels were significantly increased in comparison with the control group.
Treatment with copaiba oil at this stage did reduce the hydroxyproline levels in
comparison to the venom group although these were still elevated when compared
with the control group (Figure 4M).
Discussion
The oleoresin of Copaifera is widely used in Brazilian traditional
medicine as an anti-inflammatory and healing agent [20]. However, evidence on its effectiveness and protective roles in
treating injuries caused by Loxosceles spider bite is scarce. The
results of the present study demonstrated the efficacy of topical application of
copaiba oil in healing of dermonecrosis caused by injection of brown spider venom.
We suggest that copaiba oil exerts its therapeutic effects on skin lesions induced
by L. intermedia venom through various morphological changes,
consequently leading to repair of damaged skin.Distinct compounds identified in copaiba oleoresin are potentially responsible for
some of the pharmacological properties, for example, β-caryophyllene, characterized
by anti-inflammatory, antibacterial, anti-edema, antifungal, and antipsoriatic
effects [21, 30, 31]. Other compounds present
in copaiba oleoresin (viscous fluid) include kaurene and labdane diterpenoids,
having broad-spectrum biological activities, as previously reported, including
potential anti-inflammatory, antimicrobial, antitumor, and larvicidal properties
[22, 28, 29].Rabbit models show a high similarity to clinical events related to
Loxosceles envenomation in humans, such as occurrence of
intravascular coagulation causing occlusions of venules and arterioles that result
in tissue hypoxia [32]. Intravascular
coagulation can occur in the lungs, liver, and kidneys [7], when the venom reaches the systemic circulation. In severe
cases, it may progress to death resulting from kidney failure [33]. The abrupt reduction in platelet count observed in
venom-inoculated groups could not be countered by the application of copaiba oil
after 24 hours. Reduced platelet count and increased fibrinogen synthesis are the
first systemic responses of rabbits to injection of Loxosceles
spider venom, approximately 12 hours after envenomation [12], a response very similar to that noted in humans.Cellular changes in the bone marrow and peripheral blood of rabbits after exposure to
L. intermedia venom have been reported. Thrombocytopenia is an
important clinical sign during the diagnosis of L. intermedia
spider envenomation [11]. Thrombocytopenia
and a high number of heterophils were detected in the bloodstream of
venom-inoculated rabbits, which were directly related to histopathological findings
obtained from skin biopsies [34]. Evaluation
of leukocyte mobilization and biochemical parameters in the blood of rabbits
revealed that platelet functions and blood coagulation showed a time-dependent trend
at 3, 24, 48, 72, and 120 hours after Loxosceles envenomation.
These levels were associated with initial leukopenia and thrombocytopenia, posterior
leukocytosis, platelet aggregation, elevation of fibrinogen levels, and reduction of
coagulation factor VII [35]. Increase in
leukocytes and heterophils occurred at 72 hours, the same time at which red blood
cells declined [12].On the other hand, in the current study, blood collected 24 hours after inoculation
of spider venom from L. intermedia did not show significant
differences in the cellularity of total leukocytes in any group. A significant
reduction of heterophils was shown after venom injection but not after treatment
with copaiba oil. Diminution in the number of circulating heterophils after 24 hours
may be related to an acute inflammatory response, considering that these cells are
found at the injury site within a few hours after venom injection and are reduced in
blood circulation after 24 hours, as also observed in mice [1]. Together, these results indicated a lesser migration of
heterophils to the skin and possible protective effect associated with reduced
heterophilic response after venom injection and treatment with copaiba oil. These
results imply that copaiba oil has the potential to partially control the
inflammatory response, once heterophil levels in blood circulation decrease.Histopathological analysis of the skin obtained from venom-inoculated rabbits
demonstrated swelling of dermal endothelial cells [36], followed by deposition of intravascular fibrin, endothelial
thickening, vasodilation and inflammatory cell infiltration, predominantly by
polymorphonuclear cells [37]. Moreover, 24
hours after venom administration, a massive infiltration of leukocytes and
platelets, bleeding, and thrombus formation at the site of venom inoculation were
observed [35]. Long-term exposure to venom
induces necrosis of myofibrils and infiltration of leukocytes, damaging the skeletal
muscle. This, in turn, causes severe destruction of the epidermal integrity and
necrosis of the connective tissue enriched with collagen fibers near the epidermis -
the last events observed during the development of dermonecrotic injury in rabbits
[5].Wound healing is a complex process. Major shortcomings in this process may occur in
the early stages, producing severe edema, reducing vascular proliferation, and
decreasing cellular elements, such as leukocytes, macrophages, and fibroblasts
[38]. Studies on the healing property of
copaiba oil have concentrated on the resin phase owing to the presence of
diterpenes, but cellular and molecular mechanisms of its potential therapeutic
actions are poorly understood. In the present study, no acceleration of the healing
process was observed in any animal group. However, the venom group demonstrated an
adherent crust that broke away before 30 days of monitoring. This feature was not
observed when animals received copaiba oil; in contrast, these animals showed a
larger area of injury, at the 10th day, which may plausibly account for
the scar formation observed in the venom group.The need for precision in tissue healing is impaired by the speed of repairing the
tissue damage, without aggravating it. In this context, what occurs most often is
the formation of scars, where the tissue will lose its function [39]. Thus, the ideal treatment of wounds should
also value the quality of the healing process, for which the deposition of collagen
is vital for recovering the lost cell mass in the lesion, thus refilling the damaged
tissue. However, exaggerated deposition of collagen can cause fibrosis and impair
the formation of functional tissue [40].
After 30 days, the animals treated with copaiba oil presented a distribution of
collagen fibers more similar to the control group, which demonstrates a higher
quality of healing. If the distribution of collagen is closer to that in the
control, it is indicative that the skin is more resistant to possible lesions, thus
exerting its function of protecting the organism. Our results demonstrated that
copaiba oil promoted the regeneration of type III collagen fibers, with a
collagen-fiber distribution similar to the normal skin of the animal. It can be
inferred that copaiba oil may improve the process of skin regeneration, but further
studies should be done to evaluate the structure of this tissue.
Conclusions
The increasing number of accidents caused by brown spider bites in recent years has
become a major public health concern in Brazil. Thus, the study of the actions of
both venom and drugs has gained extreme importance to better manage envenomation and
to provide proper treatment. The present work demonstrated the potential of copaiba
oil to interfere in and curb the progression of spider-bite-induced dermonecrosis.
The results described herein suggest that treatment with copaiba oil may modify
scarring via deposition of collagen, thereby stimulating the growth of hair
follicles and regeneration of muscle tissues. In addition, we now report that
copaiba oil efficiently inhibits the heterophil reduction in the blood after venom
injection. In light of the broad-spectrum applications of copaiba oil and its
economic importance in Brazil, the present study encourages further research to
elucidate its effects on wound healing.
Authors: V C Zanetti; R B da Silveira; J L Dreyfuss; J Haoach; O C Mangili; S S Veiga; W Gremski Journal: Blood Coagul Fibrinolysis Date: 2002-03 Impact factor: 1.276
Authors: Paulo Henrique da Silva; Rafael Bertoni da Silveira; Márcia Helena Appel; Oldemir Carlos Mangili; Waldemiro Gremski; Silvio Sanches Veiga Journal: Toxicon Date: 2004-12-01 Impact factor: 3.033
Authors: Denise V Tambourgi; Danielle Paixão-Cavalcante; Rute M Gonçalves de Andrade; Matheus de F Fernandes-Pedrosa; Fábio C Magnoli; B Paul Morgan; Carmen W van den Berg Journal: J Invest Dermatol Date: 2005-04 Impact factor: 8.551
Authors: S S Veiga; V C Zanetti; C R Franco; E S Trindade; M A Porcionatto; O C Mangili; W Gremski; C P Dietrich; H B Nader Journal: Thromb Res Date: 2001-05-01 Impact factor: 3.944
Authors: Paulo H da Silva; Yoshio Hashimoto; Fábio A dos Santos; Oldemir C Mangili; Waldemiro Gremski; Silvio S Veiga Journal: Toxicon Date: 2003-08 Impact factor: 3.033