The pathogenesis of dermonecrosis induced by the
venom of the African spitting cobra Naja nigricollis was investigated in a mouse model.
Intradermal injection of
venom induced a macroscopic necrotic lesion. Histological examination revealed early
edema of the dermis, followed by blistering, loss of skin appendages and reduction in cellularity. By 24 h,
necrosis of the dermis was evident, sections of epidermis were lost, and a fibrinoid hyaline material filled the damaged areas. Abundant inflammatory infiltrate was present in the hypodermis and basal dermis, and there was an increment in the expression of
matrix metalloproteinases (
MMPs). Thrombi were observed in blood vessels. Abundant cells were present in the dermis by 7 days. By 14 and 28 days, re-epithelization had occurred,
collagen was widespread in the dermis, and few skin appendages were present. The RP-HPLC fractions that reproduced the necrotic activity were composed of low molecular mass
cytotoxins of the
three-finger toxin family and, to a lesser extent, of
phospholipases A2 (PLA2). Inhibition of PLA2 of
venom by
p-bromophenacyl bromide did not reduce the area of
necrosis, but modified the appearance of necrotic regions. Depletion of neutrophils and inhibition of
venom metalloproteinases and tissue
MMPs did not affect dermonecrosis.
IgG and F(ab')2
antivenoms were effective in the neutralization of dermonecrosis when incubated with
venom prior to injection. However, when
antivenoms were administered immediately after
venom injection, dermonecrosis was reduced only to a partial extent, underscoring the difficulties in neutralizing this effect with
antivenoms.