WEBVTT - Ep 97 Snake Venom: Collateral Damage 0:00:02.759 --> 0:00:02.960 Hi. 0:00:03.120 --> 0:00:06.960 My name is Gwen, and this is my story. It 0:00:07.040 --> 0:00:09.440 was the last day of our ten day field trip. 0:00:10.080 --> 0:00:12.879 We were working and camping at our most remote field 0:00:12.920 --> 0:00:17.040 site in western Colorado, conducting botany surveys for a research project. 0:00:18.000 --> 0:00:20.800 My field assistant, Chloe, and I decided that we would 0:00:20.800 --> 0:00:23.840 spend the evening swimming and relaxing by the Dolores River. 0:00:24.800 --> 0:00:27.160 As the sun set, I started to get ready for bed. 0:00:27.640 --> 0:00:29.560 I was tired and ready to snuggle up in my 0:00:29.600 --> 0:00:33.080 sleeping bag. I walked over to the truck to refill 0:00:33.120 --> 0:00:36.280 my water bottle and grab my toothbrush. As I reached 0:00:36.320 --> 0:00:38.760 for the driver's side door handle, I heard a noise 0:00:38.800 --> 0:00:41.600 and looked down just in time to see a rattlesnake's 0:00:41.600 --> 0:00:45.160 fangs penetrate the skin on my right ankle. The snake 0:00:45.240 --> 0:00:48.040 coiled up and started rattling its tail, and I backed 0:00:48.040 --> 0:00:51.159 away quickly. Chloe and I decided to leave all of 0:00:51.200 --> 0:00:53.519 our camping gear and head straight to the hospital and 0:00:53.520 --> 0:00:57.120 Grand Junction, which was about a three hour drive. We 0:00:57.200 --> 0:00:59.480 left at about nine thirty at night, and the only 0:00:59.560 --> 0:01:03.080 road home was a two lane highway over the Uncompagra Plateau. 0:01:03.800 --> 0:01:06.400 Because we didn't have cell service, I used our satellite 0:01:06.440 --> 0:01:08.800 messenger to text my husband with the news and to 0:01:08.840 --> 0:01:11.600 call ahead to the hospital. I was in a lot 0:01:11.640 --> 0:01:14.280 of pain, really the most pain that I can remember. 0:01:15.000 --> 0:01:17.119 We were thirty minutes into the drive when I started 0:01:17.120 --> 0:01:19.720 throwing up. We didn't pull over because I didn't want 0:01:19.720 --> 0:01:23.400 to lose any time. I was heaving for about thirty minutes, 0:01:23.480 --> 0:01:27.600 but eventually I stopped. Sweaty and exhausted. At this point, 0:01:27.880 --> 0:01:32.080 I had to poop. I instructed Chloe to pull over now, 0:01:32.680 --> 0:01:34.920 and I pooped right there on the side of the road. 0:01:35.840 --> 0:01:38.240 Once I had nothing left in me, we continued on. 0:01:39.200 --> 0:01:43.600 Soon after, I began to experience muscle spasms. It began 0:01:43.760 --> 0:01:46.440 in the tips of my fingers and toes. All of 0:01:46.480 --> 0:01:49.480 my muscles tightened as the spasms worked their way up 0:01:49.560 --> 0:01:52.760 my extremities, so that my hands turned into fists and 0:01:52.800 --> 0:01:56.360 my arms and legs tightened. This was the only time 0:01:56.440 --> 0:01:59.360 during this experience that I thought I might not be okay. 0:02:00.200 --> 0:02:02.440 Chloe told me to focus on breathing, and I did. 0:02:03.360 --> 0:02:05.440 My body felt like a tight ball and was not 0:02:05.560 --> 0:02:10.799 in my control. Eventually, the spasms subsided. The emergency room 0:02:10.919 --> 0:02:14.800 staff was expecting me. I was admitted quickly and given 0:02:14.800 --> 0:02:17.480 a large dose of anti venin and a tetanus shot. 0:02:18.080 --> 0:02:20.760 While there, I believe I met every doctor and nurse 0:02:20.800 --> 0:02:24.000 in the emergency room. It turned out they didn't see 0:02:24.040 --> 0:02:27.160 snake bites very often and wanted to take this opportunity 0:02:27.240 --> 0:02:30.880 to look at my ten day unwashed foot. I happily 0:02:30.919 --> 0:02:33.880 told everyone my story. A lot of the pain had 0:02:33.919 --> 0:02:38.320 subsided and I was just so relieved to be safe. 0:02:38.400 --> 0:02:40.639 While there, I asked a lot of questions about the 0:02:40.680 --> 0:02:43.840 recovery and didn't get clear answers. It seemed like the 0:02:43.880 --> 0:02:47.799 recovery time could be quite variable. I was discharged from 0:02:47.800 --> 0:02:51.040 the hospital in twenty four hours. My husband picked me up, 0:02:51.360 --> 0:02:53.560 We picked up our gear from the campsite, and then 0:02:53.600 --> 0:02:57.119 headed home. My foot was a gray and blue, swollen 0:02:57.200 --> 0:03:00.400 lump for about a week, and people stared every that 0:03:00.440 --> 0:03:04.320 I went. Luckily, the recovery was quick for me, and 0:03:04.440 --> 0:03:07.440 I was just about back to normal in four weeks. 0:03:08.040 --> 0:03:12.440 Whenever I do field work now, I always have snakes 0:03:12.480 --> 0:03:16.079 on my mind. I don't really prefer doing field work 0:03:16.120 --> 0:03:19.560 in places where rattlesnakes are common or we might run 0:03:19.600 --> 0:03:23.320 into them. I always wear shoes, and sometimes I wear 0:03:23.360 --> 0:03:27.840 gators I prefer when I'm hiking for fun to go 0:03:28.000 --> 0:03:31.120 to higher elevation areas where there's really no chance we'll 0:03:31.160 --> 0:03:34.600 run into any kind of rattlesnake And I worry about 0:03:34.639 --> 0:03:37.840 my dogs a lot, but in the end, like I 0:03:37.880 --> 0:03:40.320 still do a lot of field work, it's just more 0:03:40.320 --> 0:03:43.320 present on my mind. And I tell everybody that I 0:03:43.360 --> 0:03:46.680 work with what happened to me and hope that they 0:03:46.720 --> 0:03:48.160 are more cautious as well. 0:04:34.640 --> 0:04:34.960 Wow. 0:04:35.440 --> 0:04:41.200 I mean that is absolutely terrifying, absolutely terrifying. I can't 0:04:41.240 --> 0:04:45.839 imagine what a long and just I don't know, awesome 0:04:46.000 --> 0:04:47.039 car ride. 0:04:47.880 --> 0:04:48.159 Wow. 0:04:48.800 --> 0:04:52.919 Yeah, thank you so so much, Gwen for taking the 0:04:53.000 --> 0:04:56.200 time to chat with me and for telling your story. 0:04:56.640 --> 0:05:01.240 I'm yeah, it's just we're really glad that you're better now. 0:05:01.680 --> 0:05:07.400 Yeah. Hi, I'm Aaron Welsh and I'm Erin almon Updyke. 0:05:07.279 --> 0:05:10.919 And this is this podcast Will Kill You, And today. 0:05:10.640 --> 0:05:13.719 We're taking a few steps outside of our comfort zone 0:05:14.360 --> 0:05:15.960 and we're talking about snake bites. 0:05:16.400 --> 0:05:23.120 We are specifically venomous snake bites. Yes, yeah, And there's 0:05:23.160 --> 0:05:26.440 a lot out there and there's a lot to this story. 0:05:26.800 --> 0:05:30.600 And just in advance, I want to say that you know, 0:05:30.760 --> 0:05:34.520 we're probably not going to cover everything that you would 0:05:34.960 --> 0:05:38.840 want us to cover about snakes and what's going on 0:05:38.920 --> 0:05:41.560 with snakes in the world and snake bites and stuff 0:05:41.600 --> 0:05:44.680 like that. But don't worry, because we are going to 0:05:44.720 --> 0:05:47.880 cover some very interesting things number one. Number two. I 0:05:47.920 --> 0:05:51.680 think this also leaves us open to revisiting snakes in 0:05:51.720 --> 0:05:54.600 the future, Like I really want to cover that snake 0:05:54.680 --> 0:05:56.000 fungus someday. 0:05:56.440 --> 0:05:59.960 Ooh, I don't even know about snake fungus Aaron. Yeah. 0:06:00.040 --> 0:06:03.400 Yeah, it's called snake fungal disease, and I don't, to 0:06:03.440 --> 0:06:05.479 be honest, know all that much more about it, but 0:06:05.520 --> 0:06:08.080 I've I remember seeing presentations about it. 0:06:08.000 --> 0:06:11.520 And like different conferences and I was entragued. So so 0:06:11.560 --> 0:06:14.160 we're not talking about that today. We'll just focusing on 0:06:14.960 --> 0:06:18.119 the venom that a lot of snakes produce and how 0:06:18.200 --> 0:06:21.040 it affects humans if we get bitten. 0:06:21.279 --> 0:06:27.120 That's correct. Yeah, And speaking of snake bites and what 0:06:27.279 --> 0:06:30.960 happens when you get bitten, should we talk about our 0:06:31.320 --> 0:06:33.520 quarantinie for this episode. 0:06:33.960 --> 0:06:36.320 What a great transition and I really loved it. 0:06:36.320 --> 0:06:41.239 It was not at all forced, it was super smooth. 0:06:42.000 --> 0:06:47.040 But our our quarantine for this week is the snake Bite. 0:06:47.080 --> 0:06:49.240 It's the snake Bite. It's a real it's a real drink, 0:06:49.279 --> 0:06:51.679 which makes our job, you know, easier in that regard. 0:06:52.120 --> 0:06:55.680 It's a very simple drink as well. It consists of 0:06:55.720 --> 0:07:01.320 two ingredients, cider and then either logger or stop up 0:07:01.360 --> 0:07:05.400 to you and we'll we'll post the full recipe for 0:07:05.640 --> 0:07:09.640 the snake Bite as well as the non alcoholic Placybrita. 0:07:09.680 --> 0:07:12.280 I'm very curious to see what I come up with 0:07:12.640 --> 0:07:15.720 same on our website this podcast will Kill You dot com, 0:07:15.760 --> 0:07:18.320 as well as on all of our social media channels. 0:07:19.040 --> 0:07:21.880 Our website This Podcast will Kill You dot com has 0:07:21.920 --> 0:07:24.240 some pretty incredible things that you can find on it 0:07:24.320 --> 0:07:26.400 if you haven't checked it out yet. We have our 0:07:26.520 --> 0:07:29.640 bookshop dot org, iphilia account, we have a good Reads list, 0:07:29.760 --> 0:07:32.320 We have all of the sources from all of our episodes. 0:07:32.320 --> 0:07:34.440 We have transcripts from them all. We have a link 0:07:34.480 --> 0:07:37.360 to Bloodmobile who provides the music. We have our Patreon, 0:07:37.440 --> 0:07:40.680 we have merch I might have missed a few things 0:07:40.680 --> 0:07:42.560 that that was all that one breath could handle. 0:07:42.640 --> 0:07:44.600 I think you did a great job. My post it 0:07:44.680 --> 0:07:47.760 is not currently with me, so I can't I can't 0:07:47.880 --> 0:07:52.600 verify and add what I forgot exactly, but that's okay. 0:07:53.600 --> 0:07:56.160 I don't think we have any more podcast business, so 0:07:56.520 --> 0:08:00.280 can we please get started. I am really really cureedious 0:08:00.320 --> 0:08:01.320 about snake venoms. 0:08:01.840 --> 0:08:04.800 I can't wait to talk about them right after this break. 0:08:39.080 --> 0:08:46.040 So here's the thing. We are not herpetologists, and like 0:08:46.080 --> 0:08:47.920 you said at the top, we're not going to pretend 0:08:47.960 --> 0:08:50.800 like we are for this episode. So I'm not going 0:08:50.840 --> 0:08:52.800 to be getting into a lot of detail about the 0:08:52.840 --> 0:08:57.920 snakes themselves, and I'm going to try to avoid getting 0:08:57.960 --> 0:09:00.679 anything wrong when it comes to the biology of snakes 0:09:00.720 --> 0:09:06.719 by mostly ignoring the snakes themselves. Yeah, I know herpetologists 0:09:06.720 --> 0:09:10.000 who follow us, I'm sorry. But what I am going 0:09:10.000 --> 0:09:13.719 to focus on instead is the venom and the effect 0:09:13.920 --> 0:09:17.360 that various types of venom have on our human body. 0:09:17.640 --> 0:09:19.960 And so what I hope that listeners will take away 0:09:19.960 --> 0:09:23.480 from this is the very broad strokes of the different 0:09:23.600 --> 0:09:27.160 varieties of venom and how they work, and why it 0:09:27.240 --> 0:09:29.880 is that some snake bites are so dangerous to humans. 0:09:30.640 --> 0:09:35.240 Shall we begin, Let's do it. Snakes are an incredibly 0:09:35.280 --> 0:09:38.439 diverse group of reptiles. I learned there are over thirty 0:09:38.440 --> 0:09:42.080 five hundred species of snakes, but today we're going to 0:09:42.080 --> 0:09:44.840 focus on just a few of the families of snakes 0:09:44.960 --> 0:09:48.440 in the claye Callubroides, oh that's how you say it, 0:09:48.800 --> 0:09:51.760 which contains the families and the subfamilies of snakes that 0:09:51.800 --> 0:09:57.000 are of quote human medical importance. And these snakes, there's 0:09:57.080 --> 0:10:00.959 three major groups of them, the Elapids and the fami Elapidae, 0:10:01.480 --> 0:10:05.079 which are the cobras, the mambas, the sea snakes, which 0:10:05.320 --> 0:10:07.800 I still to this day am terrified of the idea 0:10:07.840 --> 0:10:09.360 of sea snakes, even. 0:10:09.160 --> 0:10:11.520 Though they're the ones you're probably least likely to encounter. 0:10:11.960 --> 0:10:15.720 I know something about them. It is the most like, 0:10:15.880 --> 0:10:18.240 I'm not afraid of snakes. I think snakes are very cool, 0:10:18.280 --> 0:10:25.280 but sea snakes terrifying me. Something you learned about me today, Yeah, yeah. 0:10:25.440 --> 0:10:29.280 Also the group the Viperids in the family Viperidae, which 0:10:29.280 --> 0:10:32.600 include the vipers and pit vipers, which are like rattlesnakes 0:10:32.640 --> 0:10:36.240 and other things as well as adders. And then the 0:10:36.280 --> 0:10:41.319 subfamily and I might not pronounce this right, attract a spitina. 0:10:42.760 --> 0:10:46.120 This is mole vipers and stiletto snakes. It's a smaller group, 0:10:46.520 --> 0:10:47.280 not super common. 0:10:47.360 --> 0:10:49.840 Stiletto snakes. That's like a very cool. 0:10:49.640 --> 0:10:52.800 Band name I wonder if it is a band, I 0:10:52.840 --> 0:10:57.080 wonder it should be someone make it. And so these 0:10:57.080 --> 0:11:00.240 are the three major groups. The elapids, the viperia, and 0:11:00.280 --> 0:11:05.080 the attracta spinina snakes that are considered of medical importance 0:11:05.160 --> 0:11:09.360 because their bites are extra dangerous to humans. All of 0:11:09.400 --> 0:11:12.920 these types of snakes have venom glands on either side 0:11:13.000 --> 0:11:16.440 of their cute little faces, and these glands are connected 0:11:16.440 --> 0:11:19.120 to ducks that transfer the venom to the base of 0:11:19.160 --> 0:11:23.439 their fangs. And in many cases, these fangs are very cool. 0:11:23.920 --> 0:11:27.640 They have canals in their hollow fangs through which the 0:11:27.720 --> 0:11:31.760 venom travels and can then be rapidly injected into the 0:11:31.840 --> 0:11:33.079 victim with a bite. 0:11:33.679 --> 0:11:35.320 It's so cool, it is. 0:11:35.880 --> 0:11:39.320 Snake fangs are very cool. They vary a lot evolutionarily 0:11:39.520 --> 0:11:42.200 between groups, like some of them fold back, some of 0:11:42.240 --> 0:11:46.079 them fit into grooves. Some, like spitting vipers, can actually 0:11:46.200 --> 0:11:50.640 spit their venom out. It is very cool. Someone else 0:11:50.679 --> 0:11:54.040 can get into that. But let's talk about venoms. So 0:11:54.320 --> 0:11:58.160 Venoms are specialized types of toxins that have to be 0:11:58.320 --> 0:12:01.440 injected into their victim in order to have an effect, 0:12:02.040 --> 0:12:05.679 as opposed to a poison, which can exert its effect 0:12:05.760 --> 0:12:11.480 after ingestion or even just by diffusing across the skin. Right, So, venoms, 0:12:11.640 --> 0:12:15.439 including snake venoms, have a lot of large molecules as 0:12:15.480 --> 0:12:17.920 part of their composition that actually have to then be 0:12:18.000 --> 0:12:20.959 injected through the skin to enter the bloodstream and then 0:12:21.080 --> 0:12:26.280 exert an effect and venom. I know you know this erin, 0:12:27.040 --> 0:12:31.000 but a lot of listeners might not. Venom is inherently 0:12:31.080 --> 0:12:37.640 an ecological phenomenon. So the composition and the activity of 0:12:37.760 --> 0:12:42.640 any given animals, but especially any given snake's venom, inherently 0:12:42.800 --> 0:12:48.040 co evolved over time with the specific physiology and ecology 0:12:48.600 --> 0:12:53.440 of primarily the prey animals that this venom is being 0:12:53.559 --> 0:12:58.280 used to assist in eating, right, and probably to some 0:12:58.400 --> 0:13:02.080 extent as well, the predator that these snakes are in 0:13:02.160 --> 0:13:07.040 threat from. So some snakes their venom is primarily used 0:13:07.080 --> 0:13:11.840 to immobilize their prey. Other snakes, their venom is actually 0:13:12.160 --> 0:13:16.800 beginning the process of digestion for them, and other snakes 0:13:16.840 --> 0:13:19.840 they're using their venom primarily to ward off other predators. 0:13:20.480 --> 0:13:27.480 So there is an incredible amount of variation in snake venom. 0:13:26.800 --> 0:13:31.400 In it's unbelievable. It's so beautiful, Yeah, it really is. 0:13:31.559 --> 0:13:35.240 It's amazing. I just it's also, of course, a lot 0:13:36.000 --> 0:13:38.439 more diverse than I realized. 0:13:38.800 --> 0:13:45.080 As always. As always, so, humans, as it turns out, 0:13:45.240 --> 0:13:49.360 are probably not super important in the evolution of snakes 0:13:49.440 --> 0:13:52.400 or snake venom. And so I want to quote from 0:13:52.440 --> 0:13:57.400 a paper that I liked here, quote human in venomings 0:13:57.880 --> 0:14:02.080 are best viewed as collateral damage of the chemical arms 0:14:02.160 --> 0:14:06.560 race taking place between various snakes and their prey. I 0:14:06.600 --> 0:14:06.960 love that. 0:14:07.280 --> 0:14:09.040 It's definitely an arms race. 0:14:09.520 --> 0:14:13.560 Yeah, and we're just collateral damage. So that's how I 0:14:13.600 --> 0:14:15.840 want us to view all of these symptoms that you'll 0:14:15.840 --> 0:14:20.480 see when we talk about the different types of venoms, because, 0:14:20.480 --> 0:14:25.120 as it turns out, snake venoms are some of the most, 0:14:25.360 --> 0:14:29.200 if not the actual most complex venoms of the entire 0:14:29.280 --> 0:14:35.239 animal kingdom. Oh, lots of other animals, scorpions, bees, ants, 0:14:36.080 --> 0:14:42.280 lots of different animals make venom. Snake venom is incredibly complex. 0:14:42.840 --> 0:14:46.560 Each individual like venom that a specific snake is going 0:14:46.600 --> 0:14:50.160 to inject into you is composed of anywhere from fifty 0:14:50.280 --> 0:14:54.440 to two hundred different components, some of which are toxins 0:14:54.480 --> 0:14:57.520 are harmful, and some of which are not but serve 0:14:57.680 --> 0:15:02.320 some other purpose, right, like just helping facilitate the entry 0:15:02.440 --> 0:15:07.240 or something like that. So Venoms are comprised of proteins, carbohydrates, lipids, 0:15:07.920 --> 0:15:11.119 and the snake venoms that are of human medical importance. 0:15:11.360 --> 0:15:16.760 Despite their incredible complexity, can generally be broken down into 0:15:16.800 --> 0:15:22.480 three major categories based on how they exert their effects. 0:15:23.440 --> 0:15:26.960 These are the neurotoxic venoms which affect our nervous system, 0:15:27.640 --> 0:15:31.200 the hemotoxic venoms, which affect a lot of times our 0:15:31.200 --> 0:15:34.680 ability to coagulate blood and will get into it, and 0:15:34.760 --> 0:15:40.480 then cytotoxic venoms which cause tissue death and tissue damage. 0:15:40.760 --> 0:15:44.840 And the complexity of all these different toxins tends to 0:15:44.920 --> 0:15:50.760 fall into a few major like molecular biology or biochemistry 0:15:50.840 --> 0:15:55.520 groupings like there are certain proteins that are very common 0:15:55.800 --> 0:16:00.760 across snake venoms, but they don't necessarily neatly fall into 0:16:00.800 --> 0:16:05.480 these categories of neurotoxic, cytotoxic, hematoxic because there's a lot 0:16:05.520 --> 0:16:09.480 of variation in their potential sites of action, where specific 0:16:09.520 --> 0:16:13.680 toxins that might look similar actually have a very different 0:16:13.720 --> 0:16:18.280 clinical effect in different snake species, which is mind blowing, 0:16:18.360 --> 0:16:24.560 yeah complicated, and it's also often a generalization that's made 0:16:24.800 --> 0:16:29.000 that the venom from elapid snakes, so those cobras, mambas, 0:16:29.120 --> 0:16:35.400 coral snakes is primarily neurotoxic in nature, and venom from 0:16:35.560 --> 0:16:41.680 viperid snakes, vipers pit vipers rattlesnakes is primarily cytotoxic and hemotoxic, 0:16:42.800 --> 0:16:48.280 And these generalizations are true to some extent, but there 0:16:48.320 --> 0:16:52.760 is so much individual variation, and there are so many 0:16:52.840 --> 0:16:57.040 exceptions to those rules, like spitting cobras, which cobras are 0:16:57.080 --> 0:16:59.960 generally neurotoxic, but spitting cobras often have a lot of 0:17:00.160 --> 0:17:06.320 cytotoxicity hemotoxicity. Rattlesnakes generally have very hemotoxic venom, but some 0:17:06.359 --> 0:17:10.879 species also have neurotoxic properties, and a lot of Australian 0:17:10.920 --> 0:17:14.040 snakes just do the most wild and crazy things. 0:17:15.480 --> 0:17:18.639 Well, and isn't there also a lot of variation among 0:17:18.760 --> 0:17:21.800 populations or even individual to individual. 0:17:21.680 --> 0:17:28.080 Exactly exactly so even between for example, mojave rattlesnakes, some groups, 0:17:28.080 --> 0:17:31.760 some populations of that species of rattlesnake have more neurotoxic 0:17:31.840 --> 0:17:34.040 venom and others have more hemotoxic venom. 0:17:34.400 --> 0:17:35.359 So interesting. 0:17:35.880 --> 0:17:38.800 I can't even express how fascinating and mind blowing it is, 0:17:40.119 --> 0:17:43.440 but it's incredibly complicated and so to just be able 0:17:43.480 --> 0:17:46.880 to understand the basics of like the different ways that 0:17:47.000 --> 0:17:51.159 various snake venoms could affect our bodies. We're going to 0:17:51.200 --> 0:17:56.360 focus on those three broad categories of venoms cytotoxic, hemotoxic, 0:17:56.400 --> 0:17:59.639 and neurotoxic, and how each of those would present if 0:17:59.640 --> 0:18:03.399 you got bitten by snakes with these various venom properties. 0:18:03.640 --> 0:18:07.720 Shall we let's do it so the first big distinction 0:18:07.880 --> 0:18:12.000 between bite types if you get bitten by a snake, besides, 0:18:12.040 --> 0:18:14.600 I should mention is it a dry bite or is 0:18:14.640 --> 0:18:18.320 it an in envenomation because it's also important to note 0:18:18.400 --> 0:18:23.760 that while many snakes are venomous, not every venomous snake 0:18:23.840 --> 0:18:28.119 bite results in in venomation, because some bites are what 0:18:28.160 --> 0:18:30.240 we call dry, so they don't actually spit any of 0:18:30.240 --> 0:18:34.240 their venomount But other than that, we'll just focus on 0:18:34.280 --> 0:18:38.320 the venomous bites. The first big distinction is whether or 0:18:38.359 --> 0:18:41.119 not there are going to be any local effects of 0:18:41.160 --> 0:18:47.240 that bite. Cytotoxic venom causes a significant amount of local 0:18:47.320 --> 0:18:53.480 effects sido meaning sell toxic meaning toxic. So cytotoxic and 0:18:53.560 --> 0:18:59.159 venoming symptoms often look like incredibly painful and sometimes very 0:18:59.200 --> 0:19:02.640 severe sweat at the site of the bite, which can 0:19:02.720 --> 0:19:06.600 sometimes lead to very large like blood filled blisters or 0:19:06.760 --> 0:19:11.959 extensive deep tissue bruising. There can be tissue damage and 0:19:12.240 --> 0:19:15.439 necrosis or death of tissue of your arm or your 0:19:15.560 --> 0:19:18.520 leg or wherever the bite occurred, and it can be 0:19:18.680 --> 0:19:22.959 so severe that if it isn't surgically debrided or cared for, 0:19:23.640 --> 0:19:27.360 the limb can end up needing amputation. Because of how 0:19:27.400 --> 0:19:28.679 severe tissue death can be. 0:19:29.080 --> 0:19:34.119 I have in my research. I came across some pictures 0:19:34.880 --> 0:19:37.080 of it by accident, and. 0:19:38.119 --> 0:19:43.840 It's terrifying, terrifying. Yeah. Yeah, there's also in some snake 0:19:43.960 --> 0:19:48.440 venoms a type of tissue damage that occurs that ends 0:19:48.520 --> 0:19:52.200 up causing blood clots in small vessels that actually then 0:19:52.359 --> 0:19:55.480 contains the venom toxins to the site of the bite 0:19:55.480 --> 0:19:58.800 wound so that they don't travel more extensively, so that 0:19:59.040 --> 0:20:02.000 those toxins can ex their effect very locally, which I 0:20:02.000 --> 0:20:02.919 think is fascinating. 0:20:03.240 --> 0:20:04.080 Yeah. 0:20:04.320 --> 0:20:07.480 So if you have a snake bite that is very painful, 0:20:07.760 --> 0:20:11.879 very swollen, very obvious, then there's a component of cytotoxicity 0:20:11.880 --> 0:20:17.080 that's going on there. Okay, okay. Another place that cytotoxicity 0:20:17.640 --> 0:20:20.680 can come into play is actually in a more systemic way. 0:20:20.760 --> 0:20:23.480 So that was all kind of the local cytotoxic effects. 0:20:24.080 --> 0:20:27.439 But as snake venom travels through the lymphatics and reaches 0:20:27.560 --> 0:20:30.480 kind of the rest of the body, some snake venom 0:20:30.520 --> 0:20:34.760 toxins have specific effects on our muscle cells, which is 0:20:34.800 --> 0:20:39.720 known as myotoxicity. These end up actually damaging or killing 0:20:39.800 --> 0:20:43.600 primarily our skeletal muscle cells, so muscles in your arms, 0:20:43.640 --> 0:20:48.439 your legs, and this process of muscle cell breakdown leads 0:20:48.480 --> 0:20:51.200 to the release of a lot of enzymes from our 0:20:51.280 --> 0:20:55.240 muscle cells and proteins that actually are very damaging to 0:20:55.359 --> 0:20:59.399 our organs, especially our kidneys. So this process can actually 0:20:59.520 --> 0:21:03.240 lead to k kidney failure. This is called rhabdomyolysis. It's 0:21:03.240 --> 0:21:06.440 not specific to snake bites, but it's a really important 0:21:06.520 --> 0:21:11.000 complication of the skeletal muscle breakdown that snake venom toxins 0:21:11.040 --> 0:21:14.119 can induce that can then cause kidney failure and death. 0:21:14.960 --> 0:21:16.359 Your face has questions. 0:21:16.600 --> 0:21:18.040 I have a question. 0:21:19.840 --> 0:21:22.720 How is this so targeted? 0:21:22.840 --> 0:21:25.000 Like are we going to talk about the structure of 0:21:25.160 --> 0:21:29.320 these different venoms and like how they do the things 0:21:29.320 --> 0:21:29.840 that they do. 0:21:30.280 --> 0:21:33.199 Yeah, So that's a good questionnaire and I'm not. And 0:21:33.240 --> 0:21:36.680 it's not because it's not necessarily known, but it's because 0:21:36.800 --> 0:21:41.159 it is so incredibly complicated. So there are kind of 0:21:41.800 --> 0:21:46.360 a few dominant categories of proteins and enzymes that are 0:21:46.359 --> 0:21:51.520 involved in snake venom. Some are called phospholipases, some are 0:21:51.560 --> 0:21:59.080 called svmps snake venom metalloproteases or snake venom seerine proteases svsps, 0:21:59.480 --> 0:22:02.280 and then they're are three finger peptides. Those are the 0:22:02.320 --> 0:22:07.080 four kind of major groups of proteins that cause a 0:22:07.080 --> 0:22:11.119 lot of damage, and there's a lot of overlap. For example, 0:22:12.000 --> 0:22:15.920 the PLA two's the phospholie paces. They have a lot 0:22:15.960 --> 0:22:20.560 of the myotoxic and inflammatory cytotoxic effects, but they also 0:22:20.920 --> 0:22:23.879 are very neurotoxic as well different ones. 0:22:24.119 --> 0:22:27.560 So it's it's okay, so yeah, yeah, so. 0:22:27.720 --> 0:22:30.720 It gets really really complicated, but in general it are 0:22:30.800 --> 0:22:33.159 it is these phospholie paces that have a lot of 0:22:33.160 --> 0:22:38.800 that specific myotoxic activity. Okay, it's I just I know, 0:22:39.240 --> 0:22:45.160 I know, Aaron, And it's so like the there are 0:22:45.160 --> 0:22:48.919 so many different ways, even in under the grouping of 0:22:49.040 --> 0:22:52.800 say cytotoxic, there are so many different specific ways that 0:22:52.880 --> 0:22:56.320 these enzymes and these proteins and these toxins can end 0:22:56.440 --> 0:22:59.760 up killing cells. It's not just like one mechanism of 0:22:59.800 --> 0:23:05.000 act I see Okay, Yeah, but that's kind of the 0:23:05.040 --> 0:23:08.560 first category of big effects that you might see is 0:23:08.800 --> 0:23:14.479 tissue death either locally or more systemically with muscle breakdown. Okay, 0:23:16.160 --> 0:23:21.399 that's cider toxic venoms and cider toxic components. The next 0:23:21.400 --> 0:23:23.720 thing that you might notice or you might look for 0:23:23.880 --> 0:23:27.439 when it comes to a bite wound is is that 0:23:27.520 --> 0:23:31.119 bite wound oozing oozing? What oozing blood? 0:23:31.200 --> 0:23:31.520 Oozing? 0:23:31.520 --> 0:23:31.600 What? 0:23:31.720 --> 0:23:32.560 Oh? Blood? Okay? 0:23:34.040 --> 0:23:36.640 You pus or like clear liquid or something? 0:23:37.240 --> 0:23:41.960 No oozing blood okay. Snake bites can cause both local 0:23:42.160 --> 0:23:45.640 and systemic hemorrhage, and the way that they do this 0:23:45.720 --> 0:23:49.000 can vary a lot, but there's two main mechanisms and 0:23:49.040 --> 0:23:52.439 they both fall under the umbrella of a hemotoxic venom. 0:23:54.000 --> 0:23:58.160 The hemotoxic venoms have two different presentations that, as we'll see, 0:23:59.040 --> 0:24:01.399 kind of go hand in hand and to create a 0:24:01.520 --> 0:24:07.800 very bad potential outcome. So some toxins, some hematoxic toxins 0:24:07.880 --> 0:24:12.320 in venom can cause vascular permeability, which we've talked about 0:24:12.440 --> 0:24:18.000 in other episodes in various ways. But Basically, these toxins 0:24:18.359 --> 0:24:22.280 attack and break down the basement membrane, the bottom layer 0:24:22.600 --> 0:24:26.000 of our blood vessels, especially in our small blood vessels, 0:24:26.000 --> 0:24:31.119 are capillaries, and this leads to leaky vessels, which leads 0:24:31.200 --> 0:24:35.000 to loss of fluid and what we call extravasation of 0:24:35.080 --> 0:24:37.800 the blood out of your blood vessels and just into 0:24:37.840 --> 0:24:41.600 your general spaces in your body. And that means that 0:24:41.640 --> 0:24:44.959 there's less fluid in our blood vessels, which can then 0:24:45.080 --> 0:24:47.840 lead to hypotension low blood pressure because you don't have 0:24:47.960 --> 0:24:50.840 enough fluid to have enough pressure in your blood vessels, 0:24:51.320 --> 0:24:53.760 and that can lead to shock, which is when you're 0:24:53.800 --> 0:24:56.960 not able to perfuse your tissues because of how low 0:24:57.000 --> 0:24:57.879 your blood pressure is. 0:24:58.000 --> 0:25:00.840 Okay, that can lead to death, and so that is 0:25:00.880 --> 0:25:03.679 indicated by an oozing a bloody oozing wound. 0:25:03.920 --> 0:25:08.200 Potentially that's one possible sign. Yeah, okay, okay. A number 0:25:08.200 --> 0:25:13.919 of other toxins might cause vasodilation, basically opening up our 0:25:13.920 --> 0:25:17.119 blood vessels in diameter, which has the same effect of 0:25:17.200 --> 0:25:21.800 reducing our blood pressure. Right. It's actually incidentally how a 0:25:21.800 --> 0:25:24.560 lot of our blood pressure lowering medications work. And I 0:25:24.600 --> 0:25:27.400 think you'll probably talk arin about how at least one 0:25:27.720 --> 0:25:32.240 anti hypertensive class of medicines was actually developed from snake venom. 0:25:32.400 --> 0:25:36.280 Yeah, I'll mention it very briefly, but it is one 0:25:36.280 --> 0:25:40.040 of the coolest things, and I yeah, I just I 0:25:40.119 --> 0:25:42.480 love it so much because it's such a beautiful little 0:25:42.520 --> 0:25:45.639 example of how we're like, let's take this thing that 0:25:46.200 --> 0:25:49.480 can be very harmful and wait a second, how is 0:25:49.480 --> 0:25:50.040 it useful? 0:25:50.240 --> 0:25:52.840 Exactly? Yeah, and it is. It's a very useful class 0:25:52.840 --> 0:25:57.080 of medicines. But basically in an venomation sense, where you're 0:25:57.119 --> 0:25:59.199 getting a large load of this all at once that 0:25:59.240 --> 0:26:02.520 can also lead to hypotension and shock. It's a different mechanism, 0:26:02.720 --> 0:26:06.639 it's the same end result. But the other part of 0:26:06.680 --> 0:26:13.600 hemotoxicity that I think is even more absolutely fascinating is 0:26:13.600 --> 0:26:18.560 that various different snake venom toxins have specific effects on 0:26:18.640 --> 0:26:20.639 our coagulation cascade. 0:26:21.000 --> 0:26:24.479 Which isn't it great that we did hemofemia? So if 0:26:24.520 --> 0:26:27.760