In Brazil, specifically in the Amazon region, 57,374 notifications of snakebites were reported, resulting in incidence rate of 37.2 cases per 100,000 inhabitants/year, during the period from 2010 to 2015 ( 4). Approximately 421,000 cases of snakebites and 20,000 deaths occur worldwide each year ( 2, 3). It is an important cause of morbidity and mortality, especially in areas of extreme poverty in the tropics and subtropics, such as sub-Saharan Africa, South, and Southeast Asia, Papua New Guinea, Central and Latin America ( 1). Snakebite is a neglected tropical disease and a major public health problem in developing countries worldwide. The present study is the first report on inflammation-coagulation crosstalk involving snakebite patients and supports the better understanding of envenomation's pathophysiology mechanisms and guides in the search for novel biomarkers and prospective therapies. Furthermore, these results suggest that a number of interactions of CXCL-8, CXCL-9, CCL-2, IL-6, and IFN-γ in HF patients are directly affected by fibrinogen levels, which may be related to the inflammatory response and coagulation mutual relationship induced by B. In addition, antivenom therapy seems to have a positive effect, leading to a profile of circulating inflammatory response similar in quantification of T1 and T2 on both groups. The profile of the circulating inflammatory response is different between the groups studied, with HF patients having higher concentrations of CCL-5 and lower IFN-γ. The molecules CXCL-8, CCL-5, CXCL-9, CCL-2, CXCL-10, IL-6, TNF, IL-2, IL-10, IFN-γ, IL-4, and IL-17A were quantified in plasma using the CBA technique at three different times (pre-antivenom therapy, 24 h, and 48 h after antivenom therapy). Seventeen patients with NF and 55 patients with HF were eligible for the study, in addition to 50 healthy controls (CG). atrox snakebites and presented different levels of fibrinogen consumption (normal fibrinogen and hypofibrinogenemia ). A prospective study was carried out with individuals who had suffered B. Thus, the goal of this study was to describe the relationship between the consumption of fibrinogen and the profile of inflammatory molecules (chemokines and cytokines) in evenomations by B. However, the crosstalk between coagulation disorders and inflammatory reaction still has gaps in snakebites. These alterations occur due the action of hemostatically active and immunogenic toxins which are capable of triggering a wide range of hemostatic and inflammatory events. These bites may cause local and systemic signs from acute inflammatory reaction and hemostatic changes, and present common hemorrhagic disorders. atrox) is responsible for 90% of the bites. In the Amazon region of Brazil, the snake Bothrops atrox ( B. Snakebites are considered a major public health problem worldwide. 7Instituto de Pesquisas Leônidas e Maria Deane, FIOCRUZ-Amazônia, Manaus, Brazil.6Laboratório de Imunopatologia, Instituto Butantan, São Paulo, Brazil.5Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Manaus, Brazil.4Programa de Pós-Graduação em Ciências Aplicadas à Hematologia, Universidade do Estado do Amazonas (UEA), Manaus, Brazil.3Programa de Pós-Graduação em Imunologia Básica e Aplicada, Universidade Federal do Amazonas (UFAM), Manaus, Brazil.Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil 2Instituto de Pesquisa Clínica Carlos Borborema (IPCCB), Fundação de Medicina Tropical Dr.1Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Brazil.Irmgardt Alicia María Wellmann 1,2, Hiochelson Najibe Santos Ibiapina 1,2, Jacqueline Almeida Gonçalves Sachett 1,2, Marco Aurélio Sartim 3, Iran Mendonça Silva 2, Sâmella Silva Oliveira 1,2, Andréa Monteiro Tarragô 3,4,5, Ana Maria Moura-da-Silva 1,6, Marcus Vinícius Guimarães Lacerda 1,2,4,7, Luiz Carlos de Lima Ferreira 1,2, Adriana Malheiro 1,3,4,5, Wuelton Marcelo Monteiro 1,2 and Allyson Guimarães Costa 1,2,3,4,5 *
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