{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T11:10:07Z","timestamp":1767179407519,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013678","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000}}],"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"APIDOM GIRCI SOHO & Direction G\u00c3\u00a9n\u00c3\u00a9rale de l\u00e2\u20ac\u2122offre de Soins","award":["WBothrops 2019"],"award-info":[{"award-number":["WBothrops 2019"]}]},{"name":"Agence Nationale de la Recherche ANR","award":["AAPG 2025 - PRC \u2013 KariBothrops"],"award-info":[{"award-number":["AAPG 2025 - PRC \u2013 KariBothrops"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Envenoming by\n                      <jats:italic>Bothrops lanceolatus<\/jats:italic>\n                      , a viperid endemic to Martinique an island in the Lesser Antilles, induces a unique clinical manifestation, i.e., thrombosis. Pathophysiological signaling leading to thrombotic events remains poorly understood. Among others, proposed mechanisms include increased expression of multimerized forms of von Willebrand factor (VWF). Prothrombotic effects of VWF are regulated by ADAMTS13, a metalloprotease which cleaves VWF multimers. Whether ADAMTS13 activity is reduced in\n                      <jats:italic>B. lanceolatus<\/jats:italic>\n                      envenoming has not been previously investigated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology\/Principal Findings<\/jats:title>\n                    <jats:p>\n                      ADAMTS13 activity was evaluated via chromogenic assay in experimental and clinical studies. Human plasma with known ADAMTS13 activities (0.70 IU\/mL) was incubated with increasing doses of\n                      <jats:italic>B. lanceolatus<\/jats:italic>\n                      venom. Incubation with\n                      <jats:italic>B. lanceolatus<\/jats:italic>\n                      venom (concentrations 10\u20131000\u2009ng\/mL) induced a dose-dependent reduction of ADAMTS13 activity. In our series of 46 patients bitten by\n                      <jats:italic>B. lanceolatus<\/jats:italic>\n                      snake, ADAMTS13 activity was determined at admission before antivenom therapy. In these patients, the median plasmatic ADAMTS13 activity was 94% (IQR: 78\u2013122%). Ten patients (22%) displayed ADAMTS13 activity less than 75%. Compared with patients with normal ADAMTS13 activity (n\u2009=\u200936), those with moderately low ADAMTS13 activity (n\u2009=\u200910) were older, had a lower platelet count, and displayed increased concentrations of creatine kinase, fibrinogen and C-reactive protein. Multivariate linear regression retained only grade severity of envenoming as independent predictor of increase length of hospital stay, while reduced ADAMTS13 activity and increased C-reactive protein levels bordered on statistical significance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions\/Significance<\/jats:title>\n                    <jats:p>\n                      For the first time, our study provided evidence suggesting that ADAMTS13 activity is reduced in experimental\n                      <jats:italic>B. lanceolatus<\/jats:italic>\n                      venom exposure and patients with\n                      <jats:italic>B. lanceolatus<\/jats:italic>\n                      envenoming. Thanks to its role on the VWF regulation, it is suggested that reduced ADAMTS13 activity can increase the risk of thrombosis in\n                      <jats:italic>B. lanceolatus<\/jats:italic>\n                      envenoming by favoring the circulation of prothrombotic VWF multimers. Low ADAMTS13 activity was associated with increased length of stay in envenomed patients.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013678","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T17:47:08Z","timestamp":1761760028000},"page":"e0013678","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["ADAMTS13 in Bothrops lanceolatus snakebite envenoming: Crude venom-induced reduction of in vitro enzymatic activity and clinical correlation in snakebite patients"],"prefix":"10.1371","volume":"19","author":[{"given":"Jonathan","family":"Florentin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Rapon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Pierre-Louis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatima","family":"Radouani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prisca","family":"Jalta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascal","family":"Fuseau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatem","family":"Kallel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7966-0110","authenticated-orcid":true,"given":"Remi","family":"Neviere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dabor","family":"Resiere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"pntd.0013678.ref001","doi-asserted-by":"crossref","first-page":"17079","DOI":"10.1038\/nrdp.2017.79","article-title":"Snakebite envenoming","volume":"3","author":"JM Guti\u00e9rrez","year":"2017","journal-title":"Nat Rev Dis Primers"},{"issue":"1","key":"pntd.0013678.ref002","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1056\/NEJMra2105228","article-title":"Snake Envenomation","volume":"386","author":"SA Seifert","year":"2022","journal-title":"N Engl J Med"},{"key":"pntd.0013678.ref003","doi-asserted-by":"crossref","first-page":"100037","DOI":"10.1016\/j.toxcx.2020.100037","article-title":"Bothrops atrox, the most important snake involved in human envenomings in the amazon: How venomics contributes to the knowledge of snake biology and clinical toxinology","volume":"6","author":"WM Monteiro","year":"2020","journal-title":"Toxicon X"},{"issue":"2","key":"pntd.0013678.ref004","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0011083","article-title":"Bothrops (Fer-de-lance) snakebites in the French departments of the Americas (Martinique and Guyana): Clinical and experimental studies and treatment by immunotherapy","volume":"17","author":"D Resiere","year":"2023","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0013678.ref005","first-page":"37","article-title":"Snake Bites by Bothrops lanceolatus in Martinique","volume":"28","author":"D Resiere","year":"2018","journal-title":"Med Sante Trop"},{"issue":"1","key":"pntd.0013678.ref006","doi-asserted-by":"crossref","first-page":"163","DOI":"10.3390\/toxins2010163","article-title":"Bothrops lanceolatus bites: guidelines for severity assessment and emergent management","volume":"2","author":"D Resiere","year":"2010","journal-title":"Toxins (Basel)"},{"issue":"1","key":"pntd.0013678.ref007","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.toxicon.2006.04.007","article-title":"Thrombotic stroke following snake bites by the \u201cFer-de-Lance\u201dBothrops lanceolatus in Martinique despite antivenom treatment: a report of three recent cases","volume":"48","author":"L Thomas","year":"2006","journal-title":"Toxicon"},{"issue":"8998","key":"pntd.0013678.ref008","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/S0140-6736(96)90590-5","article-title":"Early infusion of a purified monospecific F(ab\u2019)2 antivenom serum for Bothrops lanceolatus bites in Martinique","volume":"347","author":"L Thomas","year":"1996","journal-title":"Lancet"},{"issue":"5","key":"pntd.0013678.ref009","doi-asserted-by":"crossref","first-page":"419","DOI":"10.4269\/ajtmh.1995.52.419","article-title":"Prevention of thromboses in human patients with Bothrops lanceolatus envenoming in Martinique: failure of anticoagulants and efficacy of a monospecific antivenom. 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