Therapeutic Outcome of Anti-inflammatory and Antioxidative Medicines on the Dermonecrotic Activity of Cerastes cerastes Venom

Envenomation by Cerastes cerastes often results in local dermonecrotic lesions. While immunotherapy is effective in reversing systemic symptoms, this strategy remains deficient in counteracting the extended dermonecrosis induced from the bite site. In this study, the therapeutic effect of pharmacological drugs on the dermonecrotic activity of the venom was investigated. Venom administration caused a marked dermonecrotic lesion with increased levels of oxidative stress biomarkers (MPO, EPO, NO, H₂O₂, MDA, protein carbonyl, and thiol levels). Antioxidant capacity was decreased, as evidenced by reduced catalase, glutathione, and selenium levels. Histopathological analysis of skin biopsies revealed necrotic lesions accompanied by hemorrhage and epidermis thickening. The efficiency of cyproheptadine (C), dexamethasone (D), and tetracycline (T), as a monotherapy or in association, were evaluated on the dermonecrotic activity of the venom. Most of the treatments (CD, CT, DT, and CDT) largely reduced tissue necrosis to, respectively, 84.29, 87.83, 83.77, and 82.71% and significantly decreased MPO and EPO activities and NO, H₂O₂, MDA, and protein carbonyl levels in skin tissue homogenates. CT and CDT associations significantly increased the antioxidant status as indicated by enhanced catalase, glutathione, and selenium levels. The second challenge of the pharmacological associations was more effective in improving the oxidative/antioxidative balance. Skin tissue sections from treated animals with CT or CDT revealed tissue structure close to that observed in control animals. Therefore, the synergistic action of all tested drugs on the major pathways of inflammation (phospholipases A₂, metalloproteinases, and histamine) seems to be efficient to neutralize the necrotic activity of the venom.