Transcriptomic Insights Into the Evolution of Snake Venom: Mechanisms, Diversity, and Adaptation

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  Transcriptomic Insights Into the Evolution of Snake Venom: Mechanisms, Diversity, and Adaptation Abstract Snake venoms are evolutionarily refined biochemical arsenals composed of diverse toxins with complex functional roles in predation, defense, and competition. Over the past 2 decades, transcriptomic approaches have transformed venom research by enabling high-resolution insights into gene expression dynamics, molecular diversity, and the evolutionary mechanisms driving venom variation across lineages. In this review, we present a comprehensive synthesis of snake venom transcriptomics literature and propose a conceptual framework structured around three major axes: (1) gene family expansion through duplication and neofunctionalization; (2) regulatory complexity encompassing transcriptional, posttranscriptional, and epigenetic modulation; and (3) ecological selection pressures shaping venom profiles in response to diet, habitat, and interspecific interactions. We integrate findin...

Diagnostic and therapeutic challenges into snakebite-induced thrombotic microangiopathy: a case report and review of the literature

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Image Credit: Luis A. Roque, Aracnido Taxonomy

Diagnostic and therapeutic challenges into snakebite-induced thrombotic microangiopathy: a case report and review of the literature

Abstract

Background

Snakebite envenomation is a significant global health issue, with India accounting for a substantial number of cases, particularly in rural areas. Venom-induced consumption coagulopathy is a common complication; however, thrombotic microangiopathy remains rare and not well understood. Thrombotic microangiopathy is characterized by microvascular thrombosis, microangiopathic hemolytic anemia, thrombocytopenia, and organ dysfunction. Understanding the pathophysiological differences in snakebite-induced thrombotic microangiopathy is critical for optimizing treatment and outcomes.

Case presentation

We report a case of snakebite-induced thrombotic microangiopathy in a 22-year-old male individual from eastern India who presented with severe thrombocytopenia, acute kidney injury, and neurological deficits. Laboratory investigations revealed schistocytes, elevated lactate dehydrogenase levels, and a PLASMIC score of 6, suggesting thrombotic thrombocytopenic purpura as a subtype of thrombotic microangiopathy. The patient was treated with plasma exchange therapy and supportive measures, including hemodialysis. Initial neurological deterioration, compounded by cerebral edema, necessitated mechanical ventilation. Over time, the patient’s condition improved, and he was discharged on day 42 with recommendations for regular nephrology follow-up.

Conclusion

Snakebite-induced thrombotic microangiopathy may differ from classical thrombocytopenic purpura, potentially involving venom-mediated Von Willebrand factor activation without severe ADAMTS13 deficiency. The use of platelet transfusions before referral may have worsened microthrombus formation and neurological symptoms. This case underscores the need for early recognition of thrombotic microangiopathy in patients who experienced snakebite presenting with thrombocytopenia and microangiopathic hemolytic anemia, even with normal coagulation parameters. Further research is essential to refine diagnostic and management strategies, including cautious platelet transfusion use, to improve outcomes in such complex cases.

Panda, S., Majhi, K., Biswas, T. et al. Diagnostic and therapeutic challenges into snakebite-induced thrombotic microangiopathy: a case report and review of the literature. J Med Case Reports (2026). https://doi.org/10.1186/s13256-025-05804-z