Wasp venom-induced acute kidney injury: current progress and prospects

Ren Fail. 2023;45(2):2259230. doi: 10.1080/0886022X.2023.2259230. Epub 2023 Sep 19.

Abstract

Wasp venom can trigger local and systemic reactions, with the kidneys being commonly affected, potentially causing acute kidney injury (AKI). Despite of the recent advances, our knowledge on the underlying mechanisms of toxicity and targeted therapies remain poor. AKI can result from direct nephrotoxic effects of the wasp venom or secondary rhabdomyolysis and intravascular hemolysis, which will release myoglobin and free hemoglobin. Inflammatory responses play a central role in these pathological mechanisms. Noteworthily, the successful establishment of a suitable experimental model can assist in basic research and clinical advancements related to wasp venom-induced AKI. The combination of therapeutic plasma exchange and continuous renal replacement therapy appears to be the preferred treatment for wasp venom-induced AKI. In addition, studies on cilastatin and varespladib for wasp venom-induced AKI treatment have shown their potential as therapeutic agents. This review summarizes the available evidence on the mechanisms and treatment of wasp venom-induced AKI, with a particular focus on the role of inflammatory responses and potential targets for therapeutic drugs, and, therefore, aiming to support the development of clinical treatment against wasp venom-induced AKI.

Keywords: Acute kidney injury; cilastatin; therapeutic plasma exchange; varespladib; wasp sting; wasp venom.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury* / chemically induced
  • Acute Kidney Injury* / therapy
  • Cilastatin
  • Humans
  • Kidney
  • Plasmapheresis
  • Wasp Venoms* / toxicity

Substances

  • Wasp Venoms
  • Cilastatin

Grants and funding

This study was supported by the Natural Science Foundation of Hubei Province under Grant (number 2022CFD108). The funding agency had no role in the collection, analysis and interpretation of data, in the writing of the report, or in the decision to submit the article for publication.