ABSTRACT: Naja atra bite is one of the most common severe snakebites in emergency departments. Unfortunately, the pathophysiological changes caused by Naja atra bite are unclear due to the lack of good animal models. In this study, an animal model of Naja atra bite in Guangxi Bama miniature pigs was established by intramuscular injection at 2 mg/kg of Naja atra venom, and serum metabolites were systematically analyzed using untargeted metabolomic and targeted metabolomic approaches. Untargeted metabolomic analysis revealed that 5045 chromatographic peaks were obtained in ESI+ and 3871 chromatographic peaks were obtained in ESI-. Screening in ESI+ modes and ESI- modes identified 22 and 36 differential metabolites compared to controls. The presence of 8 core metabolites of glutamine, arginine, proline, leucine, phenylalanine, inosine, thymidine and hippuric acid in the process of Naja atra bite was verified by targeted metabolomics significant difference (P<0.05). At the same time, during the verification process of the serum clinical samples with Naja atra bite, we found that the contents of three metabolites of proline, phenylalanine and inosine in the serum of the patients were significantly different from those of the normal human serum (P<0.05). By conducting functional analysis of core and metabolic pathway analysis, we revealed a potential correlation between changes in key metabolites after the Naja atra bite and the resulting pathophysiological alterations, and our research aims to establish a theoretical foundation for the prompt diagnosis and treatment of Naja atra bite. Author summary Naja atra bite is one of the most serious tropical and subtropical diseases, and the pathophysiological mechanism of injury caused by Naja atra bite is still not clear, meanwhile, large animal models of Naja atra bite are rarely reported. In this study, a Naja atra bite Bama miniature pig model was constructed and evaluated. In addition, 22 and 36 metabolites were found to be significantly altered in ESI+ and ESI- mode by untargeted metabolomics assay, respectively. More interestingly, 8 of them co-occurred in both ESI+ and ESI- modes. We quantified these 8 metabolites absolutely by targeted metabolomics and validated them in the serum of Naja atra bite patients, which showed the same trend as the untargeted metabolomics results. We also compared the differences in the levels of these 8 metabolites in the serum of the Naja atra bite patient group and the normal human group, we found decreased expression of inosine, proline and phenylalanine. Based on this, we compared the blood metabolic profiles with those of Bungarus multicinctus and Trimeresurus stejnegeri, and finally we confirmed that inosine, proline and phenylalanine are likely to be the key metabolites in Naja atra bite.
