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Cross neutralization of coral snake venoms by commercial Australian snake antivenoms.
Clin Toxicol (Phila). 2017 Jan; 55(1):33-39.CT

Abstract

CONTEXT

Although rare, coral snake envenomation is a serious health threat in Brazil, because of the highly neurotoxic venom and the scarcely available antivenom. The major bottleneck for antivenom production is the low availability of venom. Furthermore, the available serum is not effective against all coral snake species found in Brazil. An alternative to circumvent the lack of venom for serum production and the restricted protection of the actually available antivenom would be of great value. We compared the Brazilian coral snake and mono and polyvalent Australian antivenoms in terms of reactivity and protection.

METHODS

The immunoreactivity of venoms from 9 coral snakes species were assayed by ELISA and western blot using the Brazilian Micrurus and the Australian pentavalent as well as monovalent anti-Notechis, Oxyuranus and Pseudechis antivenoms. Neutralization assays were performed in mice, using 3 LD50 of the venoms, incubated for 30 minutes with 100 μL of antivenom/animal.

DISCUSSION

All the venoms reacted against the autologous and heterologous antivenoms. Nevertheless, the neutralization assays showed that the coral snake antivenom was only effective against M. corallinus, M. frontalis, M. fulvius, M. nigrocinctus and M. pyrrhocryptus venoms. On the other hand, the Australian pentavalent antivenom neutralized all venoms except the one from M. spixii. A combination of anti-Oxyuranus and Pseudechis monovalent sera, extended the protection to M. altirostris and, partially, to M. ibiboboca. By adding Notechis antivenom to this mixture, we obtained full protection against M. ibiboboca and partial neutralization against M. lemniscatus venoms.

CONCLUSIONS

Our findings confirm the limited effectiveness of the Brazilian coral snake antivenom and indicate that antivenoms made from Australian snakes venoms are an effective alternative for coral snake bites in South America and also in the United States were coral snake antivenom production has been discontinued.

Authors+Show Affiliations

a Centro de Biotecnologia , Instituto Butantan , São Paulo , Brazil. b Departamento de Ciências da Saúde , Universidade Nove de Julho , São Paulo , Brazil.c Laboratório de Biologia Celular , Instituto Butantan , São Paulo , Brazil.d Primera Cátedra de Toxicología y Laboratorio de Toxinopatología , Facultad de Medicina de la Universidad de Buenos Aires , Buenos Aires , Argentina. e Dirección Nacional de Determinantes de la Salud e Investigación, INPB-ANLIS "Dr. Carlos G. Malbrán", Ministerio de Salud , Buenos Aires , Argentina.f Centro de Biotecnologia , IPEN , São Paulo , Brazil.g Venom Science Pty Ltd , South Australia , Australia.a Centro de Biotecnologia , Instituto Butantan , São Paulo , Brazil. h Divisão de Desenvolvimento Tecnológico e Produção , Instituto Butantan , São Paulo , Brazil. i Departamento de Bioquímica , Instituto de Química da Universidade de São Paulo , São Paulo , Brazil.f Centro de Biotecnologia , IPEN , São Paulo , Brazil.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27595162

Citation

Ramos, Henrique Roman, et al. "Cross Neutralization of Coral Snake Venoms By Commercial Australian Snake Antivenoms." Clinical Toxicology (Philadelphia, Pa.), vol. 55, no. 1, 2017, pp. 33-39.
Ramos HR, Vassão RC, de Roodt AR, et al. Cross neutralization of coral snake venoms by commercial Australian snake antivenoms. Clin Toxicol (Phila). 2017;55(1):33-39.
Ramos, H. R., Vassão, R. C., de Roodt, A. R., Santos E Silva, E. C., Mirtschin, P., Ho, P. L., & Spencer, P. J. (2017). Cross neutralization of coral snake venoms by commercial Australian snake antivenoms. Clinical Toxicology (Philadelphia, Pa.), 55(1), 33-39. https://doi.org/10.1080/15563650.2016.1222615
Ramos HR, et al. Cross Neutralization of Coral Snake Venoms By Commercial Australian Snake Antivenoms. Clin Toxicol (Phila). 2017;55(1):33-39. PubMed PMID: 27595162.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cross neutralization of coral snake venoms by commercial Australian snake antivenoms. AU - Ramos,Henrique Roman, AU - Vassão,Ruth Camargo, AU - de Roodt,Adolfo Rafael, AU - Santos E Silva,Ed Carlos, AU - Mirtschin,Peter, AU - Ho,Paulo Lee, AU - Spencer,Patrick Jack, Y1 - 2016/09/05/ PY - 2016/9/7/pubmed PY - 2017/3/7/medline PY - 2016/9/6/entrez KW - Micrurus KW - immunoreactivity KW - venom SP - 33 EP - 39 JF - Clinical toxicology (Philadelphia, Pa.) JO - Clin Toxicol (Phila) VL - 55 IS - 1 N2 - CONTEXT: Although rare, coral snake envenomation is a serious health threat in Brazil, because of the highly neurotoxic venom and the scarcely available antivenom. The major bottleneck for antivenom production is the low availability of venom. Furthermore, the available serum is not effective against all coral snake species found in Brazil. An alternative to circumvent the lack of venom for serum production and the restricted protection of the actually available antivenom would be of great value. We compared the Brazilian coral snake and mono and polyvalent Australian antivenoms in terms of reactivity and protection. METHODS: The immunoreactivity of venoms from 9 coral snakes species were assayed by ELISA and western blot using the Brazilian Micrurus and the Australian pentavalent as well as monovalent anti-Notechis, Oxyuranus and Pseudechis antivenoms. Neutralization assays were performed in mice, using 3 LD50 of the venoms, incubated for 30 minutes with 100 μL of antivenom/animal. DISCUSSION: All the venoms reacted against the autologous and heterologous antivenoms. Nevertheless, the neutralization assays showed that the coral snake antivenom was only effective against M. corallinus, M. frontalis, M. fulvius, M. nigrocinctus and M. pyrrhocryptus venoms. On the other hand, the Australian pentavalent antivenom neutralized all venoms except the one from M. spixii. A combination of anti-Oxyuranus and Pseudechis monovalent sera, extended the protection to M. altirostris and, partially, to M. ibiboboca. By adding Notechis antivenom to this mixture, we obtained full protection against M. ibiboboca and partial neutralization against M. lemniscatus venoms. CONCLUSIONS: Our findings confirm the limited effectiveness of the Brazilian coral snake antivenom and indicate that antivenoms made from Australian snakes venoms are an effective alternative for coral snake bites in South America and also in the United States were coral snake antivenom production has been discontinued. SN - 1556-9519 UR - https://www.unboundmedicine.com/medline/citation/27595162/Cross_neutralization_of_coral_snake_venoms_by_commercial_Australian_snake_antivenoms_ L2 - https://www.tandfonline.com/doi/full/10.1080/15563650.2016.1222615 DB - PRIME DP - Unbound Medicine ER -