Sample records for antivenins

  1. Production of effective antivenin to treat cobra snake (Naja naja oxiana envenoming

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    Akbari, A.


    Full Text Available Conventional treatment of Naja naja oxiana (NNO envenoming requires large volumes of equine antivenin raised against NNO crude venom. The poor efficiency of this antivenin is assumed to be due to the high molecular weight non-toxic proteins, a strong immunogen, present in the crude venom. These proteins cause depression of antibody formation against the low molecular weight toxic components of venom. In the present study the low molecular weight lethal components were isolated from crude venom of NNO venom by sephadex G50 get filtration chromatography. A sera was prepared by immunizing horses with toxic fraction. One milliliter of this serum neutralized 1.8mg of NNO crude venom. This high titer antivenin is thus 2.2 times more potent than the sera obtained against NNO crude venom.

  2. Enzymatic analysis of Hemiscorpius lepturus scorpion venom using zymography and venom-specific antivenin. (United States)

    Seyedian, Ramin; Pipelzadeh, Mohammad Hassan; Jalali, Amir; Kim, Euikyung; Lee, Hyunkyoung; Kang, Changkeun; Cha, Mijin; Sohn, Eun-Tae; Jung, Eun-Sun; Rahmani, Ali Hassan; Mirakabady, Abbas Zare


    Hemiscorpius lepturus envenomation exhibits various pathological changes in the affected tissues, including skin, blood cells, cardiovascular and central nervous systems. The enzymatic activity and protein component of the venom have not been described previously. In the present study, the electrophoretic profile of H. lepturus venom was determined by SDS-PAGE (12 and 15%), resulting in major protein bands at 3.5-5, 30-35 and 50-60 kDa. The enzymatic activities of the venom was, for the first time, investigated using various zymography techniques, which showed the gelatinolytic, caseinolytic, and hyaluronidase activities mainly at around 50-60 kDa, 30-40 kDa, and 40-50 kDa, respectively. Among these, the proteolytic activities was almost completely disappeared in the presence of a matrix metalloproteinase inhibitor, 1, 10-phenanthroline. Antigen-antibody interactions between the venom and its Iranian antivenin was observed by Western blotting, and it showed several antigenic proteins in the range of 30-160 kDa. This strong antigen-antibody reaction was also demonstrated through an enzyme-linked immunosorbent assay (ELISA). The gelatinase activity of the venom was suppressed by Razi institute polyvalent antivenin, suggesting the inhibitory effect of the antivenin against H. lepturus venom protease activities. Prudently, more extensive clinical studies are necessary for validation of its use in envenomed patients. Copyright 2010 Elsevier Ltd. All rights reserved.

  3. Kenyan medicinal plants used as antivenin: a comparison of plant usage

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    Kisangau Daniel P


    Full Text Available Abstract The success of snake bite healers is vaguely understood in Kenya, partly due to their unknown materia medica and occult-mystical nature of their practice. A comparison is made of plants used in snake bite treatments by two culturally distinct African groups (the Kamba and Luo. Thirty two plants used for snakebite treatment are documented. The majority of the antidotes are prepared from freshly collected plant material – frequently leaves. Though knowledge of snake bite conditions etiological perceptions of the ethnic groups is similar, field ethnobotanical data suggests that plant species used by the two ethnic groups are independently derived. Antivenin medicinal plants effectively illustrate the cultural context of medicine. Randomness or the use of a variety of species in different families appears to be a feature of traditional snake bite treatments. A high degree of informant consensus for the species was observed. The study indicates rural Kenya inhabitants rely on medicinal plants for healthcare.

  4. A Scorpion¡¯s Poison Antivenin R&D+i Project Case from a Mexican Public University.


    Vega-Gonz¨¢lez Luis Roberto


    All over the world there is a huge complex problem caused by the sting of poisonous animals. In many countries all around the orb there are some animal species hazardous for human beings. A case from a Mexican University R&D institute- Private firm innovation project about scorpion¡¯s antivenins health area is presented. The scientific-technological allied participant organizations performed a long life cycle innovation project, which includes research and development, knowledge transference,...

  5. Management of Tissue Loss After Agkistrodon Snakebite: Appropriate Use of Crotalidae-Fab Antivenin. (United States)

    Larson, Kenneth W; Schaefer, Keith R; Austin, Cindy; Norton, Rhy; Finley, Phillip J


    Although initially created for the treatment of rattlesnake (genus: Crotalus) bites, Crotalidae-Fab antivenin is used to treat many different pit viper envenomations. However, the efficacy of Crotalidae-Fab in preventing tissue loss from copperhead (Agkistrodon contortrix) or cottonmouth (Agkistrodon piscivorus) snakebites remains unclear. Recent reports show that Agkistrodon-related bites rarely require treatment beyond simple observation and pain control. The purpose of this study was to examine the amount of tissue loss in patients who received Crotalidae-Fab compared with those who did not after an Agkistrodon bite. After institutional review board approval, a retrospective study was completed at a Level 1 trauma center. Between 2009 and 2013, a total of 57 snakebites were identified. Of the 57 bites, the snake species was documented in 36 cases including 31 copperheads, 1 cottonmouth, and 4 rattlesnakes. The other 21 bites were from unknown or nonvenomous species. Of the 32 Agkistrodon-related bites, 15 patients received Crotalidae-Fab (average of 3 vials administered) and 17 did not receive Crotalidae-Fab. None of the 32 patients, regardless of treatment option, had tissue loss or required surgical interventions. Only 1 patient received Crotalidae-Fab and debridement of a vesicle associated with the bite. No clinically significant differences were observed between the groups. These findings support previous literature that failed to show added benefit of Crotalidae-Fab treatment for Agkistrodon bites beyond patient comfort and pain control. Evaluation of current protocols for Agkistrodon envenomations is warranted. Snakebite wound education in trauma physicians and nurses may decrease unnecessary use of antivenom medication.

  6. Ophiophagus hannah Venom: Proteome, Components Bound by Naja kaouthia Antivenin and Neutralization by N. kaouthia Neurotoxin-Specific Human ScFv

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    Witchuda Danpaiboon


    Full Text Available Venomous snakebites are an important health problem in tropical and subtropical countries. King cobra (Ophiophagus hannah is the largest venomous snake found in South and Southeast Asia. In this study, the O. hannah venom proteome and the venom components cross-reactive to N. kaouthia monospecific antivenin were studied. O. hannah venom consisted of 14 different protein families, including three finger toxins, phospholipases, cysteine-rich secretory proteins, cobra venom factor, muscarinic toxin, L-amino acid oxidase, hypothetical proteins, low cysteine protein, phosphodiesterase, proteases, vespryn toxin, Kunitz, growth factor activators and others (coagulation factor, endonuclease, 5’-nucleotidase. N. kaouthia antivenin recognized several functionally different O. hannah venom proteins and mediated paratherapeutic efficacy by rescuing the O. hannah envenomed mice from lethality. An engineered human ScFv specific to N. kaouthia long neurotoxin (NkLN-HuScFv cross-neutralized the O. hannah venom and extricated the O. hannah envenomed mice from death in a dose escalation manner. Homology modeling and molecular docking revealed that NkLN-HuScFv interacted with residues in loops 2 and 3 of the neurotoxins of both snake species, which are important for neuronal acetylcholine receptor binding. The data of this study are useful for snakebite treatment when and where the polyspecific antivenin is not available. Because the supply of horse-derived antivenin is limited and the preparation may cause some adverse effects in recipients, a cocktail of recombinant human ScFvs for various toxic venom components shared by different venomous snakes, exemplified by the in vitro produced NkLN-HuScFv in this study, should contribute to a possible future route for an improved alternative to the antivenins.

  7. Ophiophagus hannah venom: proteome, components bound by Naja kaouthia antivenin and neutralization by N. kaouthia neurotoxin-specific human ScFv. (United States)

    Danpaiboon, Witchuda; Reamtong, Onrapak; Sookrung, Nitat; Seesuay, Watee; Sakolvaree, Yuwaporn; Thanongsaksrikul, Jeeraphong; Dong-din-on, Fonthip; Srimanote, Potjanee; Thueng-in, Kanyarat; Chaicumpa, Wanpen


    Venomous snakebites are an important health problem in tropical and subtropical countries. King cobra (Ophiophagus hannah) is the largest venomous snake found in South and Southeast Asia. In this study, the O. hannah venom proteome and the venom components cross-reactive to N. kaouthia monospecific antivenin were studied. O. hannah venom consisted of 14 different protein families, including three finger toxins, phospholipases, cysteine-rich secretory proteins, cobra venom factor, muscarinic toxin, L-amino acid oxidase, hypothetical proteins, low cysteine protein, phosphodiesterase, proteases, vespryn toxin, Kunitz, growth factor activators and others (coagulation factor, endonuclease, 5'-nucleotidase). N. kaouthia antivenin recognized several functionally different O. hannah venom proteins and mediated paratherapeutic efficacy by rescuing the O. hannah envenomed mice from lethality. An engineered human ScFv specific to N. kaouthia long neurotoxin (NkLN-HuScFv) cross-neutralized the O. hannah venom and extricated the O. hannah envenomed mice from death in a dose escalation manner. Homology modeling and molecular docking revealed that NkLN-HuScFv interacted with residues in loops 2 and 3 of the neurotoxins of both snake species, which are important for neuronal acetylcholine receptor binding. The data of this study are useful for snakebite treatment when and where the polyspecific antivenin is not available. Because the supply of horse-derived antivenin is limited and the preparation may cause some adverse effects in recipients, a cocktail of recombinant human ScFvs for various toxic venom components shared by different venomous snakes, exemplified by the in vitro produced NkLN-HuScFv in this study, should contribute to a possible future route for an improved alternative to the antivenins.

  8. HPTLC detection of altitudinal variation of the potential antivenin stigmasterol in different populations of the tropical ethnic antidote Rauvolfia serpentina. (United States)

    Dey, Abhijit; Pandey, Devendra Kumar


    To determine the altitudinal variation of stigmasterol, a potential antivenin, in roots from seven populations of Rauvolfia serpentina (L). Benth. ex Kurz. (Apocynaceae) (R. serpentina), an important herb found in Indian subcontinent which has long been used in the treatment of snakebite, blood pressure and schizophrenia. Altitudinal variation of stigmasterol content in R. serpentina roots was analyzed by high performance thin layer chromatography. Chromatography was performed on silica gel 60 F254 thin layer chromatography plates with benzene-acetone 86:14 (v/v) as mobile phase. Densitometric analysis was done at λ=366 nm after derivatization with vanillin-10% (v/v) sulphuric acid alcohol reagent. The method was validated for precision and recovery. The present experiment demonstrates a simple, rapid, precise and sensitive high performance thin layer chromatography protocol for qualitative and quantitative determination of stigmasterol from different populations of R. serpentina. Results demonstrated that in root samples stigmasterol was present at Rf value of 0.44. This investigation demonstrates that stigmasterol content in R. serpentina roots varies in different altitudes. Popular ethnomedicinal use of this herb against snakebite may be contributed by the occurrence of stigmasterol in its roots. Copyright © 2014 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  9. Comparación entre dos métodos de producción para la elaboración de antivenenos ofídicos Snake Antivenin: Comparison Between Two Production Methods

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    Adolfo Rafael de Roodt


    . Nevertheless, the treatment of venomous snakebites in domestic animals can turn diffcult due several problems among which, the conspicuous, is the low availability or lack of antivenoms for veterinary use. As commercial pressures on the pharmaceutical industry have led to a reduction in the production of antivenins in several parts of the world, their availability is sometimes rather limited and sometimes these products are impossible to obtain. In this work, we immunized horses with venom of South American vipers to obtain hyperimmune plasma. The plasma was processed to separate whole IgG of F(ab´2 fragments using two conventional methods (caprylic acid fractionation or double saline precipitation and pepsin digestion. The obtained antivenins were tested for their biochemical and immunochemical characteristics and neutralizing potency. The SDS-PAGE of the antivenins showed, in the processed antivenin, bands in the order of 150 and 100 kDa in the whole IgG or F(ab´2 fragments, respectively. The presence of albumin or contaminants of high or low molecular weight was not detected in any of the preparations. No important differences were observed in the neutralizing potency of the antivenins, although production cost was very low with the method used to obtain pure IgG. The low production cost makes the production of antivenins for veterinary use proftable when the production of F(ab´2 fragments is not possible.

  10. An Experimental Study for Improving Snake Antivenin Production Using Gamma Radiation and a Biotechnological Technique

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    Mohamed, H.K.


    Snake-bite is considered a neglected tropical disease that affects thousands of people worldwide. Administration of antivenom is the corner stone in the therapy of snake-bite. The study aimed to improve the production of antivenom using gamma irradiation to detoxify venom and calcium phosphate nanoparticles as alternative adjuvant. This was carried out by studying the toxicological and immunological properties of the Naja haje venom before and after exposure to 2 KGy gamma radiation. Calcium phosphate nanoparticles were selected to be used as adjuvant as they showed better entrapment efficacy than Alum or chitosan nanoparticles. In order to achieve the goal of the present study, the native, γ irradiated and nanoparticles loaded venom as well nanoparticles loaded irradiated venom were used for preparation of their specific antivenom using rabbits. Data revealed that gamma irradiation of Naja haje venom reduced its lethality to one sixth as compared to its native venom. There was no change in the antigenic reactivity between both native and γ irradiated Naja haje venoms. Inhibition in the phospholipase and proteolytic activities after gamma irradiation were shown. Furthermore, injection of γ irradiated Naja haje venom did not significantly change activities of serum LDH, CPK, CK-MB, ALT and AST as well as urea and creatinine levels compared to the normal group. In addition, the immune response of immunized rabbits was evaluated through determination of antibody titer using ELISA technique, serum titer produced with γ irradiated venom loaded on CPN showed highest titer as compared to other sera. Results indicated that the sooner antivenom was injected the higher the neutralizing capacity obtained. All the prepared antivenoms were able to neutralize the toxicological activities of Naja haje snake venom to same extent. Thus, gamma radiation is a reliable tool for detoxification of Naja haje venom without affecting its immunogenicity. Furthermore. Calcium phosphate nanoparticles are promising and safe system when applied as an adjuvant in immunization process

  11. Comparación entre dos métodos de producción para la elaboración de antivenenos ofídicos Snake Antivenin: Comparison Between Two Production Methods


    Adolfo Rafael de Roodt; Silvana Litwin; Judith Estevez; Eduardo G Gould; Jorge A Dolab; Jorge Gould


    Las mordeduras producidas por serpientes venenosas son un serio problema médico en varias regiones del mundo y sobre las cuales los sistemas de salud actúan en diferentes grados en lo referente a tratamiento y prevención. Sin embargo, el tratamiento de las mordeduras de serpientes venenosas en animales domésticos puede resultar difícil por diversos motivos, siendo uno de estos la baja oferta o ausencia de antivenenos para uso veterinario. Las presiones comerciales en la industria farmacéutica...

  12. Use of antivenom for snakebites reported to United States poison centers. (United States)

    Spiller, Henry A; Bosse, George M; Ryan, Mark L


    In 2001, a new antivenin was introduced to the United States and became widely available in the snakebite season of 2002. We investigated what impact this may have had on snakebite treatment and medical outcome. The study used a retrospective review of all snakebites to humans reported to the National Poison Center Database System from 2000 to 2007. During the 8 years, there were 37,760 snakebites, with a mean of 4720 bites per year. There was a 27% increase in bites reported to a Poison center for the 8-year period and an overall 13.5% increase in the use of antivenin. The 2 categories primarily responsible for the increased use of antivenin were copperhead and crotaline-unknown. Rattlesnake bites remained the category most frequently treated with antivenin with a mean 52.5% treatment rate and only moderate increase for the 8 years. There was no change in the percentage or number of patients with a major outcome (mean, 3.8%) or death (mean, 0.5%). There was a decrease in patients with a minor outcome and an increase in patients with a moderate outcome. The new antivenin is reported to have a reduced potential for adverse reactions. This may have had a role in the decision of which snakebite victims received antivenin. With the introduction of a new antivenin, there has been a dramatic increase in the number of snakebite patients treated with antivenin. This has been most noticeable in snake bite categories that were less frequently treated with antivenin in the past. Copyright © 2010 Elsevier Inc. All rights reserved.

  13. Progress and improvement of the manufacturing process of snake antivenom


    Zolfagharian H.; Mohammadpour Dounighi, N.


    Antivenoms have been used successfully for more than a century and up to now constitute the only effectivetreatment for snakebites .The production of antivenin started long time ago when the calmette was preparedthe antivenom in 1894.The method currently used to prepare antivenom by most of the manufacturers areoriginated from the method of Pope which was develop in 1938. Several new approaches in the production ofantivenom have been proposed to produce IgG, F(ab)2, F(ab) antivenin to improve...

  14. Increased Efficacy of Antivenom Combined with Hyperbaric Oxygen on Deinagkistrodon acutus Envenomation in Adult Rats

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    Mo Li


    Conclusions: Antivenin and HBO, respectively, induced a neuroprotective effect after D. acutus envenomation by attenuating brain edema, upregulating nestin expression in SVZ, and improving coagulopathy and oxidative stress. The intervention efficacy of antivenom with HBO was maximum within 5 h after envenomation and was more efficacious than antivenom alone.

  15. Texas coral snake (Micrurus tener) bites. (United States)

    Morgan, David L; Borys, Douglas J; Stanford, Rhandi; Kjar, Dean; Tobleman, William


    The clinical features of bites from Texas coral snakes (Micrurus tener) have not been well studied. Our goal was to review the largest number of victims of Texas coral snakebites to determine their characteristics, effects, treatment, and outcome. Retrospective case series of Micrurus tener exposures reported to the Texas Poison Center Network from 2000 to 2004. Eighty-two patients were included in the analysis. Most (57.3%) were 18 to 49-year-old men. Almost 90% had local swelling, pain, erythema, or paresthesias. Only 7.3% had systemic effects, and none of these were severe. Over half received coral snake antivenin, and 15.9% were given opioids for pain. No patient died and no patient required mechanical ventilation due to hypoventilation from the snakebite. There were more local findings and less severe systemic effects than previously reported. Antivenin is not needed for most of these patients, and opioids may be administered safely.

  16. Scorpion envenomation study in Behbahan County, Southwest Iran

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    Hamid Kassiri


    Full Text Available Objective: To study the incidence and epidemiology of scorpion sting cases that were referred to the health services centers of Behbahan County, Khuzistan Province, southwestern Iran, during the two yeare (2007-2008. Methods: In this descriptive retrospective research, the data has come from files of scorpionstung patients referring to the health services centers of Behbahan during study period. A special scorpion sting sheet was prepared and completed for every case of scorpion sting. Analysis of 3441 case sheets received during this period was carried out. The frequencies of medical and entomoepidemiologic parameters were turned to the percentage position. Results: A total of 3 441 cases of scorpion stings were reported during the two-year period from 2007 to 2008. The average incidence of scorpion stings was 8.8‰ in the two years. The frequency of cases was higher during August, September, June and July that 2 056 cases of scorpion stings were reported. Most stings were occurred during summer. Nearly 51.3% of the cases were men. All cases had received antivenin. Majority of scorpion sting cases (56.5% lived in the rural areas. The most common sting site was the hand. About 74.4% have received the antivenin 0-6 h after the sting. The early injection of the antivenin is very important. The most of the cases of scorpion stings (59% were occurred by yellow scorpions. Conclusions: Surveillance for cases of scorpion stings must begin at all regions of Behbahan County. Treatment of cases of scorpion stings is conducted according to a protocol set by the Ministry of Health, Treatment and Medical Education. This protocol included directions for lines of treatment and the dose of antivenin recommended. Thereafter all cases are referred to hospital for further observation and management.

  17. Crotalid envenomation: the southern Arizona experience. (United States)

    Tokish, J T; Benjamin, J; Walter, F


    To review a regional experience with the treatment of snakebites. Five major southern Arizona hospitals, including two Level I trauma centers. A review of all snakebite admissions over a five-year period was performed. During the period reviewed, 164 patients were admitted for snakebites. Rattlesnakes were responsible for 98 percent of identified envenomations. Thirty-six percent of the patients were transported by air to the admitting facility. Eighty percent of patients were admitted to the intensive care unit for an average of 1.6 days. Total hospital stays averaged 2.8 days. Ninety percent of patients received antivenin, usually only on the day of admission. Of those receiving antivenin, 20 percent had an anaphylactoid reaction, and 1 percent required readmission for serum sickness. Laboratory evaluation indicated abnormalities in platelet count, coagulation parameters, and fibrinogen levels, but these rarely required treatment. Thirteen percent of patients underwent surgical intervention, including a 4 percent fasciotomy rate, and a single amputation. The use of field treatment, including "cut and suck," tourniquets, and cryotherapy, increased the likelihood of surgery. The authors concluded that the intensive care unit and helicopter transport system were overused. They recommend that established objective envenomation severity scores be used to dictate patient treatment, specifically the use of antivenin.

  18. Effects of the canine rattlesnake vaccine in moderate to severe cases of canine crotalid envenomation

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    Leonard MJ


    Full Text Available McGee J Leonard,1 Catherine Bresee,2 Andrew Cruikshank1 1Animal Specialty and Emergency Center, Los Angeles, CA, USA; 2The Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA Abstract: This is a retrospective multicenter study (2006–2012 examining a population of dogs with moderate to severe crotalid envenomation for protective effects of the canine rattlesnake vaccine. Five nonacademic emergency and referral veterinary hospitals in Southern California were involved in the study and contributed records regarding a total of 82 client-owned dogs that were treated for naturally occurring rattlesnake envenomation. All dogs received antivenin (Crotalidae polyvalent, with dosages ranging from one to three vials (mean: 1.3±0.6. Fourteen dogs (17% had a history of prior vaccination against crotalid venom. In univariate logistic regression modeling, cases with lower body weight (P=0.0001 or higher snakebite severity scores (P<0.0001 were associated with greater morbidity. No statistically significant difference in morbidity or mortality between vaccinated and unvaccinated dogs was found. The findings of this study did not identify a significantly protective effect of previous vaccination in the cases of moderate to severe rattlesnake envenomation that require treatment with antivenin. Keywords: rattlesnake envenomation, vaccine, antivenin, canine

  19. Dynamic changes of horse serum T-globulin immunization with snake venoms, tetanus and diphtheria toxoids. (United States)

    Lee, H F; Lee, J D; Lee, Y C


    In course of immunizing horses with snake venoms, tetanus and diphtheria toxoids, a new serum component, T-globulin, was formed and migrated between the beta- and gamma-globulins. The T-globulin content was parallel with the antibody titre after the middle course of immunization. There were many components in snake antivenin and T-globulin was composed of most of those components. The components of diphtheria T-globulin were the same as those of crude antitoxin and tetanus T-globulin except one precipitin.

  20. Progress and improvement of the manufacturing process of snake antivenom

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    Zolfagharian H.


    Full Text Available Antivenoms have been used successfully for more than a century and up to now constitute the only effectivetreatment for snakebites .The production of antivenin started long time ago when the calmette was preparedthe antivenom in 1894.The method currently used to prepare antivenom by most of the manufacturers areoriginated from the method of Pope which was develop in 1938. Several new approaches in the production ofantivenom have been proposed to produce IgG, F(ab2, F(ab antivenin to improve their quality .Theseimprovement include complete or partial modification in the antivenom production regarding animal,immunization protocols , new adjuvants in hyperimmunization of animals , purification processes ( caprylicacid ,chromatography , diafiltration and ulterafiltration ,enzymatic digestion of IgG (pepsin, papain andfractionation of venom .When the IgG is digested enzymatically, different fragments are obtained depending on the enzyme used, that is, if papain is used, three fragments are obtained, the crystallizing fragment (Fc and two antigen-binding fragments F(ab and, if pepsin is used, one F(ab'2 fragment is obtained, while thecrystallizing fragment is digested. Fab and F(ab2 fragments conserve their capacity to specifically bind to the antigen that gave rise to them.

  1. Management of Poisonous Snake Bites in Southern Taiwan

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    Kao-Ping Chang


    Full Text Available Snake bite envenomation is not uncommon in Taiwan. This study focuses on the pattern of poisonous snake bites and their management in southern Taiwan over a 5-year period. The case histories of 37 patients with poisonous snake bites admitted to the Kaohsiung Medical University Hospital between June 2001 and July 2005 were analyzed retrospectively. Three patients, bitten by unknown species of venomous snakes, were excluded from this study. The frequency of snake bites from each species of snake, the local and systemic manifestations of snake bite, treatment of complications and final outcomes were analyzed. Of the remaining 34 patients, 11 (32.4% were bitten by bamboo vipers, 10 (29.4% by Russell's pit vipers, 8 (23.5% by Taiwan cobras and 5 (14.7% by Taiwan Habu. The majority of snake bites (28 occurred between May and November. Those affected were mainly outdoor hikers (14 and workers (9. The antivenin requirements for treatment in the emergency room were in accordance with standard procedures. No mortality was noted among those envenomed by poisonous snakes. Although poisonous snake bite is not a common life-threatening emergency in the study area, we observed both an environmental risk and a seasonal incidence of snake bite. Keeping the varied clinical manifestations of snake bite in mind is important for effective management. Ready availability and appropriate use of antivenin, close monitoring of patients, institution of ventilatory support and early referral to a larger hospital when required, all help reduce mortality.

  2. Snake Venom PLA2, a Promising Target for Broad-Spectrum Antivenom Drug Development

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    Huixiang Xiao


    Full Text Available Snakebite envenomation is a neglected global health problem, causing substantial mortality, disability, and psychological morbidity, especially in rural tropical and subtropical zones. Antivenin is currently the only specific medicine for envenomation. However, it is restricted by cold storage, snakebite diagnosis, and high price. Snake venom phospholipase A2s (svPLA2s are found in all kinds of venomous snake families (e.g., Viperidae, Elapidae, and Colubridae. Along with their catalytic activity, svPLA2s elicit a wide variety of pharmacological effects that play a pivotal role in envenomation damage. Hence, neutralization of the svPLA2s could weaken or inhibit toxic damage. Here we overviewed the latest knowledge on the distribution, pathophysiological effects, and inhibitors of svPLA2s to elucidate the potential for a novel, wide spectrum antivenom drug targeting svPLA2s.

  3. Clinical Aspects and Emergent Management of Snake Bites Presented to Emergency Department

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    Bedriye Sonmez


    Full Text Available Aim: Evaluating the epidemiologic characteristics and management of snake bites presenting to emergency departments. Material and Method: In this retrospective study 74 cases of snakebites admitted to Emergency Department of Diyarbakir Training and Research Hospital between 2008 and 2009 were retrospectively evaluated. Results: Fourty-six (62.2% of patients were male and 28 (37.8% were female. Mean age of the study population was 34.85±19.17 (min 7- max 80 years. Most of the snakebites occurred between 18.00 to 06.00 hours and at home (73%. 79.7% of snake bites occurred to upper extremities. %93 of cases had intravenous administration of antivenin (one dose. Neither none of the patients needed recurrent administration. Discussion: Snake bites are still a major public health problem especially in rural areas. Particularly emergency care physicians should be adequately capable and sophisticated in multidisciplinary management of snake bites.

  4. A review of chemistry and biological activities of the genus Aerva--a desert plant. (United States)

    Chawla, Payal; Chawla, Amit; Vasudeva, Neeru; Sharma, Surendra Kumar


    There are approximately 28 species of Aerva genus, but only a few species are medicinal of which A. persica, A. lanata and A. javanica are of great value. A number of flavonol glycosides (e.g., aervanone, kaempferol-3-galactoside, isorhamnetin-3-O-β-D-glucoside) have been reported from Aerva persica as major phytoconstituents and the minor constituents are β-cyanins (glycine betaine and trigonelline), sterols and carbohydrates. This plant is used as medicinal herb in several traditional systems of medicine all over the world, like diuretic, demulcent, purgative, emetic and tinder. Aerva plants are used to cure ulcer, lithiasis, dropsical affections, eye affection, toothache, headache, in disorders of abdomen and inflammation of internal organs. Roots and flowers are reported to possess hypoglycemic, antioxidant, anthelmintic, analgesic, antimalarial, antivenin activities and medicinal properties against rheumatism and kidney troubles.

  5. Antibodies against Venom of the Snake Deinagkistrodon acutus. (United States)

    Lee, Chi-Hsin; Lee, Yu-Ching; Liang, Meng-Huei; Leu, Sy-Jye; Lin, Liang-Tzung; Chiang, Jen-Ron; Yang, Yi-Yuan


    Snake venom protein from Deinagkistrodon acutus (DA protein), one of the major venomous species in Taiwan, causes hemorrhagic symptoms that can lead to death. Although horse-derived antivenin is a major treatment, relatively strong and detrimental side effects are seen occasionally. In our study, yolk immunoglobulin (IgY) was purified from eggs, and DA protein was recognized using Western blotting and an enzyme-linked immunosorbent assay (ELISA), similar to therapeutic horse antivenin. The ELISA also indicated that specific IgY antibodies were elicited after the fifth booster, plateaued, and lasted for at least 3 months. To generate monoclonal single-chain variable fragment (scFv) antibodies, we used phage display technology to construct two libraries with short or long linkers, containing 6.24 × 10(8) and 5.28 × 10(8) transformants, respectively. After four rounds of biopanning, the eluted phage titer increased, and the phage-based ELISA indicated that the specific clones were enriched. Nucleotide sequences of 30 individual clones expressing scFv were analyzed and classified into four groups that all specifically recognized the DA venom protein. Furthermore, based on mass spectrometry, the scFv-bound protein was deduced to be snake venom metalloproteinase proteins. Most importantly, both IgY and mixed scFv inhibited the lethal effect in mice injected with the minimum lethal dosage of the DA protein. We suggest that together, these antibodies could be applied to the development of diagnostic agents or treatments for snakebite envenomation in the future. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  6. Snake bite envenomation in Riyadh province of Saudi Arabia over the period (2005–2010) (United States)

    Al-Sadoon, Mohammed K.


    The present investigation is a retrospective review of snake bites in Riyadh province over the period (2005–2010). A total of 1019 cases of bites admitted to the Ministry of Health medical centers in Riyadh province were analyzed on the basis of age, sex, time of bite and its site on the body, outcome of treatment, antiserum dose and type of snake. Bites occurred throughout the six years with the highest frequency in 2005 and least in 2006 where most of the bite cases were mild and all evolved to cure except four patients who died following the administration of antivenom during 24 h after snake bite. Most of the patients were males (81.7%) and the most attacked age was within the range of 11–30 years (51.5%). All the bites were mainly in the exposed limbs and the most frequently bitten anatomical regions were the lower limbs (427 cases, 41.9%), principally the feet. The study incriminates Cerastes cerastes gasperettii in most of the bites indicating it as the snake of medical importance in Riyadh province. Also, the study indicates low degree of threat in spite of high rate of snake bites as a result of the availability of the medical facilities and the antivenin use in medical centers in Riyadh province. PMID:25737653

  7. Scorpion envenomation in children and its management

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    R V Bharath


    Full Text Available Introduction: The present study was aimed to describe our experience with epidemiological characteristics, management options, and outcome of scorpion envenomation in children. Materials and Methods: The present retrospective study was conducted at Narayana Medical College and Hospital. The epidemiologic details including geographical locality of the event, age distribution, gender, and sting sites were noted in all hospitalized children with scorpion bite injury. Results: During the study period, a total 52 children were managed for scorpion sting. Mean age was 8.87 years. Male children were commoner victims of scorpion sting. Scorpion sting had bimodal pattern. Prazocin was used in 25 children. There was evidence of pulmonary edema in 23 cases. Seven patients required elective ventilation, and 5 of them could be weaned off within 72 hours. Mean hospital stay was 3.69 days. Two children expired in the present series. Conclusion: In present study, there was bimodal distribution of the scorpion sting cases, male children were more affected, and almost all of them improved with good outcome. We did not use anti-venin in the present study. The data from the study will serve not only to create heightened public awareness about scorpion envenomation but also to develop public awareness strategies and preventive measures.

  8. Envenenamiento de Chelydra serpentina (Reptilia: Testudines por Tityus trivittatus (Scorpionida: Buthidae Envenomation of Chelydra serpentina (Reptilia: Testudines by Tityus trivittatus (Scorpionida: Buthidae

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    Adolfo R de Roodt


    Full Text Available Se describe el caso de un ejemplar de tortuga mordedora (Chelydra serpentina que fue hallada con los miembros tetanizados en extensión, midriasis y poca respuesta a estímulos externos, en cuyo recinto se encontró un ejemplar de escorpión Tityus trivittatus. Ante el claro cuadro de envenenamiento, se trató al quelonio con antiveneno escorpiónico específico retornando a un estado de relajación muscular a las seis horas y encontrándoselo totalmente normal a las 24 horas sin mostrar secuelas posteriores. Este es el primer comunicado sobre el envenenamiento de quelonios por escorpiones. Se discuten algunos aspectos de este envenenamiento escorpiónico y su tratamiento con antiveneno específico.We report the case of a snapping turtle (Chelydra serpentina found tetanized, with the limbs in extension, mydriasis and poor response to external stimuli, in whose terrarium was found a Tityus trivittatus scorpion. Based on the clear clinical picture of envenoming, the turtle was treated with a specific scorpion antivenin, returning to a state of muscle relaxation after six hours of treatment and it was found totally normal at 24 hours, without envenoming sequelae. This is the first report on turtle envenomation by scorpion. The scorpion envenomation in reptiles and the treatment with specific antivenom is discussed.

  9. Enzymatic Analysis of Iranian Echis carinatus Venom Using Zymography. (United States)

    Kamyab, Mostafa; Kim, Euikyung; Hoseiny, Seyed Mehdi; Seyedian, Ramin


    Snakebite is a common problem especially in tropical areas all over the world including Iran. Echis carinatus as one of the most dangerous Iranian snakes is spreading in this country excluding central and northwest provinces. In this study gelatinase and fibrinogenolytic properties as two disintegrating matrix metalloproteinase enzymes were evaluated by a strong clear halo between 56-72 kDa in addition to another band located 76-102 kDa for gelatinase and one major band around 38 kDa for fibrinogenolytic enzyme respectively. The electrophorectc profile of our venom demonstrated at least one protein band between 24-31 kDa like previous reports and another two bands between 52-76 kDa and below 17 kDa stemmed probably due to the effect of natural selection in one species. According to our results Razi institute antivenin could neutralize in-vitro effects of gelatinase enzyme comprehensively. The electrophoretic profile of Iranian commercial antivenom as the main intravenous treatment of envenomed patients showed impurities in addition to F (ab') 2 weighing 96 kDa in SDS-PAGE analysis. It proposes more efforts for refinement to avoid short and long unwanted effects in envenomed patients.

  10. Inventing an arsenal: adaptive evolution and neofunctionalization of snake venom phospholipase A2 genes

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    Lynch Vincent J


    Full Text Available Abstract Background Gene duplication followed by functional divergence has long been hypothesized to be the main source of molecular novelty. Convincing examples of neofunctionalization, however, remain rare. Snake venom phospholipase A2 genes are members of large multigene families with many diverse functions, thus they are excellent models to study the emergence of novel functions after gene duplications. Results Here, I show that positive Darwinian selection and neofunctionalization is common in snake venom phospholipase A2 genes. The pattern of gene duplication and positive selection indicates that adaptive molecular evolution occurs immediately after duplication events as novel functions emerge and continues as gene families diversify and are refined. Surprisingly, adaptive evolution of group-I phospholipases in elapids is also associated with speciation events, suggesting adaptation of the phospholipase arsenal to novel prey species after niche shifts. Mapping the location of sites under positive selection onto the crystal structure of phospholipase A2 identified regions evolving under diversifying selection are located on the molecular surface and are likely protein-protein interactions sites essential for toxin functions. Conclusion These data show that increases in genomic complexity (through gene duplications can lead to phenotypic complexity (venom composition and that positive Darwinian selection is a common evolutionary force in snake venoms. Finally, regions identified under selection on the surface of phospholipase A2 enzymes are potential candidate sites for structure based antivenin design.

  11. Aspectos epidemiológicos e clínicos dos acidentes ofídicos ocorridos nos municípios do Estado do Amazonas Epidemiological and clinical aspects of snake accidentes in the municipalities of the State of Amazonas, Brazil

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    Célio Campos Borges


    municipality (70.2%. The local signs and symptoms most frequently observed in those who received medical care more than 6 hours after the accident (57.3% were edema (76.9%, pain (68.7%, erithema (10.2% and hemorrhage (9.3%. The systemic manifestation most frequently observed was hemorrhage (18.8%. Serotherapy was administered in only 65.9% of patients, the intravenous route being the route most commonly used to administer the antivenin (52.3%, while other non- recommended routes were widely used. In the majority of patients the antivenin given was antibotropic. The most frequent complications were: abscess 13.7%, necrosis 12.3%, secondary infection 8.3%, renal insufficiency 2.5% and gangrene 2.5%. The medical procedures most used in the treatment of these complications were drainage 52.6%, debridement 28.9%, amputation 10.5%, surgical cleaning 5.3% and peritoneal dialysis 2.6%. The fatality rate was 1%.

  12. Evaluation of Snake Bites with Bedside Ultrasonography

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    Josef E Jolissaint


    Full Text Available History of present illness: While watering his lawn, a 36-year-old man felt two sharp bites to his bilateral ankles. He reports that he then saw a light brown, 2-foot snake slither away from him. He came to the emergency department because of pain and swelling in his ankles and inability to bear weight. Physical examination revealed bilateral ankle swelling and puncture marks on his left lateral heel and medial right ankle. Palpation, passive flexion and extension elicited severe pain bilaterally. Blood work including prothrombin time (PT, partial thromboplastin time (PTT, international normalized ratio (INR, and fibrinogen were within normal limits. Consultation with Poison Control indicated the snake was likely a copperhead, which is a venomous snake whose bites rarely require antivenin. Significant findings: In this case, ultrasonography of the lateral surface of the left foot revealed soft tissue edema (red arrow and fluid collection (white asterisk adjacent to the extensor tendon (white arrow. The edematous area resembles cobblestones, with hypoechoic areas of fluid spanning relatively hyperechoic fat lobules. The tendon is surrounded by anechoic fluid, expanding the potential space in the sheath. No hyperechoic foreign objects were noted. Discussion: The patient was diagnosed with soft tissue injury and extensor tenosynovitis after a snake envenomation. Snake venom contains metalloproteinases and other enzymatic proteins that cause local tissue edema and necrosis.1 After a snake bite, ultrasound can be used to assess for retained fangs, soft tissue edema, tendon sheath fluid, muscle fasciculation, and injury to deeper musculature that may not be readily apparent on physical exam.2,3 Most patients with tenosynovitis will recover with immobilization of the joint and non-steroidal anti-inflammatory medications.4 Rarely, the tendon may become infected requiring antibiotics and surgical intervention.4 Topics: Ultrasound, snake envenomation

  13. Review of Eastern coral snake (Micrurus fulvius fulvius) exposures managed by the Florida Poison Information Center Network: 1998-2010. (United States)

    Wood, A; Schauben, J; Thundiyil, J; Kunisaki, T; Sollee, D; Lewis-Younger, C; Bernstein, J; Weisman, R


    Envenomation by the Eastern coral snake is rare but may be associated with significant morbidity. While effective, acquisition of North American Coral Snake Antivenin (NACSAV) is difficult because production was discontinued for many years. The purpose of this study is to characterize coral snake exposures in Florida and determine the effects of varying treatment paradigms on patient outcomes. This study is an observational case series of cases received at Florida poison centers. Included cases were Eastern coral snake exposures occurring between January 1, 1998 and October 31, 2010. Excluded cases included those found to be unrelated or those not followed for at least 24 h post envenomation. Case comments were reviewed to obtain data. Comparisons were made between asymptomatic patients receiving empiric antivenom therapy (empiric group) and those asymptomatic patients who received antivenom upon developing signs of systemic envenomation (withhold group). Of the 553 cases identified, 387 were included in the final analysis. According to case comments, 56.3% of patients had no reported systemic symptoms. Most commonly, patients were reported to have pain (40.6%), paresthesias (28.4%), nausea (12.7%), and emesis (11.4%). NACSAV was administered to 252 patients (65%). Of those patients receiving NACSAV, 18.25% were reported to have had an adverse reaction. Patients in the withhold group (n = 106) had significantly fewer minor, moderate, and major outcomes than patients in the empiric group (n = 134, p < 0.01). While patients in the withhold group had favorable outcomes compared with those in the empiric group, this strategy cannot be applied to all patients presenting asymptomatic to healthcare facilities due to study limitations. Further studies are needed to determine what treatment strategy is most appropriate for asymptomatic patients presenting to healthcare facilities.

  14. Optimization and preliminary characterization of venom isolated from 3 medically important jellyfish: the box (Chironex fleckeri), Irukandji (Carukia barnesi), and blubber (Catostylus mosaicus) jellyfish. (United States)

    Wiltshire, C J; Sutherland, S K; Fenner, P J; Young, A R


    To optimize venom extraction and to undertake preliminary biochemical studies of venom from the box jellyfish (Chironex fleckeri), the Irukandji jellyfish (Carukia barnesi), and the blubber jellyfish (Catostylus mosaicus). Lyophilized crude venoms from box jellyfish tentacles and whole Irukandji jellyfish were prepared in water by homogenization, sonication, and rapid freeze thawing. A second technique, consisting of grinding samples with a glass mortar and pestle and using phosphate-buffered saline, was used to prepare crude venom from isolated nematocysts of the box jellyfish, the bells of Irukandji jellyfish, and the oral lobes of blubber jellyfish. Venoms were compared by use of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot test. Toxicity of some venoms was determined by intravenous median lethal dose assay in mice. Different venom extraction techniques produced significantly different crude venoms for both box and Irukandji jellyfish. Irukandji and blubber venom SDS-PAGE protein profiles were established for the first time. Analysis of Western blot tests revealed that box jellyfish antivenin reacted specifically with the venom of each jellyfish. Toxicity was found in Irukandji jellyfish venom derived by use of the mortar-and-pestle method, but not in the lyophilized venom. Glass mortar-and-pestle grinding and use of an appropriate buffer was found to be a simple and suitable method for the preparation of venom from each jellyfish species studied. This study contributes to biochemical investigations of jellyfish venoms, particularly the venom of the Irukandji jellyfish, for which there are, to our knowledge, no published studies. It also highlights the importance of optimizing venom extraction as the first step toward understanding the complex biological effects of jellyfish venoms.

  15. Human cytokine response to Texas crotaline envenomation before and after antivenom administration. (United States)

    Crocker, Patrick; Zad, Omid; Milling, Truman; Maxson, Todd; King, Benjamin; Whorton, Elbert


    the bite patients than in controls (all P values < .05). Crotaline venom produces a broad cytokine response in human bite victims. In particular, IL-4, myeloperoxidase, and Apo A-I and C3 levels remain altered despite antivenom therapy, whereas PAI-1 and regulated upon activation, normal t-cell expressed and secreted levels seem to normalize after antivenin as other markers are affected. Understanding this profile and further study of the markers identified might lead to improved therapies and better prognostic indicators. Copyright © 2010 Elsevier Inc. All rights reserved.

  16. Prospective evaluation of pain, swelling, and disability from copperhead envenomation. (United States)

    Roth, Brett; Sharma, Kapil; Onisko, Nancy; Chen, Tiffany


    In light of the existing controversy regarding antivenin treatment for copperhead envenomation, a more detailed analysis of the disability from this species is needed. Our objective was to prospectively determine the duration of pain, swelling, and functional disability, i.e., residual venom effects, in patients with copperhead envenomation. Patients with venomous snakebite reported to the North Texas Poison Center between April 2009 and November 2011 were assessed. Patients with confirmed envenomations were contacted by a specialist in poison information. Day zero was the day of the bite and verbal phone consent for study enrollment was obtained at that time. The patient (or their guardian) was contacted by phone daily thereafter, and asked to rate their pain, edema/swelling, and disability using the modified DASH and LEFS scales. Patients were followed to resolution of all symptoms or return to baseline. About 104 cases of venomous snakebite were followed; of which 17 were excluded due to being a dry bites (5) or for having insufficient data during follow-up (11) or due to coagulopathy (1). Overall, residual venom effects from copperhead bites for most patients last between 7 and 13 days. Median time to complete pain resolution was 7 days (mean = 10.7 days). Median length of time to resolution of swelling was 10 days (mean = 13 days) and median length of time to resolution of functional disability was 9 days (mean = 12.2 days). Residual venom effects from copperhead envenomation in this study had a slightly shorter duration than some other studies. Data are skewed due to outliers where residual venom effects lasted for up to 89 days. Initial reoccurrence of some symptoms may be seen. Antivenom (AV) is currently being used for a large percentage of patients with copperhead envenomation. Finally, no differences in duration of venom effects were seen based on age or location of bite. Our study suggests that residual venom effects from copperhead

  17. Indigenous knowledge of medicinal plants used by Saperas community of Khetawas, Jhajjar District, Haryana, India

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    Kumar Sunil


    snake charming is banned in India as part of efforts to protect India's steadily depleting wildlife, this knowledge is also rapidly disappearing in this community. Such type of ethno botanical studies will help in systematic documentation of ethno botanical knowledge and availing to the scientific world plant therapies used as antivenin by the Saperas community.

  18. Mordedura de Serpiente en Niños en el Hospital Universitario Ramón González Valencia (1983-1993

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    Gerardo González V.


    medicine section of the Ramón González Valencia Universitary Hospital in Bucaramanga (Colombia from 1983 – 1993.40 children with diagnosis of snake bite were selected. Resulte: The major frecuency was found in the school age with a little male predominance. 95% of children carne from the rural area. The most snake genus was Bothrops (85%, we had just one case for Micrurus and the rest of them were not identified. 91%of the snake hites were in feet and legs distal thirC:. 65% of people assist for medical attention in the first 24 hours. Every patient had eye-teeth marks, and localized oedema and pain in the bite; most common haemorrhagic manifestations were ecchymosis (80% and gingival bleeding. 69% of cases were Grade II and lII. 33% of them had complicationsj the most common one was Disseminated Intravascular Coagulation. We found.prolongued PT and PTT in 85% and 63% of cases respectively. BC was not specific. 97.5% of our children received especific antivenin for treatment, 28% transfusions and 100% antibiotic and antitetanic prophylaxis.

    Hospitalization average days were 5. Three of our patients (7.5% had sorne sequel andjust one died.
    In conclussion there not be a good education in the community on risk about appropiatte use of shoes,
    first aid, avoidiry empire treatments that to yatrogene and inmediately a consultation to the nearest clinical center should be done. The medical and paramedical personnel should be prepared about attention of patients with snake bite. It was included a protocol for the management, easy to apply in our health centers.