An affinity purified ovine antivenom for the treatment of Vipera berus envenoming

Smith, Daniel; Reddi, Krisana; Laing, G.D.; Theakston, R.G.David; Landon, J.

doi:10.1016/0041-0101(92)90384-h

Cited by 75 publications

(27 citation statements)

References 8 publications

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“…30 These high levels of IgG may explain why sheep often produce relatively high levels of specific antibodies (e.g., 7-15 g/L) to an immunogen. 31 The size of sheep also helps ensure their suitability for scaling-up the procedure to produce antivenoms commercially. 32,33 Levels of the venom-specific antibodies were consis- tently greater using the highest immunogen concentration (4 mg/sheep), so that the optimum immunization dose may not have been reached.…”

Section: Discussionmentioning

confidence: 99%

A novel Fab-based antivenom for the treatment of mass bee attacks.

Jones

Corteling²,

Bhogal³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. The frequency of mass bee attacks has dramatically increased in the Americas following the introduction and spread of the aggressive Africanized 'killer' bee (Apis mellifera scutellata). As yet no specific therapy is available, which led us to develop an ovine Fab-based antivenom as a potential new treatment. Sera from sheep immunized against the venom contained high levels of specific antibodies, as demonstrated by ELISA and by small-scale affinity chromatography, against both whole (A. m. mellifera) venom and purified melittin. A nerve muscle preparation was used to show the myotoxic effects of the venom and neutralization by the antivenom. Antivenom neutralizing ability was also demonstrated using assays for venom phospholipase A 2 and in vivo activities. Venom from both European and Africanized bees appeared identical when analyzed by acid-urea gel electrophoresis. This antivenom may therefore provide the first specific therapy for the treatment of mass envenomation by either European or Africanized 'killer' bees.The accidental introduction of the native African bee Apis mellifera scutellata into Brazil in 1957 and its subsequent displacement and hybridization of the long-established European bees A. m. mellifera and A. m. ligustica has resulted in the highly aggressive Africanized 'killer' bee. 1,2 It is better adapted to warmer climates than its European counterparts and, as a result, has been highly successful and spread rapidly throughout Latin America. In 1992, the Africanized bee crossed the border into the United States and is now found in Texas, Arizona, New Mexico, and southern California. 3 It is predicted to eventually be distributed as far east as North Carolina. 2 These bees attack much more readily and in greater numbers than the European varieties, 1 and thousands of stings may be inflicted on a single individual. 4,5 About 50 simultaneous stings can cause systemic envenoming and about 500 are probably necessary to cause death by direct toxicity, 4,6-10 although one death in Arizona was due to only ϳ125 stings. 11 By 1985, it was estimated that these bees had caused between 700 and 1,000 deaths, 12 and in Mexico there have been more than 190 such deaths between 1988 and 1993, with future estimates of 60 deaths per year. 13 Clinical features can include rhabdomyolysis, intravascular hemolysis, respiratory distress, hepatic dysfunction, hypertension, myocardial damage, shock, and/or renal failure. 4,5,8,11 Each Africanized bee injects an average of 94 g of venom in less than a minute, compared with 147 g for the slightly larger European bee, and circulating venom levels in patients of up to 3.8 mg/L have been recorded. 4,14,15 The venom contains many biologically active components such as melittin, phospholipase A 2 , apamin, mast cell degranulating peptide, hyaluronidase, histamine, and dopamine. 16 Of these, melittin is predominant (ϳ50% by dry weight) and can disrupt cell membranes and produce pores even at low concentrations. 16,17 Phospholipase A 2 enhances this membrane disruptio...

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Section: Discussionmentioning

confidence: 99%

A novel Fab-based antivenom for the treatment of mass bee attacks.

Jones

Corteling²,

Bhogal³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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“…Sampling of blood and urine for analyses of V. berus venom was done in six patients before or after treatment with ovine Fab antivenom (ViperaTAb, Protherics, UK) (11,32). The analyses were performed with a radioimmunoassay (31).…”

Section: Kinetic Datamentioning

confidence: 99%

A Nationwide Study ofVipera BerusBites During One Year—Epidemiology and Morbidity of 231 Cases

Karlson-Stiber¹,

Salmonson²,

Persson³

2006

Clinical Toxicology

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“…The first example of an Fab therapeutic antibody was Digibind (Glaxo Wellcome, Uxbridge, United Kingdom), which has been used effectively and safely in many patients with digoxin toxicity. 12 OvineFab antitoxins have been used to treat systemic envenoming by the European adder (Vipera berus), 13,14 North American crotalids, 15 Nigerian saw-scaled or carpet viper (Echis ocellatus), 16 and to treat colchicine poisoning. 17 Raising antivenoms in sheep rather than horses has a number of advantages.…”

mentioning

confidence: 99%

A new monospecific ovine Fab fragment antivenom for treatment of envenoming by the Sri Lankan Russell's viper (Daboia Russelii Russelii): a preliminary dose-finding and pharmacokinetic study.

Ariaratnam¹,

Meyer²,

Perera³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. Russell's viper is the most important cause of life-threatening snake bite and acute renal failure in Sri Lanka. Only equine polyspecific antivenoms imported from India are available. They have not proved effective clinically or in clearing venom antigenemia and they frequently cause reactions. In an attempt to reduce mortality and morbidity, a new monospecific ovine Fab fragment antivenom (PolongaTab ; Therapeutic Antibodies, Inc., London, United Kingdom) was raised against Sri Lankan Russell's viper venom. In a preliminary dose-finding study in 35 patients, an initial dose of 3-4 g restored blood coagulability permanently and stopped systemic bleeding, even in severely envenomed patients. Venom antigenemia disappeared within 1 hr of antivenom treatment but recurred, probably as a result of continued absorption of venom from the site of the bite, after the rapid clearance of therapeutic antibody. Twelve patients (34%) experienced early reactions that were usually mild and always responded to epinephrine.

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An affinity purified ovine antivenom for the treatment of Vipera berus envenoming

Cited by 75 publications

References 8 publications

A novel Fab-based antivenom for the treatment of mass bee attacks.

A novel Fab-based antivenom for the treatment of mass bee attacks.

A Nationwide Study ofVipera BerusBites During One Year—Epidemiology and Morbidity of 231 Cases

A new monospecific ovine Fab fragment antivenom for treatment of envenoming by the Sri Lankan Russell's viper (Daboia Russelii Russelii): a preliminary dose-finding and pharmacokinetic study.

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