Cardiovascular, haematological and neurological effects of the venom of the Papua New Guinean small-eyed snake (Micropechis ikaheka) and their neutralisation with CSL polyvalent and black snake antivenoms

Tibballs, James; Kuruppu, Sanjaya; Hodgson, Wayne Clarence; Carroll, T.; Hawdon, Gabrielle; Sourial, Magdy; Baker, Tim; Winkel, Kenneth D.

doi:10.1016/j.toxicon.2003.09.002

Cited by 13 publications

(9 citation statements)

References 13 publications

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“…monovalent) to neutralise the activity of venom from a different and often unrelated species. This phenomenon is not uncommon [6][7][8][9][10]. Minton (1967) examined the effect of various antivenoms manufactured by CSL Ltd through a series of LD 50 studies using mice and found that they were effective in neutralising a range of both Australian and exotic elapid venoms.…”

mentioning

confidence: 99%

Cross‐Neutralisation of the Neurotoxic Effects of Egyptian Cobra Venom with Commercial Tiger Snake Antivenom

Kornhauser

O’Leary

Mirtschin³

et al. 2012

Basic Clin Pharma Tox

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Cross-neutralisation has been demonstrated for haemorrhagic venoms including Echis spp. and Cerastes spp. and for Australia elapid procoagulant toxins. A previous study showed that commercial tiger snake antivenom (TSAV) was able to neutralise the systemic effects of the Egyptian cobra, Naja haje, in vivo but it is unclear if this was true cross-neutralisation. The aim of the current study was to determine whether TSAV can neutralise the in vitro neurotoxic effects of N. haje venom. Both Notechis scutatus (10 lg/ml) and N. haje (10 lg/ml) venoms caused inhibition of indirect (supramaximal V, 0.1 Hz, 0.2 msec.) twitches of the chick biventer cervicis nerve-muscle preparation with t 90 values (i.e. the time to produce 90% inhibition of the original twitch height) of 26 ± 1 min. (n = 4) and 36 ± 4 min.; (n = 4). This effect at 10 lg/ml was significantly attenuated by the prior addition of TSAV (5 U/ml). A comparison of the reverse-phase HPLC profiles of both venoms showed some similarities with peak elution times, and SDS-PAGE analysis elucidated comparable bands across both venoms. Further analysis using Western immunoblotting indicated TSAV was able to detect N. haje venom, and enzyme immunoassay showed that in-house biotinylated polyclonal monovalent N. scutatus antibodies were able to detect N. haje venom. These findings demonstrate crossneutralisation between different and geographically separated snakes supporting potential immunological similarities in snake toxin groups for a large range of snakes. This provides more evidence that antivenoms could be developed against specific toxin groups to cover a large range of snakes.Snake envenoming is an important public health problem in tropical and subtropical countries (e.g. Africa, Asia, Oceania and Latin America). Indeed, it has been estimated that at least 440,000 envenomings and 20,000 deaths occur annually [1]. The effects of systemic envenoming by elapid snakes may include neuromuscular paralysis, myotoxicity, coagulopathy and renal toxicity [2][3][4][5]. Local effects are often seen as well, such as severe pain, swelling and necrosis.The mainstay of treatment for systemic snake envenoming is the administration of either monovalent or polyvalent antivenom. Many underdeveloped countries, in which some of the deadliest snakes inhabit, do not have the resources and/or the financial means to stock, or facilitate the development of appropriate antivenoms. This necessitates the use of antivenoms that are not targeted against the species of snakes in that country. Antivenom paraspecificity, or antivenom crossneutralisation, refers to the ability of antivenom raised against a single species (i.e. monovalent) to neutralise the activity of venom from a different and often unrelated species. This phenomenon is not uncommon [6][7][8][9][10]. Minton (1967) examined the effect of various antivenoms manufactured by CSL Ltd through a series of LD 50 studies using mice and found that they were effective in neutralising a range of both Australian and exotic elapid ...

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mentioning

confidence: 99%

Cross‐Neutralisation of the Neurotoxic Effects of Egyptian Cobra Venom with Commercial Tiger Snake Antivenom

Kornhauser

O’Leary

Mirtschin³

et al. 2012

Basic Clin Pharma Tox

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“…Snake venom may also affect the haematologic, neurologic, renal, and cardiovascular systems. Signs may include diplopia, visual defects, and airway problems such as difficulty swallowing and opening of the mouth [21][22][23]. Monovalent horse antivenom therapy is generally used to treat snake bites in Turkey, but if the type of snake is not known, as generally is the case, specific anti-venom serum cannot be given.…”

Section: Discussionmentioning

confidence: 99%

“…Antivenom produced from sheep is less allergic than that from other sources but its availability may be a problem (not available in Turkey) [24]. Enzymes and low molecular weight peptides in the snake venom can also cause problems leading to coagulopathy [8,[19][20][21]. Neutralization of these peptides and enzymes with antivenom is generally warranted, because selective elimination of these molecules has proved impossible.…”

Section: Discussionmentioning

confidence: 99%

The use of therapeutic plasmapheresis in the treatment of poisoned and snake bite victims: An academic emergency department's experiences

et al. 2006

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The objective of this study is to describe the clinical status, procedural interventions, and outcomes of critically ill patients with poisoning and snake bite injuries presenting to a tertiary-care emergency department for treatment with therapeutic plasmapheresis. Records of 20 patients who presented to our academic emergency department over a 2-year period and who underwent plasmapheresis for poisoning or snake bite were retrospectively reviewed. Plasmapheresis was performed using centrifugation technology via an intravenous antecubital venous or subclavian vein catheter access. Human albumin or fresh frozen plasma were used as replacement fluids. Data extracted from the patient record included demographic data, clinical status, and outcome measures. Sixteen patients underwent plasmapheresis because of toxicity from snake bite. Three patients were treated for drug poisoning (phenytoin, theophylline, bipyridene HCl) and one patient for mushroom poisoning. Haematologic parameters such as platelet count, PT, and INR resolved rapidly in victims of snake bite injuries after treatment with plasmapheresis. Loss of limbs did not occur in these cases. Seven patients required admission to the intensive care unit. One patient with mushroom poisoning died. Mean length of hospital stay was 14.3 days (range 3-28 days) for all cases. Plasmapheresis was a clinically effective and safe approach in the treatment of snake bite envenomation and other drug poisoning victims especially in the management of hematologic problems and in limb preservation/salvage strategies. In addition to established conventional therapies, emergency physicians should consider plasmapheresis among the therapeutic options in treatment strategies for selected toxicologic emergencies.

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“…A porcine model was chosen by considerations of availability, cost, acceptability to the institutional animal review committee for experimental study, the expectation that venom toxicity is similar to that seen in humans, and literature supporting its use. [35][36][37][38] The university animal care use committee approved the study. Subjects were 12 pigs ranging from 9.1 kg to 11.4 kg.…”

Section: Methodsmentioning

confidence: 99%

Pressure-Immobilization Bandages Delay Toxicity in a Porcine Model of Eastern Coral Snake (Micrurus fulvius fulvius) Envenomation

German

Hack

Brewer

et al. 2005

Annals of Emergency Medicine

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Cardiovascular, haematological and neurological effects of the venom of the Papua New Guinean small-eyed snake (Micropechis ikaheka) and their neutralisation with CSL polyvalent and black snake antivenoms

Cited by 13 publications

References 13 publications

Cross‐Neutralisation of the Neurotoxic Effects of Egyptian Cobra Venom with Commercial Tiger Snake Antivenom

Cross‐Neutralisation of the Neurotoxic Effects of Egyptian Cobra Venom with Commercial Tiger Snake Antivenom

The use of therapeutic plasmapheresis in the treatment of poisoned and snake bite victims: An academic emergency department's experiences

Pressure-Immobilization Bandages Delay Toxicity in a Porcine Model of Eastern Coral Snake (Micrurus fulvius fulvius) Envenomation

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