Cross neutralization of Hypnale hypnale (hump-nosed pit viper) venom by polyvalent and monovalent Malayan pit viper antivenoms in vitro and in a rodent model

Tan, Choo Hock; Leong, Poh Kuan; Fung, Shin Yee; Sim, Si Mui; Ponnudurai, Gnanajothy; Ariaratnam, C. A.; Khomvilai, Sumana; Sitprija, Visith; Tan, Nget Hong

doi:10.1016/j.actatropica.2010.11.001

Cited by 53 publications

(65 citation statements)

References 13 publications

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“…hypnale venom has an intraperitoneal median lethal dose (LD 50 ) of 6.0 µg/g (95% CI 4.2-8.1 µg/g) of mouse body weight, which is intermediate between the intravenous LD 50 (0.9 µg/g) and the intramuscular LD 50 (13.7 µg/g) reported by our research group in an earlier study (23). This suggests that the potency of toxins causing lethality differs depending on the administration route.…”

Section: Lethality Of the Venommentioning

confidence: 97%

“…Recent clinical studies indicated that envenomation by this snake resulted in local edema, necrosis, regional lymphadenopathy, as well as systemic effects characterized by hemostatic dysfunction (coagulopathy, fibrinolysis, thrombocytopenia, spontaneous systemic hemorrhage) and acute renal failure, with an overall fatality rate of 1.7% in authenticated cases (11,12,(19)(20)(21)(22). To date, apart from the Calloselasma rhodostoma antivenoms (produced by the Thai Red Cross Society) which were shown to confer paraspecific neutralization in rodent models, there is no specific antivenom that is clinically effective against the H. hypnale venom (11,12,23).…”

Section: +mentioning

confidence: 99%

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Enzymatic and toxinological activities of Hypnale hypnale (hump-nosed pit viper) venom and its fractionation by ion exchange high performance liquid chromatography

Tan¹,

Sim²,

Gnanathasan³

et al. 2011

J. Venom. Anim. Toxins incl. Trop. Dis

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Abstract:Hypnale hypnale (hump-nosed pit viper) has been recently identified as one of the medically important venomous snakes in Sri Lanka and on the southwestern coast of India. The characterization of its venom is essential for understanding the pathophysiology of envenomation and for optimizing its management. In the present study, the biological properties of Hypnale hypnale venom and venom fractions obtained using Resource Q ion exchange chromatography were determined. The venom exhibited toxic activities typical of pit viper venom, comparable to that of its sister taxon, the Malayan pit viper (Calloselasma rhodostoma). Particularly noteworthy were its high activities of thrombin-like enzyme, proteases, phospholipase A 2 , L-amino acid oxidase and hyaluronidase. The thrombin-like enzyme was mainly acidic and distributed over several chromatography fractions, indicating its existence in multiple isoforms. The hemorrhagic and necrotic activities of the venom were likely associated with the proteolytic enzyme found mainly in the basic fraction. Phospholipase A 2 and phosphomonoesterase exist in both acidic and basic isoforms, while L-amino acid oxidase and hyaluronidase are highly acidic. The venom clotting activity on fibrinogens showed distinct species specificity in the following increasing order for clotting time: bovine < rabbit < goat < human < horse < < dog, and was comparable to that of C. rhodostoma venom. Its clot formation on human fibrinogen is gradual and prolonged, a phenomenon suggestive of consumptive coagulopathy as a complication observed clinically. At an intramuscular sublethal dose, the venom did not cause acute kidney injury in a rodent model, contrary to the positive control group treated with Daboia russelii venom. Nephrotoxicity may result from higher venom doses in the context of coagulopathy, as a complication provoked by venom hematoxicity.

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Section: Lethality Of the Venommentioning

confidence: 97%

Section: +mentioning

confidence: 99%

Enzymatic and toxinological activities of Hypnale hypnale (hump-nosed pit viper) venom and its fractionation by ion exchange high performance liquid chromatography

Tan¹,

Sim²,

Gnanathasan³

et al. 2011

J. Venom. Anim. Toxins incl. Trop. Dis

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“…Thai Red Cross Malayan Pit Viper antivenom because of the close phylogenetic relationship between H. hypnale and C. rhodostoma may be useful in the treatment of hump nosed viper bite [10,21]. This however is not available in Sri Lanka.…”

Section: Discussionmentioning

confidence: 99%

Can Fresh Frozen Plasma Prevent Acute Kidney Injury after Hump-Nosed Viper Bite?

Sellahewa¹

2013

OJNeph

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Hump-nosed viper bite is the commonest venomous snakebite in Sri Lanka. Acute kidney injury (AKI) in association with coagulopathy is an important cause of mortality. Immunomodulating effects of fresh frozen plasma (FFP) could block the nephrotoxic effects of venom; and by replenishing depleted clotting factors resulting from venom induced consumption coagulopathy could offer an additional benefit in offsetting renal injury triggered by haematological disturbances. In a non-randomised observational study carried out from 2005 to 2008 in adults at the National hospital of Sri Lanka, the mean time for resolution of coagulopathy among 42 patients treated with FFP at the inception of coagulopathy was 4.7 hours compared to 18 patients treated with isotonic Saline among whom the mean time for normalisation of coagulopathy was 6.2 hours. None of these 60 patients developed acute renal failure. A separate cohort of 32 patients with coagulopathy after hump-nosed viper bite who had not received FFP during this study period developed acute renal failure and required haemodialysis. In the absence of safe and effective antivenom for hump-nosed viper in Sri Lanka, FFP may be a therapeutic option. FFP if given early to selected patients at inception of coagulopathy may prevent AKI and serve to save lives after hump-nosed viper bites.

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“…Tan et al [25] have shown that Thai Red Cross Malayan Pit Viper antivenom because of the close phylogenetic relationship between H. hypnale and C. rhodostoma could be useful in the treatment of hump nosed viper bite [25]. This antivenom however is not available in Sri Lanka.…”

Section: Treatment Of Envenomationmentioning

confidence: 99%

Hump-nosed Pit Viper Bite in Sri Lanka?Unravelling an Enigma

Sellahewa¹

2013

J Trop Dis

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Cross neutralization of Hypnale hypnale (hump-nosed pit viper) venom by polyvalent and monovalent Malayan pit viper antivenoms in vitro and in a rodent model

Cited by 53 publications

References 13 publications

Enzymatic and toxinological activities of Hypnale hypnale (hump-nosed pit viper) venom and its fractionation by ion exchange high performance liquid chromatography

Enzymatic and toxinological activities of Hypnale hypnale (hump-nosed pit viper) venom and its fractionation by ion exchange high performance liquid chromatography

Can Fresh Frozen Plasma Prevent Acute Kidney Injury after Hump-Nosed Viper Bite?

Hump-nosed Pit Viper Bite in Sri Lanka?Unravelling an Enigma

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