Successful Treatment of Crotalid-Induced Neurotoxicity With a New Polyspecific Crotalid Fab Antivenom

Clark, Richard F.; Williams, Saralynn R; Nordt, Sean Patrick; Boyer, Leslie V.

doi:10.1016/s0196-0644(97)70111-2

Cited by 66 publications

(45 citation statements)

References 11 publications

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“…Data extracted from the electronic records of the PCS included patient age, gender, month of bite, anatomic locations of the bite and fasciculations, interventions and therapies, and outcome severity. Our PubMed literature review also revealed 10 other previously published cases (3,4,6,8). These results are summarized in Table 1.…”

Section: Resultssupporting

confidence: 61%

Fasciculations after rattlesnake envenomations: A retrospective statewide poison control system study

Vohra

Cantrell

Williams

2008

Clinical Toxicology

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Section: Resultssupporting

confidence: 61%

Fasciculations after rattlesnake envenomations: A retrospective statewide poison control system study

Vohra

Cantrell

Williams

2008

Clinical Toxicology

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“…17 The North American C scutulatus scutulatus (Mojave rattlesnake) is reported to cause significant clinical neurotoxicity from a similar toxin, Mojave toxin. 18 It is possible this component of FabAV explains the immunologic cross-reactivity and subsequent decreased lethality in the C durissus terrificus envenomation arm of our murine model. These reports and others 19,20 provide evidence for extensive immunochemical similarities among various North and South American crotaline venoms.…”

Section: Discussionmentioning

confidence: 92%

Crotalidae Polyvalent Immune Fab (Ovine) Antivenom Is Effective in the Neutralization of South American Viperidae Venoms in a Murine Model

Richardson¹,

Tanen²,

Tong³

et al. 2005

Annals of Emergency Medicine

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“…19 Clark et al reported that Fabs were effective in reversing neurotoxicity associated with crotalid bites. 20 Internationally, Fabs are currently being investigated as antidotal therapy for the West African carpet viper (Echis ocellatus), 35 Northern Europe common adder (Vipera berus), 36 and a Mexican scorpion species (Centruroides noxius Hoffmann). 37 …”

Section: Discussionmentioning

confidence: 99%

“…14 Fab fragments have been developed to treat a variety of conditions, including digoxin 15 colchicine, 16 tricyclic antidepressant, 17 and phencyclidine overdoses 18 as well as Crotalidae snakebites. 19,20 In order to improve safety and efficacy in humans, intact IgG Ab is cleaved with papain, yielding two antigen-binding Fabs, each with a molecular weight of approximately 50,000 daltons and one Fc fragment. 21 Since the Fc fragment does not bind antigen, and it increases the potential for hypersensitivity reactions, it is eliminated.…”

mentioning

confidence: 99%

Intradermal Anti‐Loxosceles Fab Fragments Attenuate Dermonecrotic Arachnidism

Gomez

Miller

Trachy

et al. 1999

Academic Emergency Medicine

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Abstract. Objective: Bites from the brown recluse spider and other arachnids from the genus Loxosceles frequently induce necrotic skin lesions that can be recalcitrant to treatment and disfiguring. The authors used a rabbit model of dermonecrotic arachnidism to address the therapeutic efficacy of intradermal (id) polyclonal anti-Loxosceles Fab fragments (␣Loxd Fab) raised against Loxosceles deserta spider venom. Methods: Fab fragments were prepared by papain digestion and affinity chromatography from the IgG fraction of L. deserta antivenom raised in rabbits. Eighteen inbred New Zealand white rabbits were assigned to six groups of three. The rabbits received L. deserta venom (3 g, id) injections into each flank. Cohorts of rabbits received single id injections (at one venom site/rabbit) of 30 g ␣Loxd Fab at different times (T = 0, 1, 2, 4, 8, and 12 hours) after venom injection. In each rabbit the opposite flank was left untreated. As an additional control, one group of rabbits (T = 0) received nonspecific Fab (30 g, id) in the opposite flank. Dermal lesions were quantified as a function of time through the use of a series of digital photographs and imaging software. In addition, myeloperoxidase (MPO) activity, a measure of neutrophil accumulation, was determined in lesion biopsies. Lesion areas and MPO activities were analyzed by repeated-measures analysis of variance (ANOVA). Results: Lesion areas and MPO activity were markedly reduced when ␣Loxd Fab was administered very early after venom injections. As the interval between venom inoculation and antivenom treatment increased, the therapeutic benefit of ␣Loxd Fab decreased. The final time tested that demonstrated therapeutic efficacy of ␣Loxd Fab was T = 4 hours. Lesion attenuation was no longer apparent when ␣Loxd Fab was given 8 hours post inoculation. Conclusions: Intradermal administration of ␣Loxd Fab attenuates Loxosceles-induced dermonecrotic lesion formation when given up to 4 hours after venom inoculation in this rabbit model.

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Successful Treatment of Crotalid-Induced Neurotoxicity With a New Polyspecific Crotalid Fab Antivenom

Cited by 66 publications

References 11 publications

Fasciculations after rattlesnake envenomations: A retrospective statewide poison control system study

Fasciculations after rattlesnake envenomations: A retrospective statewide poison control system study

Crotalidae Polyvalent Immune Fab (Ovine) Antivenom Is Effective in the Neutralization of South American Viperidae Venoms in a Murine Model

Intradermal Anti‐Loxosceles Fab Fragments Attenuate Dermonecrotic Arachnidism

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