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Kumar R, Rathore AS. Snakebite Management: The Need of Reassessment, International Relations, and Effective Economic Measures to Reduce the Considerable SBE Burden. J Epidemiol Glob Health 2024:10.1007/s44197-024-00247-z. [PMID: 38856820 DOI: 10.1007/s44197-024-00247-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/20/2024] [Indexed: 06/11/2024] Open
Abstract
The sole treatment for snakebite envenomation (SBE), the anti-snake venom (ASV), suffers from considerable drawbacks, including side effects and limited species specificity. Additionally, despite its existence for more than a century, uniform availability of good quality ASV does not yet exist. The present review describes the journey of a SBE victim and highlights the global crisis of SBE management. A detailed analysis of the current ASV market has also been presented along with the worldwide snake distribution. The current production of country specific licensed ASV throughout the globe along with their manufacturers has been examined at the snake species level. Furthermore, a detailed analysis of on-ground situation of SBE management in antivenom manufacturing countries has been done using the most recent literature. Additionally, the export and import of different ASVs have been discussed in terms of procurement policies of individual countries, their shortcomings, along with the possible solution at the species level. It is interesting to note that in most countries, the existence of ASV is really either neglected or overstated, implying that it is there but unsuitable for use, or that it is not present but can be obtained from other countries. This highlights the urgent need of significant reassessment and international collaborations not just for development and production, but also for procurement, distribution, availability, and awareness. A PROMISE (Practical ROutes for Managing Indigenous Snakebite Envenoming) approach has also been introduced, offering simple, economical, and easy to adopt steps to efficiently alleviate the worldwide SBE burden.
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Affiliation(s)
- Ramesh Kumar
- Department of Chemical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, India
| | - Anurag S Rathore
- Department of Chemical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, India.
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Jalali A, Mohajer S, Jowkar Z, Kazemi SM. The need to expand cover of polyvalent snake antivenom in Iran. Toxicon 2024; 238:107585. [PMID: 38145880 DOI: 10.1016/j.toxicon.2023.107585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/15/2023] [Accepted: 12/19/2023] [Indexed: 12/27/2023]
Affiliation(s)
- Amir Jalali
- Department of Applied Cellular Sciences and Tissue Engineering, Langroud School of Allied Medical Sciences, Guilan University of Medical Sciences, Rasht, Iran
| | - Sedigheh Mohajer
- General ICU, Poursina Medical and Educational Center, Rasht, Guilan, Iran
| | - Zahra Jowkar
- Department of English Language and Literature, Shiraz University, Shiraz, Iran
| | - Seyed Mahdi Kazemi
- Zagros Herpetological Institute, 37156-88415, P. O. No 12, Somayyeh 14 Avenue, Qom, Iran.
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Schulte L, Damm M, Avella I, Uhrig L, Erkoc P, Schiffmann S, Fürst R, Timm T, Lochnit G, Vilcinskas A, Lüddecke T. Venomics of the milos viper ( Macrovipera schweizeri) unveils patterns of venom composition and exochemistry across blunt-nosed viper venoms. Front Mol Biosci 2023; 10:1254058. [PMID: 37719269 PMCID: PMC10500195 DOI: 10.3389/fmolb.2023.1254058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/21/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction: Snakebite is a neglected tropical disease and a globally important driver of death and morbidity. Vipers of the genus Macrovipera (Viperidae: Viperinae) are among the snakes of higher medical importance in the Old World. Despite the medical relevance of Macrovipera venoms, the knowledge regarding them is heterogeneously distributed with virtually all works conducted so far focusing on subspecies of Macrovipera lebetinus, while other species within the genus are largely overlooked. Here we present the first proteomic evaluation of the venom from the Greek endemic Milos viper (Macrovipera schweizeri). In line with clinical symptoms typically elicited by Macrovipera envenomations, Milos viper venom primarily comprises coagulotoxic and cytotoxic protein families, such as metalloproteinases (svMP) and serine proteases (svSP). Methods: We conducted comparative bioactivity assays on venoms from M. schweizeri and the M. lebetinus subspecies M. lebetinus cernovi, M. lebetinus obtusa, and M. lebetinus turanica, and showed that they all exhibit similarities in levels of cytotoxicity proteolytic activity, and inhibition of prokaryotic growth. Lastly, we compared Macrovipera venom profiles by 1D-SDS-PAGE and RP-HPLC, as well as our proteomic data with previously published Macrovipera venom proteomes. Results and discussion: The analyzes performed to reveal that a general venom profile seems to be conserved across blunt-nosed vipers, and that, M. schweizeri envenomations, similarly to those caused by other blunt-nosed vipers, are able to cause significant tissue damage. The present work represents an important starting point for the development of comparative studies across the full taxonomic range of the genus Macrovipera and can potentially help optimize the treatment of envenomations caused by M. schweizeri.
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Affiliation(s)
- Lennart Schulte
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Giessen, Germany
- Institute for Insect Biotechnology, Justus Liebig University Giessen, Giessen, Germany
- LOEWE-Centre for Translational Biodiversity Genomics, Frankfurt, Germany
| | - Maik Damm
- LOEWE-Centre for Translational Biodiversity Genomics, Frankfurt, Germany
| | - Ignazio Avella
- CIBIO, Research Centre in Biodiversity and Genetic Resources, InBIO Associated Laboratory, University Port, Porto, Portugal
- Department of Biology, Faculty of Sciences, University of Porto, Porto, Portugal
- CIBIO, BIOPOLIS Program in Genomics, Biodiversity and Land Planning, Vairão, Portugal
| | - Lilien Uhrig
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Giessen, Germany
| | - Pelin Erkoc
- LOEWE-Centre for Translational Biodiversity Genomics, Frankfurt, Germany
- Institute of Pharmaceutical Biology, Faculty of Biochemistry, Chemistry and Pharmacy, Goethe University Frankfurt, Frankfurt, Germany
| | - Susanne Schiffmann
- LOEWE-Centre for Translational Biodiversity Genomics, Frankfurt, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Frankfurt, Germany
| | - Robert Fürst
- LOEWE-Centre for Translational Biodiversity Genomics, Frankfurt, Germany
- Institute of Pharmaceutical Biology, Faculty of Biochemistry, Chemistry and Pharmacy, Goethe University Frankfurt, Frankfurt, Germany
| | - Thomas Timm
- Institute of Biochemistry, Justus Liebig University Giessen, Giessen, Germany
| | - Günter Lochnit
- Institute of Biochemistry, Justus Liebig University Giessen, Giessen, Germany
| | - Andreas Vilcinskas
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Giessen, Germany
- Institute for Insect Biotechnology, Justus Liebig University Giessen, Giessen, Germany
- LOEWE-Centre for Translational Biodiversity Genomics, Frankfurt, Germany
| | - Tim Lüddecke
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Giessen, Germany
- LOEWE-Centre for Translational Biodiversity Genomics, Frankfurt, Germany
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Kazemi SM, Hosseinzadeh MS, Weinstein SA. Identifying the geographic distribution pattern of venomous snakes and regions of high snakebite risk in Iran. Toxicon 2023; 231:107197. [PMID: 37321410 DOI: 10.1016/j.toxicon.2023.107197] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/07/2023] [Accepted: 06/11/2023] [Indexed: 06/17/2023]
Abstract
We describe species richness patterns of venomous snakes in Iran in order to produce snakebite risk prediction maps and identify gaps in regional health care centers capable of managing snakebites. We digitized distribution maps from the literature, Global Biodiversity Information Facility (GBIF), and the results of our own field studies of 24 terrestrial venomous snake species (including 4 endemic to Iran). Species richness patterns were associated with eight environmental factors. The variables have been extracted from the WorldClim dataset (bio12 = annual precipitation, bio15 = precipitation seasonality, bio17 = precipitation of the driest quarter, bio2 = mean diurnal range, bio3 = isothermality (bio2/bio7), bio4 = temperature seasonality, bio9 = mean temperature of the driest quarter and slope). Based on spatial analyses, species richness in Iran is highly affected by three environmental variables (bio12, 15, and 17) associated with precipitation. The relationship patterns among these predictors and species richness were strong and linear. The hotspot regions for venomous snakes species are concentrated on the western to southwestern and north to northeastern regions of Iran, which is partially consistent with the known Irano-Anatolian biodiversity hotspot. Because of the high number of endemic species and climatic conditions on the Iranian Plateau, the venoms of snakes distributed in those areas may contain novel properties and components.
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Affiliation(s)
- Seyed Mahdi Kazemi
- Zagros Herpetological Institute, 37156-88415, P. O. No 12, Somayyeh 14 Avenue, Qom, Iran
| | | | - Scott A Weinstein
- Playford Family Medicine, 297 Peachey Rd., Munno Para, South Australia, 5115, Australia; Young Adult Institute, 220 E. 42nd St., 8th Floor, NY, NY, 10017, USA; Premier Health Care, 227 E. 41st St., 8th Floor, NY, NY, 10017, USA.
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