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Kakati H, Patra A, Mukherjee AK. Composition, pharmacology, and pathophysiology of the venom of monocled cobra (Naja kaouthia)- a medically crucial venomous snake of southeast Asia: An updated review. Toxicon 2024; 249:108056. [PMID: 39111718 DOI: 10.1016/j.toxicon.2024.108056] [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: 06/18/2024] [Revised: 07/31/2024] [Accepted: 07/31/2024] [Indexed: 08/15/2024]
Abstract
The Monocled Cobra (Naja kaouthia), a category one medically significant snake from the Elapidae family, inflicts severe envenomation in South and Southeast Asian countries. N. kaouthia is distributed throughout the eastern and northeastern parts of India, Nepal, Bangladesh, Myanmar, Thailand, Vietnam, Malaysia, and southwestern China. Envenomation by N. kaouthia is a medical emergency, and the primary clinical symptoms are neurotoxicity and localized tissue destruction. Unfortunately, data on the actual magnitude of N. kaouthia envenomation is scarce due to poor record keeping, lack of diagnostic kits, and region-wise well-coordinated epidemiological surveys. The present review highlights the diversity in the composition of N. Kaouthia venom (NKV) across various geographical regions, as revealed through biochemical and proteomic analyses. The qualitative and quantitative differences in the toxin isoforms result in differences in lethality and pathophysiological manifestation that may limit the effectiveness of antivenom therapy. Studies on commercial polyvalent antivenom (PAV) effectiveness against distinct NKV samples have revealed varying toxicity and enzymatic activity neutralization. Additionally, the identification of snake venom's poorly immunogenic toxins by mass spectrometry, quantification of venom-specific antibodies, and implications for antivenom therapy against snakebites are highlighted. Future directions involve clinical studies on NK envenomation where the snake is frequently encountered and the correlation of this data with NKV composition in that region. For more efficient and superior hospital management of NK envenomation, research should enhance the current immunization procedure to boost the development of antibodies against less immunogenic venom components of this snake.
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Affiliation(s)
- Hirakjyoti Kakati
- Department of Molecular Biology and Biotechnology, School of Sciences, Tezpur University, Tezpur- 784028, Assam, India
| | - Aparup Patra
- Institute of Advanced Studies in Science and Technology, Vigyan Path Garchuk, Paschim Boragaon, Guwahati-781035, Assam, India; Amrita Research Centre, Amrita Vishwa Vidyapeetham, Faridabad, Haryana, 121002, India
| | - Ashis K Mukherjee
- Department of Molecular Biology and Biotechnology, School of Sciences, Tezpur University, Tezpur- 784028, Assam, India; Institute of Advanced Studies in Science and Technology, Vigyan Path Garchuk, Paschim Boragaon, Guwahati-781035, Assam, India.
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Abiola J, Berg AM, Aiyelaagbe O, Adeyi A, König S. Dabsylated Bradykinin Is Cleaved by Snake Venom Proteases from Echis ocellatus. Biomedicines 2024; 12:1027. [PMID: 38790989 PMCID: PMC11118064 DOI: 10.3390/biomedicines12051027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/22/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024] Open
Abstract
The vasoactive peptide bradykinin (BK) is an important member of the renin-angiotensin system. Its discovery is tightly interwoven with snake venom research, because it was first detected in plasma following the addition of viper venom. While the fact that venoms liberate BK from a serum globulin fraction is well described, its destruction by the venom has largely gone unnoticed. Here, BK was found to be cleaved by snake venom metalloproteinases in the venom of Echis ocellatus, one of the deadliest snakes, which degraded its dabsylated form (DBK) in a few minutes after Pro7 (RPPGFSP↓FR). This is a common cleavage site for several mammalian proteases such as ACE, but is not typical for matrix metalloproteinases. Residual protease activity < 5% after addition of EDTA indicated that DBK is also cleaved by serine proteases to a minor extent. Mass spectrometry-based protein analysis provided spectral proof for several peptides of zinc metalloproteinase-disintegrin-like Eoc1, disintegrin EO4A, and three serine proteases in the venom.
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Affiliation(s)
- Julius Abiola
- IZKF Core Unit Proteomics, Interdisciplinary Center for Clinical Research, University of Münster, Röntgenstr. 21, 48149 Münster, Germany; (J.A.)
- Organic Unit, Department of Chemistry, University of Ibadan, Ibadan 200005, Nigeria
| | - Anna Maria Berg
- IZKF Core Unit Proteomics, Interdisciplinary Center for Clinical Research, University of Münster, Röntgenstr. 21, 48149 Münster, Germany; (J.A.)
| | - Olapeju Aiyelaagbe
- Organic Unit, Department of Chemistry, University of Ibadan, Ibadan 200005, Nigeria
| | - Akindele Adeyi
- Animal Physiology Unit, Department of Zoology, University of Ibadan, Ibadan 200005, Nigeria
| | - Simone König
- IZKF Core Unit Proteomics, Interdisciplinary Center for Clinical Research, University of Münster, Röntgenstr. 21, 48149 Münster, Germany; (J.A.)
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3
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Abdollahnia A, Bahmani K, Aliahmadi A, As'habi MA, Ghassempour A. Mass spectrometric analysis of Odonthobuthus Doriae scorpion venom and its non-neutralized fractions after interaction with commercial antivenom. Sci Rep 2024; 14:10389. [PMID: 38710718 DOI: 10.1038/s41598-024-59150-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/08/2024] [Indexed: 05/08/2024] Open
Abstract
It is believed that antivenoms play a crucial role in neutralizing venoms. However, uncontrolled clinical effects appear in patients stung by scorpions after the injection of antivenom. In this research, non-neutralized components of the venom of the Iranian scorpion Odonthobuthus doriae were analyzed after interacting with the commercial antivenom available in the market. The venom and antivenom interaction was performed, then centrifuged, and the supernatant was analyzed by high-performance liquid chromatography (HPLC). Two peaks of Odonthobuthus doriae venom were observed in the chromatogram of the supernatant. Two components were isolated by HPLC and analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) instruments. Peptide sequencing was done by Liquid Chromatography Quadrupole Time-of-Flight Tandem Mass Spectrometry (LC-Q-TOF MS/MS). Results indicate that the components of scorpion venom mainly have a molecular weight below 10 kDa, consisting of toxic peptides that disrupt the function of sodium and potassium channels. The MALDI-TOF MS results show that two toxic peptides with molecular masses of 6941 Da and 6396 Da were not neutralized by the antivenom. According to the MS/MS sequencing data, the components have been related to peptides A0A5P8U2Q6_MESEU and A0A0U4FP89_ODODO, which belong to the sodium and potassium channels toxins family, respectively.
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Affiliation(s)
- Adel Abdollahnia
- Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, G.C. Evin, Tehran, Iran
| | - Kiumars Bahmani
- Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atousa Aliahmadi
- Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, G.C. Evin, Tehran, Iran
| | - Mohammad Ali As'habi
- Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, G.C. Evin, Tehran, Iran
| | - Alireza Ghassempour
- Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, G.C. Evin, Tehran, Iran.
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Kramer S, Kotapati C, Cao Y, Fry BG, Palpant NJ, King GF, Cardoso FC. High-content fluorescence bioassay investigates pore formation, ion channel modulation and cell membrane lysis induced by venoms. Toxicon X 2024; 21:100184. [PMID: 38389571 PMCID: PMC10882159 DOI: 10.1016/j.toxcx.2024.100184] [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: 08/15/2023] [Revised: 01/07/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
Venoms comprise highly sophisticated bioactive molecules modulating ion channels, receptors, coagulation factors, and the cellular membranes. This array of targets and bioactivities requires advanced high-content bioassays to facilitate the development of novel envenomation treatments and biotechnological and pharmacological agents. In response to the existing gap in venom research, we developed a cutting-edge fluorescence-based high-throughput and high-content cellular assay. This assay enables the simultaneous identification of prevalent cellular activities induced by venoms such as membrane lysis, pore formation, and ion channel modulation. By integrating intracellular calcium with extracellular nucleic acid measurements, we have successfully distinguished these venom mechanisms within a single cellular assay. Our high-content bioassay was applied across three cell types exposed to venom components representing lytic, ion pore-forming or ion channel modulator toxins. Beyond unveiling distinct profiles for these action mechanisms, we found that the pore-forming latrotoxin α-Lt1a prefers human neuroblastoma to kidney cells and cardiomyocytes, while the lytic bee peptide melittin is not selective. Furthermore, evaluation of snake venoms showed that Elapid species induced rapid membrane lysis, while Viper species showed variable to no activity on neuroblastoma cells. These findings underscore the ability of our high-content bioassay to discriminate between clades and interspecific traits, aligning with clinical observations at venom level, beyond discriminating among ion pore-forming, membrane lysis and ion channel modulation. We hope our research will expedite the comprehension of venom biology and the diversity of toxins that elicit cytotoxic, cardiotoxic and neurotoxic effects, and assist in identifying venom components that hold the potential to benefit humankind.
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Affiliation(s)
- Simon Kramer
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, Brisbane, Queensland, Australia, 4072
| | - Charan Kotapati
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, Brisbane, Queensland, Australia, 4072
| | - Yuanzhao Cao
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, Brisbane, Queensland, Australia, 4072
| | - Bryan G Fry
- School of Biological Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia, 4072
| | - Nathan J Palpant
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, Brisbane, Queensland, Australia, 4072
| | - Glenn F King
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, Brisbane, Queensland, Australia, 4072
| | - Fernanda C Cardoso
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, Brisbane, Queensland, Australia, 4072
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Bahmani K, Abdollahnia A, Vatanpour H, Ghassempour A, Kaboli M, Shahidi MR. Evaluation of venom diversity and antivenom quality from the venom of long-term captive vs recently wild captured Pseudocerastes persicus snake: An In vitro and In vivo study. Toxicon 2024; 241:107662. [PMID: 38417708 DOI: 10.1016/j.toxicon.2024.107662] [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: 12/02/2023] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 03/01/2024]
Abstract
Snakebite envenomation is a life-threatening condition and antivenoms are used as the most effective treatment. Venom obtained from snakes in long-term captivity showed some variations in comparison to the venom of the wild snakes. The objective of this study is to compare the venom of the Pseudocerastes persicus under long-term captivity and wild conditions as well as the antivenom obtained from these venoms. We have analyzed venom samples and produced trivalent antivenoms using the venom of long-term captive (LTC) or recently wild-captured (RWC) Pseudocerastes persicus, and RWC Macrovipera lebetina, and Echis carinatus. The HPLC analysis revealed that the RWC snakes' venom had three peaks that were not present in the LTC snake's venom. Further analysis using MALDI-TOF and MS/MS showed that the fraction with a retention time (RT) of 14 min contained a toxin from the Kunitz-type serine protease inhibitor (KUT) class, while the fraction with RT 21 a peptide identified within the snake venom metalloproteinase (SVMP) class. The third peak was identified as a sphingolipid. Interestingly, the in vivo preclinical tests showed no significant differences in the effectiveness of the antivenoms. which could be due to the cross-immunogenicity or cross-reactivity between different toxins in the venom. According to our results, small variations in the venom composition of a species do not lead to a decrease in the efficacy of the polyvalent antivenom.
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Affiliation(s)
- Kiumars Bahmani
- Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Adel Abdollahnia
- Department of Phytochemistry, Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, G.C., Evin, Tehran, Iran
| | - Hossein Vatanpour
- Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Alireza Ghassempour
- Department of Phytochemistry, Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, G.C., Evin, Tehran, Iran.
| | - Mohammad Kaboli
- College of Natural Resources and Agriculture, University of Tehran, Karaj, Iran
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Lim ASS, Tan KY, Tan CH. Immunoreactivity and neutralization efficacy of Pakistani Viper Antivenom (PVAV) against venoms of Saw-scaled Vipers (Echis carinatus subspp.) and Western Russell's Vipers (Daboia russelii) from the Indian subcontinent. Acta Trop 2024; 250:107099. [PMID: 38097152 DOI: 10.1016/j.actatropica.2023.107099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/31/2023]
Abstract
Snakebite envenoming (SBE) is a priority Neglected Tropical Disease listed by the World Health Organization. South Asia is heavily affected, and virtually all countries in the region import polyvalent antivenom products from India for clinical use. The imported antivenoms, however, have suboptimal effectiveness due to geographical venom variation. Recently, a domestic bivalent product, named Pakistani Viper Antivenom (PVAV) has been developed specifically for Pakistani vipers, Echis carinatus sochureki and Daboia russelii. As a bivalent viperid antivenom, it is unknown yet if PVAV exhibits higher immunological binding and neutralization activities against viper venoms from distant locales compared with polyvalent antivenoms manufactured in India. This study thus examined the preclinical efficacy of PVAV against venoms of Western Russell's Vipers and Saw-scaled Viper subspecies from selected locales in the Indian subcontinent. PVAV generally outperformed the commonly used VINS polyvalent antivenom (VPAV, manufactured in India) in binding toward venoms, and showed superior or comparable neutralization efficacy against the venom procoagulant and hemorrhagic effects of Saw-scaled Vipers as well as Russell's Vipers from Pakistan and Sri Lanka. Based on normalized potency values, PVAV is far more potent than VPAV in neutralizing the lethality of all viper venoms, except that of the Indian Russell's Viper. The study shows conserved antigenicity of toxins responsible for major toxicity across these viperid venoms, and suggests the feasible production of a viper-specific antivenom with higher potency and broader geographical utility for the region.
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Affiliation(s)
- Andy Shing Seng Lim
- Venom Research and Toxicology Laboratory, Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Kae Yi Tan
- Protein and Interactomics Laboratory, Department of Molecular Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Choo Hock Tan
- Venom Research and Toxicology Laboratory, Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
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Kancha MM, Mehrabi M, Bitaraf FS, Vahedi H, Alizadeh M, Bernkop-Schnürch A. Preparation, Characterization, and Anticancer Activity Assessment of Chitosan/TPP Nanoparticles Loaded with Echis carinatus Venom. Anticancer Agents Med Chem 2024; 24:533-543. [PMID: 38243949 DOI: 10.2174/0118715206279731231129105221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/22/2023] [Accepted: 11/07/2023] [Indexed: 01/22/2024]
Abstract
AIMS AND BACKGROUND Echis carinatus venom is a toxic substance naturally produced by special glands in this snake species. Alongside various toxic properties, this venom has been used for its therapeutic effects, which are applicable in treating various cancers (liver, breast, etc.). OBJECTIVE Nanotechnology-based drug delivery systems are suitable for protecting Echis carinatus venom against destruction and unwanted absorption. They can manage its controlled transfer and absorption, significantly reducing side effects. METHODS In the present study, chitosan nanoparticles were prepared using the ionotropic gelation method with emulsion cross-linking. The venom's encapsulation efficiency, loading capacity, and release rate were calculated at certain time points. Moreover, the nanoparticles' optimal formulation and cytotoxic effects were determined using the MTT assay. RESULTS The optimized nanoparticle formulation increases cell death induction in various cancerous cell lines. Moreover, chitosan nanoparticles loaded with Echis carinatus venom had a significant rate of cytotoxicity against cancer cells. CONCLUSION It is proposed that this formulation may act as a suitable candidate for more extensive assessments of cancer treatment using nanotechnology-based drug delivery systems.
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Affiliation(s)
- Maral Mahboubi Kancha
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Medical Nanotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohsen Mehrabi
- Department of Medical Nanotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Fatemeh Sadat Bitaraf
- Department of Medical Biotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hamid Vahedi
- Department of Gastroenterology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Morteza Alizadeh
- Department of Tissue Engineering, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Andreas Bernkop-Schnürch
- Department of Pharmaceutical Technology, University of Innsbruck, Institute of Pharmacy, Center for Chemistry and Biomedicine, 6020, Innsbruck, Austria
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Nafiseh NN, Hossein V, Nasser MD, Mojtaba N, Minoo A, Mohammad Ali B, Giti P. Analysis and Identification of Putative Novel Peptides Purified from Iranian Endemic Echis Carinatus Sochureki Snake Venom by MALDI-TOF Mass Spectrometry. ARCHIVES OF RAZI INSTITUTE 2023; 78:1503-1527. [PMID: 38590689 PMCID: PMC10998951 DOI: 10.22092/ari.2023.78.5.1503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 05/23/2023] [Indexed: 04/10/2024]
Abstract
The Iranian Echis Carinatus (IEC) venom is an exclusive natural source of bio-substances for a wide range of purposes in the blood coagulation cascade. The present study for the first time was aimed to assess novel pro-coagulant, anti-coagulant and anti-platelet proteins, named EC1.5 (a), EC5.1 (b) and EC4 (a) from Iranian Echis Carinatus (IEC) venom. These peptides were purified by multi-step chromatography methods. Hematological properties were measured using activated clotting tests, platelet aggregation studies, and hemorrhage assessment. Subsequently, these proteins were identified through both their intact molecular mass and peptide mass fingerprint (PMF) using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Multiple sequence alignments were performed by ClustalW, Bioedit software. Molegro Data Modeller (MDM) 3.0 software was used to predict the putative tertiary structure of proteins.EC1.5 (a), a single-band protein with a molecular mass of 66 and 55 kDa, was observed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis as a reduced and non-reduced state, respectively. Based on the Mascot results, we considered that EC1.5 (a) is a metalloproteinase of group ΙΙ which exhibited potent pro-coagulant activity. It is predicted that the EC1.5 (a) with hemorrhagic activity, potentially is a metalloproteinase/disintegrin region that constitutes the disintegrin-like domains. Our findings demonstrate that the disintegrin domain of EC1.5 (a) lacks platelet aggregation inhibitory activity. On the contrary, this factor shows the property of a platelet aggregation inducer. Also, the EC5.1 (b) was observed as a single-band protein with a molecular mass of 7.5 kDa. EC5.1 (b) showed both anti-coagulant and anti-platelet properties. Additionally, the structure of the EC5.1 (b) fraction is expected to be similar to that of phospholipase A2, while EC4 (a) structure is potentially very similar to that of Echistatin with 5 kDa molecular mass. We introduce the predicted structure of P-II snake venom metalloproteinase/ disintegrin domains, phospholipase A2 and Echistatin-like fractions. Further research is therefore needed to determine the complete structure of these novel fractions and elucidate their mechanism of action and future therapeutic applications of cardiovascular and homeostasis disorders.
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Affiliation(s)
- Nasri Nasrabadi Nafiseh
- Student Research Committee, Pharmaceutical Sciences Research Center, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Karaj, Iran
| | - Vatanpour Hossein
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Karaj, Iran
| | | | - Najafi Mojtaba
- Department of Venomous Animals and Anti-venom, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Karaj, Iran
| | - Ahmadinejad Minoo
- Department of Molecular Genetic and Animal Breeding, Gorgan University of Agricultural Sciences and Natural Resources, Golestan, Iran
| | - Bayatzadeh Mohammad Ali
- Blood Transfusion Research Center, Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Pouyanmehr Giti
- Ph.D. student of toxicology, Tehran Islamic Azad University, Tehran, Iran
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Vanuopadath M, Rajan K, Alangode A, Nair SS, Nair BG. The Need for Next-Generation Antivenom for Snakebite Envenomation in India. Toxins (Basel) 2023; 15:510. [PMID: 37624267 PMCID: PMC10467155 DOI: 10.3390/toxins15080510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 08/26/2023] Open
Abstract
The limitations posed by currently available antivenoms have emphasized the need for alternative treatments to counteract snakebite envenomation. Even though exact epidemiological data are lacking, reports have indicated that most global snakebite deaths are reported in India. Among the many problems associated with snakebite envenomation, issues related to the availability of safer and more efficient antivenoms are of primary concern. Since India has the highest number of global snakebite deaths, efforts should be made to reduce the burden associated with snakebite envenoming. Alternative methods, including aptamers, camel antivenoms, phage display techniques for generating high-affinity antibodies and antibody fragments, small-molecule inhibitors, and natural products, are currently being investigated for their effectiveness. These alternative methods have shown promise in vitro, but their in vivo effectiveness should also be evaluated. In this review, the issues associated with Indian polyvalent antivenoms in neutralizing venom components from geographically distant species are discussed in detail. In a nutshell, this review gives an overview of the current drawbacks of using animal-derived antivenoms and several alternative strategies that are currently being widely explored.
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Affiliation(s)
| | | | | | | | - Bipin Gopalakrishnan Nair
- School of Biotechnology, Amrita Vishwa Vidyapeetham, Kollam 690 525, Kerala, India; (M.V.); (K.R.); (A.A.); (S.S.N.)
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Gopal G, Muralidar S, Prakash D, Kamalakkannan A, Indhuprakash ST, Thirumalai D, Ambi SV. The concept of Big Four: Road map from snakebite epidemiology to antivenom efficacy. Int J Biol Macromol 2023; 242:124771. [PMID: 37169043 DOI: 10.1016/j.ijbiomac.2023.124771] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/13/2023]
Abstract
Snake envenomation is a life-threatening disease caused by the injection of venom toxins from the venomous snake bite. Snakebite is often defined as the occupational or domestic hazard mostly affecting the rural population. India experiences a high number of envenoming cases and fatality due to the nation's diversity in inhabiting venomous snakes. The Indian Big Four snakes namely Russell's viper (Daboia russelii), spectacled cobra (Naja naja), common krait (Bungarus caeruleus), and saw-scaled viper (Echis carinatus) are responsible for majority of the snake envenoming cases and death. The demographic characteristics including occupation, stringent snake habitat management, poor healthcare facilities and ignorance of the rural victims are the primary influencers of high mortality. Biogeographic venom variation greatly influences the clinical pathologies of snake envenomation. The current antivenoms against the Big Four snakes are found to be less immunogenic against the venom toxins emphasizing the necessity of alternative approaches for antivenom generation. This review summarizes the burden of snake envenomation in India by the Big Four snakes including the geographic distribution of snake species and biogeographic venom variation. We have provided comprehensive information on snake venom proteomics that has aided the better understanding of venom induced pathological features, summarized the impact of current polyvalent antivenom therapy highlighting the need for potential antivenom treatment for the effective management of snakebites.
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Affiliation(s)
- Gayathri Gopal
- Biopharmaceutical Research Lab, Anusandhan Kendra-1, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India; School of Chemical and Biotechnology, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India
| | - Shibi Muralidar
- Biopharmaceutical Research Lab, Anusandhan Kendra-1, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India; School of Chemical and Biotechnology, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India
| | - Diwahar Prakash
- Biopharmaceutical Research Lab, Anusandhan Kendra-1, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India; School of Chemical and Biotechnology, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India
| | - Abishek Kamalakkannan
- Biopharmaceutical Research Lab, Anusandhan Kendra-1, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India; School of Chemical and Biotechnology, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India
| | - Srichandrasekar Thuthikkadu Indhuprakash
- Biopharmaceutical Research Lab, Anusandhan Kendra-1, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India; School of Chemical and Biotechnology, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India
| | - Diraviyam Thirumalai
- Biopharmaceutical Research Lab, Anusandhan Kendra-1, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India; School of Chemical and Biotechnology, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India
| | - Senthil Visaga Ambi
- Biopharmaceutical Research Lab, Anusandhan Kendra-1, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India; School of Chemical and Biotechnology, SASTRA Deemed-to-be-University, Thanjavur 613401, Tamil Nadu, India.
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Lim ASS, Tan KY, Quraishi NH, Farooque S, Khoso ZA, Ratanabanangkoon K, Tan CH. Proteomic Analysis, Immuno-Specificity and Neutralization Efficacy of Pakistani Viper Antivenom (PVAV), a Bivalent Anti-Viperid Antivenom Produced in Pakistan. Toxins (Basel) 2023; 15:toxins15040265. [PMID: 37104203 PMCID: PMC10145215 DOI: 10.3390/toxins15040265] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 04/05/2023] Open
Abstract
Snakebite envenoming is a neglected tropical disease prevalent in South Asia. In Pakistan, antivenoms are commonly imported from India despite the controversy over their effectiveness. To solve the problem, the locals have developed the Pakistani Viper Antivenom (PVAV), raised against Sochurek’s Saw-scaled Viper (Echis carinatus sochureki) and Russell’s Viper (Daboia russelii) of Pakistani origin. This study is set to evaluate the composition purity, immuno-specificity and neutralization efficacy of PVAV. Chromatographic and electrophoretic profiling coupled with proteomic mass spectrometry analysis showed PVAV containing high-purity immunoglobulin G with minimum impurities, notably the absence of serum albumin. PVAV is highly immuno-specific toward the venoms of the two vipers and Echis carinatus multisquamatus, which are indigenous to Pakistan. Its immunoreactivity, however, reduces toward the venoms of other Echis carinatus subspecies and D. russelii from South India as well as Sri Lanka. Meanwhile, its non-specific binding activities for the venoms of Hump-nosed Pit Vipers, Indian Cobras and kraits were extremely low. In the neutralization study, PVAV effectively mitigated the hemotoxic and lethal effects of the Pakistani viper venoms, tested in vitro and in vivo. Together, the findings suggest the potential utility of PVAV as a new domestic antivenom for the treatment of viperid envenoming in Pakistan.
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Affiliation(s)
- Andy Shing Seng Lim
- Venom Research and Toxicology Laboratory, Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Kae Yi Tan
- Protein and Interactomics Laboratory, Department of Molecular Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Naeem H. Quraishi
- Snake Antivenom/Antirabies Serology Laboratory, Department of Community Medicine & Public Health Sciences, People’s University of Medical and Health Sciences for Women, Nawabshah 67450, Pakistan
| | - Saud Farooque
- Snake Antivenom/Antirabies Serology Laboratory, Department of Community Medicine & Public Health Sciences, People’s University of Medical and Health Sciences for Women, Nawabshah 67450, Pakistan
| | - Zahoor Ahmed Khoso
- Snake Antivenom/Antirabies Serology Laboratory, Department of Community Medicine & Public Health Sciences, People’s University of Medical and Health Sciences for Women, Nawabshah 67450, Pakistan
| | - Kavi Ratanabanangkoon
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 73170, Thailand
| | - Choo Hock Tan
- Venom Research and Toxicology Laboratory, Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
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Puzari U, Goswami M, Rani K, Patra A, Mukherjee AK. Computational and in vitro analyses to identify the anticoagulant regions of Echicetin, a snake venom anticoagulant C-type lectin (snaclec): possibility to develop anticoagulant peptide therapeutics? J Biomol Struct Dyn 2023; 41:15569-15583. [PMID: 36994880 DOI: 10.1080/07391102.2023.2191138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/05/2023] [Indexed: 03/31/2023]
Abstract
Snake venom C-type lectins (Snaclecs) display anticoagulant and platelet-modulating activities; however, their interaction with the critical components of blood coagulation factors was unknown. Computational analysis revealed that Echicetin (Snaclec from Echis carinatus venom) interacted with heavy chain of thrombin, and heavy and light chains of factor Xa (FXa). Based on FXa and thrombin binding regions of Echicetin, the two synthetic peptides (1A and 1B) were designed. The in silico binding studies of the peptides with thrombin and FXa showed that peptide 1B interacted with both heavy and light chains of thrombin and, peptide 1A interacted with only heavy chain of thrombin. Similarly, peptide 1B interacted with both heavy and light chains of FXa; however, peptide 1A interacted only with heavy chain of FXa. Alanine screening predicted the hot-spots residues for peptide 1A (Aspartic acid6, Valine8, Valine9, and Tyrosine17 with FXa, and Isoleucine14, Lysine15 with thrombin) and peptide 1B (Valine16 with FXa). Spectrofluorometric interaction study showed a lower Kd value for peptide 1B binding with both FXa and thrombin than peptide 1A, indicating higher binding strength of the former peptide. The circular dichroism spectroscopy also established the interaction between thrombin and the custom peptides. The in vitro study demonstrated higher anticoagulant activity of peptide 1B than peptide 1A due to higher inhibition of thrombin and FXa. Inhibition of anticoagulant activity of the peptides by respective anti-peptide antibodies corroborates our hypothesis that peptides 1A and 1B represent the anticoagulant regions of Echicetin and may be developed as antithrombotic peptide drug prototypes.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Upasana Puzari
- Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, Assam, India
| | - Mahasweta Goswami
- Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, Assam, India
| | - Komal Rani
- Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, Assam, India
| | - Aparup Patra
- Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, Assam, India
- Life Sciences Division, Institute of Advanced Study in Science and Technology, Guwahati, Assam, India
| | - Ashis K Mukherjee
- Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, Assam, India
- Life Sciences Division, Institute of Advanced Study in Science and Technology, Guwahati, Assam, India
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Kalita B, Utkin YN, Mukherjee AK. Current Insights in the Mechanisms of Cobra Venom Cytotoxins and Their Complexes in Inducing Toxicity: Implications in Antivenom Therapy. Toxins (Basel) 2022; 14:toxins14120839. [PMID: 36548736 PMCID: PMC9780984 DOI: 10.3390/toxins14120839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/02/2022] Open
Abstract
Cytotoxins (CTXs), an essential class of the non-enzymatic three-finger toxin family, are ubiquitously present in cobra venoms. These low-molecular-mass toxins, contributing to about 40 to 60% of the cobra venom proteome, play a significant role in cobra venom-induced toxicity, more prominently in dermonecrosis. Structurally, CTXs contain the conserved three-finger hydrophobic loops; however, they also exhibit a certain degree of structural diversity that dictates their biological activities. In their mechanism, CTXs mediate toxicity by affecting cell membrane structures and membrane-bound proteins and activating apoptotic and necrotic cell death pathways. Notably, some CTXs are also responsible for depolarizing neurons and heart muscle membranes, thereby contributing to the cardiac failure frequently observed in cobra-envenomed victims. Consequently, they are also known as cardiotoxins (CdTx). Studies have shown that cobra venom CTXs form cognate complexes with other components that potentiate the toxic effects of the venom's individual component. This review focuses on the pharmacological mechanism of cobra venom CTXs and their complexes, highlighting their significance in cobra venom-induced pathophysiology and toxicity. Furthermore, the potency of commercial antivenoms in reversing the adverse effects of cobra venom CTXs and their complexes in envenomed victims has also been discussed.
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Affiliation(s)
- Bhargab Kalita
- Amrita School of Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Kochi 682041, India
| | - Yuri N. Utkin
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow 117997, Russia
| | - Ashis K. Mukherjee
- Institute of Advanced Study in Science and Technology, Guwahati 781035, India
- Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur 784028, India
- Correspondence:
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Bhatia S, Blotra A, Vasudevan K. Evaluating Antivenom Efficacy against Echis carinatus Venoms—Screening for In Vitro Alternatives. Toxins (Basel) 2022; 14:toxins14070481. [PMID: 35878219 PMCID: PMC9322380 DOI: 10.3390/toxins14070481] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 02/01/2023] Open
Abstract
In India, polyvalent antivenom is the mainstay treatment for snakebite envenoming. Due to batch-to-batch variation in antivenom production, manufacturers have to estimate its efficacy at each stage of IgG purification using the median effective dose which involves 100–120 mice for each batch. There is an urgent need to replace the excessive use of animals in snake antivenom production using in vitro alternatives. We tested the efficacy of a single batch of polyvalent antivenom from VINS bioproducts limited on Echis carinatus venom collected from three different locations—Tamil Nadu (ECVTN), Goa (ECVGO) and Rajasthan (ECVRAJ)—using different in vitro assays. Firstly, size-exclusion chromatography (SEC-HPLC) was used to quantify antivenom–venom complexes to assess the binding efficiency of the antivenom. Secondly, clotting, proteolytic and PLA2 activity assays were performed to quantify the ability of the antivenom to neutralize venom effects. The use of both binding and functional assays allowed us to measure the efficacy of the antivenom, as they represent multiple impacts of snake envenomation. The response from the assays was recorded for different antivenom–venom ratios and the dose–response curves were plotted. Based on the parameters that explained the curves, the efficacy scores (ES) of antivenom were computed. The binding assay revealed that ECVTN had more antivenom–venom complexes formed compared to the other venoms. The capacity of antivenom to neutralize proteolytic and PLA2 effects was lowest against ECVRAJ. The mean efficacy score of antivenom against ECVTN was the greatest, which was expected, as ECVTN is mainly used by antivenom manufacturers. These findings pave a way for the development of in vitro alternatives in antivenom efficacy assessment.
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In vitro laboratory analyses of commercial anti-scorpion (Mesobuthus tamulus) antivenoms reveal their quality and safety but the prevalence of a low proportion of venom-specific antibodies. Toxicon 2022; 215:37-48. [DOI: 10.1016/j.toxicon.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/15/2022] [Accepted: 06/01/2022] [Indexed: 11/18/2022]
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Kakati H, Patra A, Kalita B, Chanda A, Rapole S, Mukherjee AK. A comparison of two different analytical workflows to determine the venom proteome composition of Naja kaouthia from North-East India and immunological profiling of venom against commercial antivenoms. Int J Biol Macromol 2022; 208:275-287. [PMID: 35331793 DOI: 10.1016/j.ijbiomac.2022.03.095] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 11/05/2022]
Abstract
The Indian monocled cobra (Naja kaouthia) is one of the most prevalent venomous snakes in northeast India (NEI) and is the cause of many fatalities. The composition of NEI N. kaouthia venom (NkV) was deciphered using two different proteomic approaches: (i) 1D SDS-PAGE coupled to label-free quantification of protein bands using stringent identification criteria and (ii) reversed-phase high-performance liquid chromatography (RP-HPLC) followed by quantification based on area under the RP-HPLC peaks. The proteomic data from both strategies were compared. Proteomic analyses from both workflows identified 32 proteins (toxins) distributed over 10-14 snake venom protein families in NEI NkV. The relative abundances of the venom proteins determined from the analytical workflows coincided with the densitometry band intensities of the NEI NkV. Phospholipase A2 (13.1-16.0%) and three-finger toxins (58.5-64.2%) represented the most abundant enzymatic and non-enzymatic proteins in NEI NkV, respectively. Immuno-cross-reactivity studies by enzyme-linked immunoassay and immunoblot analyses pointed to the poor efficacy of commercial PAVs in recognizing the low molecular mass (<15 kDa) toxins of NEI NkV. Spectrofluorometric titration determined the presence of NEI NkV-specific antibodies in commercial PAV, at a level that was higher than that previously reported for eastern India NkV-specific antibodies in commercial antivenom.
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Affiliation(s)
- Hirakjyoti Kakati
- Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur 784028, Assam, India
| | - Aparup Patra
- Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur 784028, Assam, India; Division of Life Sciences, Institute of Advanced Study in Science and Technology, Vigyan Path, Paschim Boragaon, Garchuk, Guwahati 781035, Assam, India
| | - Bhargab Kalita
- Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi 682041, Kerala, India; Proteomics Lab, National Centre for Cell Science, NCCS Complex, Savitribai Phule Pune University Campus, Ganeshkhind Road, Pune 411007, Maharashtra, India
| | - Abhishek Chanda
- Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur 784028, Assam, India
| | - Srikanth Rapole
- Proteomics Lab, National Centre for Cell Science, NCCS Complex, Savitribai Phule Pune University Campus, Ganeshkhind Road, Pune 411007, Maharashtra, India
| | - Ashis K Mukherjee
- Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur 784028, Assam, India; Division of Life Sciences, Institute of Advanced Study in Science and Technology, Vigyan Path, Paschim Boragaon, Garchuk, Guwahati 781035, Assam, India.
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Sandesha VD, Darshan B, Tejas C, Girish KS, Kempaiah K. A comparative cross-reactivity and paraspecific neutralization study on Hypnale hypnale, Echis carinatus, and Daboia russelii monovalent and therapeutic polyvalent anti-venoms. PLoS Negl Trop Dis 2022; 16:e0010292. [PMID: 35344557 PMCID: PMC9037957 DOI: 10.1371/journal.pntd.0010292] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 04/25/2022] [Accepted: 03/01/2022] [Indexed: 12/30/2022] Open
Abstract
Envenoming by the hump-nosed pit viper (Hypnale hypnale) raises concern as it inflicts significant debilitation and death in the Western Ghats of India and in the adjacent island nation of Sri Lanka. In India, its medical significance was realized only during 2007 due to its misidentification as Echis carinatus and sometimes as Daboia russelii. Of late, several case reports have underlined the ineptness of the existing polyvalent anti-venom therapy against H. hypnale envenoming. Currently, H. hypnale bite has remained dreadful in India due to the lack of neutralizing anti-venom therapy. Hence, this study was undertaken to establish a systematic comparative, biochemical, pathological, and immunological properties of Sri Lankan H. hypnale venom alongside Indian E. carinatus, and D. russelii venoms. All three venoms differed markedly in the extent of biochemical activities including proteolytic, deoxyribonuclease, L-amino acid oxidase, 5'-nucleotidase, hyaluronidase, and indirect hemolytic activities. The venoms also differed markedly in their pathological properties such as edema, hemorrhage, myotoxic, cardiotoxic, and coagulant activities. The venoms showed stark differences in their protein banding pattern. Strikingly, the affinity-purified rabbit monovalent anti-venoms prepared against H. hypnale, E. carinatus, and D. russelii venoms readily reacted and neutralized the biochemical and pathological properties of their respective venoms, but they insignificantly cross-reacted with, and thus failed to show paraspecific neutralization of any of the effects of the other two venoms, demonstrating the large degree of variations between these venoms. Further, the Indian therapeutic polyvalent anti-venoms from VINS Bioproducts, and Bharath Serums and Vaccines failed to protect H. hypnale venom-induced lethal effects in mice.
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Affiliation(s)
| | - Bhaskar Darshan
- Department of Studies in Biochemistry, University of Mysore, Manasagangotri, Mysuru, Karnataka, India
| | - Chandrashekar Tejas
- Department of Studies in Biochemistry, University of Mysore, Manasagangotri, Mysuru, Karnataka, India
| | - Kesturu S. Girish
- Department of Studies and Research in Biochemistry, Tumkur University, Tumakuru, Karnataka, India
| | - Kemparaju Kempaiah
- Department of Studies in Biochemistry, University of Mysore, Manasagangotri, Mysuru, Karnataka, India
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Ramana LN, Mathapati SS, Salvi N, Khadilkar MV, Malhotra A, Santra V, Sharma TK. A paper microfluidic device based colorimetric sensor for the detection and discrimination of elapid versus viper envenomation. Analyst 2022; 147:685-694. [PMID: 35072182 DOI: 10.1039/d1an01698a] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Snake bites are a neglected tropical disease, causing mortality and severe damage to various vital organs like the nervous system, kidneys and heart. There is increasing interest in designing new antivenom treatments that are more specific to particular groups (either taxonomic or regional) of species, given the increasing evidence that current polyvalent Indian antivenom is ineffective in many situations. Under these circumstances, being able to detect the species, or a group of species, responsible for the envenomation becomes important. Unfortunately, no such diagnostic tool is available in the Indian market. Such a tool will need to be rapid, sensitive and affordable. To address this need, we have combined the power of nanotechnology and paper microfluidics and herein report a device that has the ability to detect and differentiate viper venom from elapid and scorpion venom. In principle, this assay is based on the release of the dye from the stimuli-responsive glutaraldehyde cross-linked methylene blue-loaded gelatin (GMG) nanoparticles in the presence of snake venom metalloproteases and serine proteases. The developed equipment-free assay can detect and discriminate viper venom from that of elapids and scorpions. The low-end detection limit of the sensor is ∼3.0 ng for the saw-scaled viper Echis carinatus, while the same for Russell's viper Daboia russelii is ∼6.0 ng. The performance of the sensor remains unaltered for different batches of GMG nanoparticles. Altogether, this finding establishes the role of nanotechnology and paper microfluidics in the rapid and accurate detection of viper venom.
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Affiliation(s)
- Lakshmi Narashimhan Ramana
- Aptamer Technology and Diagnostics Laboratory, Multidisciplinary Clinical and Translational Research Group, Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana 121001, India.
| | - Santosh S Mathapati
- Multidisciplinary Clinical and Translational Research Group, Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana 121001, India
| | - Nitin Salvi
- Premium Serums and Vaccines Pvt. Ltd, Maharashtra, 410504, India
| | - M V Khadilkar
- Premium Serums and Vaccines Pvt. Ltd, Maharashtra, 410504, India
| | - Anita Malhotra
- School of Natural sciences, College of Environment sciences and Engineering, Bangor University, Bangor LL57 2UW, UK
| | - Vishal Santra
- Society for Nature Conservation, Research and Community Engagement (CONCERN), Nalikul, Hooghly, 712407, West Bengal, India
- Captive and Field Herpetology, 13 Hirfron, Anglesey, LL65 1YU, Wales, UK
| | - Tarun Kumar Sharma
- Aptamer Technology and Diagnostics Laboratory, Multidisciplinary Clinical and Translational Research Group, Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana 121001, India.
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20
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Mender MM, Bolton F, Berry C, Young M. Antivenom: An immunotherapy for the treatment of snakebite envenoming in sub-Saharan Africa. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2021; 129:435-477. [PMID: 35305724 DOI: 10.1016/bs.apcsb.2021.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Snakebite envenoming (SBE) leads to significant morbidity and mortality, resulting in over 90,000 deaths and approximately 400,000 amputations annually. In sub-Saharan Africa (SSA) alone, SBE accounts for over 30,000 deaths per annum. Since 2017, SBE has been classified as a priority Neglected Tropical Disease (NTD) by the World Health Organisation (WHO). The major species responsible for mortality from SBE within SSA are from the Bitis, Dendroaspis, Echis and Naja genera. Pharmacologically active toxins such as metalloproteinases, serine proteinases, 3-finger toxins, kunitz-type toxins, and phospholipase A2s are the primary snake venom components. These toxins induce cytotoxicity, coagulopathy, hemorrhage, and neurotoxicity in envenomed victims. Antivenom is currently the only available venom-specific treatment for SBE and contains purified equine or ovine polyclonal antibodies, collected from donor animals repeatedly immunized with low doses of adjuvanted venom. The resulting plasma or serum contains a high titre of specific antibodies, which can then be collected and stored until required. The purified antibodies are either whole IgG, monovalent fragment antibody (Fab) or divalent fragment antibody F(ab')2. Despite pharmacokinetic and pharmacodynamic differences, all three are effective in the treatment of SBE. No antivenom is without adverse reactions but, the level of their impact and severity varies from benign early adverse reactions to the rarely occurring fatal anaphylactic shock. However, the major side effects are largely reversible with immediate administration of adrenaline and corticosteroids. There are 16 different antivenoms marketed within SSA, but the efficacy and safety profiles are only published for less than 50% of these products.
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Affiliation(s)
- Mender M Mender
- School of Bioscience, Cardiff University, Cardiff, United Kingdom; Department of Research and Development, MicroPharm Ltd, Newcastle Emlyn, United Kingdom.
| | - Fiona Bolton
- Department of Research and Development, MicroPharm Ltd, Newcastle Emlyn, United Kingdom
| | - Colin Berry
- School of Bioscience, Cardiff University, Cardiff, United Kingdom
| | - Mark Young
- School of Bioscience, Cardiff University, Cardiff, United Kingdom
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21
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Modahl CM, Saviola AJ, Mackessy SP. Integration of transcriptomic and proteomic approaches for snake venom profiling. Expert Rev Proteomics 2021; 18:827-834. [PMID: 34663159 DOI: 10.1080/14789450.2021.1995357] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Snake venoms contain many protein and peptide isoforms with high levels of sequence variation, even within a single species. AREAS COVERED In this review, we highlight several examples, from both published and unpublished work in our lab, demonstrating how a combined venom gland transcriptome and proteome methodology allows for comprehensive characterization of venoms, including those from understudied rear-fanged snake species, and we provide recommendations for using these approaches. EXPERT OPINION When characterizing venoms, peptide mass fingerprinting using databases built predominately from protein sequences originating from model organisms can be disadvantageous, especially when the intention is to document protein diversity. Therefore, the use of species-specific venom gland transcriptomes corrects for the absence of these unique peptide sequences in databases. The integration of transcriptomics and proteomics improves the accuracy of either approach alone for venom profiling.
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Affiliation(s)
| | - Anthony J Saviola
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Stephen P Mackessy
- School of Biological Sciences, University of Northern Colorado, Greeley, USA
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22
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Puzari U, Fernandes PA, Mukherjee AK. Advances in the Therapeutic Application of Small-Molecule Inhibitors and Repurposed Drugs against Snakebite. J Med Chem 2021; 64:13938-13979. [PMID: 34565143 DOI: 10.1021/acs.jmedchem.1c00266] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The World Health Organization has declared snakebite as a neglected tropical disease. Antivenom administration is the sole therapy against venomous snakebite; however, several limitations of this therapy reinforce the dire need for an alternative and/or additional treatment against envenomation. Inhibitors against snake venoms have been explored from natural resources and are synthesized in the laboratory; however, repurposing of small-molecule therapeutics (SMTs) against the principal toxins of snake venoms to inhibit their lethality and/or obnoxious effect of envenomation has been garnering greater attention owing to their established pharmacokinetic properties, low-risk attributes, cost-effectiveness, ease of administration, and storage stability. Nevertheless, SMTs are yet to be approved and commercialized for snakebite treatment. Therefore, we have systematically reviewed and critically analyzed the scenario of small synthetic inhibitors and repurposed drugs against snake envenomation from 2005 to date and proposed novel approaches and commercialization strategies for the development of efficacious therapies against snake envenomation.
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Affiliation(s)
- Upasana Puzari
- Department of Molecular Biology and Biotechnology, School of Sciences, Tezpur University, Tezpur-784028, Assam, India
| | - Pedro Alexandrino Fernandes
- LAQV@REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Rua Do Campo Alegre S/N, 4169-007 Porto, Portugal
| | - Ashis K Mukherjee
- Department of Molecular Biology and Biotechnology, School of Sciences, Tezpur University, Tezpur-784028, Assam, India.,Institute of Advanced Study in Science and Technology, Vigyan Path Garchuk, Paschim Boragaon, Guwahati-781035, Assam, India
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23
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Devi A, Doley R. Neutralization of Daboxin P activities by rationally designed aptamers. Toxicon 2021; 203:93-103. [PMID: 34619285 DOI: 10.1016/j.toxicon.2021.09.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
Inefficacy and associated risks of current antivenom has raised the need for alternative approaches of snakebite management. Aptamers are one such alternative which is being pursued for therapeutic interventions as well as for design of diagnostic kits due to its high specificity. Present study focussed on designing and validating nucleic acid aptamers against snake venom PLA2, a hydrolytic enzyme present in all venomous snakes. The aptamers were designed by adding nucleic acid chain on the surface of Daboxin P, a major PLA2 enzyme of Daboia russelii venom. Binding characteristics of the aptamers were confirmed by docking to Daboxin P as well as acidic and basic PLA2s from different snake species using in silico docking. The aptamers folded into different tertiary structures and bound to the active and Ca2+ binding site of PLA2 enzymes. Molecular dynamics simulation analysis of Daboxin P-aptamer complexes showed that the complexes were stable in an aqueous environment. The electrophoretic mobility shift assay further confirmed the binding of the synthetic aptamers to Daboxin P and other snake venom PLA2 enzymes. The aptamers inhibited the sPLA2 activity with an IC50 value ranging between 0.52 μM and 0.77 μM as well as the anticoagulant activity of Daboxin P. The aptamers could also inhibit the PLA2 activity of Echis carinatus crude venom and anti-coagulant activity of Bungarus caeruleus crude venom, members of big four snakes. However, the aptamers didn't inhibit fibrinogenolytic or proteolytic activity of big four venom as well as the coagulation and hemolytic activities. Thus, aptamers can be rationally designed to inhibit the biochemical and biological activities of snake venom proteins.
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Affiliation(s)
- Arpita Devi
- Molecular Toxinology Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Napaam, Tezpur, Assam, India
| | - Robin Doley
- Molecular Toxinology Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Napaam, Tezpur, Assam, India.
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Patra A, Kalita B, Khadilkar MV, Salvi NC, Shelke PV, Mukherjee AK. Assessment of quality and pre-clinical efficacy of a newly developed polyvalent antivenom against the medically important snakes of Sri Lanka. Sci Rep 2021; 11:18238. [PMID: 34521877 PMCID: PMC8440654 DOI: 10.1038/s41598-021-97501-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 07/06/2021] [Indexed: 02/08/2023] Open
Abstract
Snake envenomation is a severe problem in Sri Lanka (SL) and Indian polyvalent antivenom (PAV) is mostly used for treating snakebite albeit due to geographical variation in venom composition, Indian PAV shows poor efficacy in neutralizing the lethality and toxicity of venom from the same species of snakes in SL. Therefore, the quality and in vivo venom neutralization potency of a country-specific PAV produced against the venom of the five most medically important snakes of SL (Daboia russelii, Echis carinatus, Hypnale hypnale, Naja naja, Bungarus caeruleus) was assessed. LC-MS/MS analysis of two batches of PAV showed the presence of 88.7-97.2% IgG and traces of other plasma proteins. The tested PAVs contained minor amounts of undigested IgG and F(ab')2 aggregates, showed complement activation, were devoid of IgE, endotoxin, and content of preservative was below the threshold level. Immunological cross-reactivity and in vitro neutralization of enzymatic activities, pharmacological properties demonstrated superior efficacy of SL PAV compared to Indian PAV against SL snake venoms. The in vivo neutralization study showed that the tested PAVs are potent to neutralize the lethality and venom-induced toxicity of SL snake venoms. Therefore, our study suggests that introduction of SL-specific PAV will improve snakebite management in SL.
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Affiliation(s)
- Aparup Patra
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, School of Science, Tezpur University, Tezpur, Assam, 784028, India
| | - Bhargab Kalita
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, School of Science, Tezpur University, Tezpur, Assam, 784028, India
| | - Milind V Khadilkar
- Premium Serums and Vaccines Pvt. Ltd, Narayangaon, Pune, Maharashtra, 410504, India
| | - Nitin C Salvi
- Premium Serums and Vaccines Pvt. Ltd, Narayangaon, Pune, Maharashtra, 410504, India
| | - Pravin V Shelke
- Premium Serums and Vaccines Pvt. Ltd, Narayangaon, Pune, Maharashtra, 410504, India
| | - Ashis K Mukherjee
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, School of Science, Tezpur University, Tezpur, Assam, 784028, India.
- Institute of Advanced Study in Science and Technology, Vigyan Path, Garchuk, Paschim Boragaon, Guwahati, Assam, 781035, India.
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Zaeri S, Fatemikia H, Kamyab M, Esmaili A, Kim E, Mohammadpour Dounighi N, Salemi A, Khadem P, Seyedian R. Hemodynamic Changes Provoked through Intravascular Injection of the Echis carinatus Venom in Rats. ARCHIVES OF RAZI INSTITUTE 2021; 76:599-607. [PMID: 34824752 PMCID: PMC8605837 DOI: 10.22092/ari.2020.342944.1490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/29/2020] [Indexed: 06/13/2023]
Abstract
Echis carinatus (E. carinatus) is known for its hematological and nephrotoxic properties in the envenomed patients. Based on the limited data upon the cardiovascular changes associated with this dangerous venomous snake in Iran, the current study purposed to evaluate the venom-induced hemodynamic manifestations in rats. Venom (120 µg/kg) was administered intravenously within one minute through the left femoral vein, and the hemodynamic parameters were continuously recorded using a pressure transducer (MLT844, ADInstruments, Australia). The venom caused prominent hypotension leading to death a few minutes after a transient uprise in blood pressure. It also induced a decrease in heart and pulmonary rates, yet it had no arrhythmogenic properties. Additionally, pre-treatment with the pepsin-derived Iranian polyvalent antivenom (30 µl/Kg) completely neutralized the hemodynamic responses but had no effect when instilled two minutes after venom injection. Heparin (300 IU/kg) and epinephrine (1.5 µg/kg) prevented dramatic hypotension when used 10 minutes before venom instillation; however, atropine (1 mg/kg), dexamethasone (1 mg/kg), and ketorolac (10 mg/ml) had no effects. All treated rats were killed post-injection. Histologically, the lung was the most vulnerable organ with mononuclear infiltration, microcystic formation, and significant capillary congestion. Prominent renal pathological deterioration also occurred, including mesangial cell infiltration and diffuse bleeding, leading to acute tubular necrosis. Modest portal inflammation and vascular congestion were observed in the hepatic tissue of the envenomed rats. The crude venom of Iranian Echis carinatus caused hypotension leading to bradycardia, a decrease in pulmonary rate, and death without significant histological changes to the heart.
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Affiliation(s)
- S Zaeri
- Department of Pharmacology, Bushehr University of Medical Sciences, Bushehr, Iran
| | - H Fatemikia
- Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Iran
| | - M Kamyab
- Department of Aquatic Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University Tehran, Iran
| | - A Esmaili
- Department of Pathology, Bushehr University of Medical Sciences, Bushehr, Iran
| | - E Kim
- College of Veterinary Medicine, Gyeongsang National University, Jinju, KR
| | - N Mohammadpour Dounighi
- Department of Human Vaccine and Serum, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - A Salemi
- Department of Human Vaccine and Serum, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - P Khadem
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - R Seyedian
- Department of Pharmacology, Bushehr University of Medical Sciences, Bushehr, Iran
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Mukherjee AK, Mackessy SP. Prevention and improvement of clinical management of snakebite in Southern Asian countries: A proposed road map. Toxicon 2021; 200:140-152. [PMID: 34280412 DOI: 10.1016/j.toxicon.2021.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 07/10/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
In the Southern Asian countries, snakebite takes a substantial toll in terms of human life, inflicts acute morbidity and long term disability both physical and psychological, and therefore represents a neglected socio-economic problem and severe health issue that requires immediate medical attention. The 'Big Four' venomous snakes, viz. Daboia russelii, Naja naja, Bungarus caeruleus and Echis carinatus, are prominent, medically important species and are the most dangerous snakes of this region; therefore, the commercial polyvalent antivenom (PAV) contains antibodies against the venoms of these snakes. However, envenomations by species other than the 'Big Four' snakes are grossly neglected, and PAV is only partially effective in neutralizing the venom of these snakes. Many issues confounding effective treatment of snakebite are discussed in this review, and these hurdles preventing successful treatment of snakebite must be addressed. However, in South Asian countries, the pre-hospital treatment and appropriate first aid are equally important to mitigate the problem of snakebite and therefore, these issues are also highlighted here. Further, this review suggests a roadmap and guidelines for the prevention of snakebite and improvement of hospital management of snakebite in these Southern Asian countries.
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Affiliation(s)
- Ashis K Mukherjee
- Division of Life Sciences, Institute of Advanced Study in Science and Technology, Vigyan Path Garchuk, Paschim Boragaon, Guwahati, 781035, Assam, India; Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, 78028, Assam, India; School of Biological Sciences, University of Northern Colorado, Greeley, CO, 80639-0017, USA.
| | - Stephen P Mackessy
- School of Biological Sciences, University of Northern Colorado, Greeley, CO, 80639-0017, USA
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Patra A, Herrera M, Gutiérrez JM, Mukherjee AK. The application of laboratory-based analytical tools and techniques for the quality assessment and improvement of commercial antivenoms used in the treatment of snakebite envenomation. Drug Test Anal 2021; 13:1471-1489. [PMID: 34089574 DOI: 10.1002/dta.3108] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 12/18/2022]
Abstract
Snakebite envenomation is a public health problem of high impact, particularly for the developing world. Antivenom, which contains whole or protease-digested immunoglobulin G, purified from the plasma of hyper-immunized animals (mainly horses), is the mainstay for the treatment of snakebite envenomation. The success of antivenom therapy depends upon its ability to abrogate or reduce the local and systemic toxicity of envenomation. In addition, antivenom administration must be safe for the patients. Therefore, antivenom manufacturers must ensure that these products are effective and safe in the treatment of envenomations. Antivenom efficacy and safety are determined by the physicochemical characteristics of formulations, purity of the immunoglobulin fragments and antibodies, presence of protein aggregates, endotoxin burden, preservative load, and batch to batch variation, as well as on the ability to neutralize the most important toxins of the venoms against which the antivenom is designed. In this context, recent studies have shown that laboratory-based simple analytical techniques, for example, size exclusion chromatography, sodium dodecyl sulphate polyacrylamide gel electrophoresis, mass spectrometry, immunological profiling including immuno-turbidimetry and enzyme-linked immunosorbent assays, Western blotting, immune-chromatographic technique coupled to mass spectrometry analysis, reverse-phase high performance liquid chromatography, spectrofluorometric analysis, in vitro neutralization of venom enzymatic activities, and other methodologies, can be applied for the assessment of antivenom quality, safety, stability, and efficacy. This article reviews the usefulness of different analytical techniques for the quality assessment of commercial antivenoms. It is suggested that these tests should be applied for screening the quality of commercial antivenoms before their preclinical and clinical assessment.
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Affiliation(s)
- Aparup Patra
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, India
| | - María Herrera
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Ashis K Mukherjee
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, India.,Life Science Division, Institute of Advanced Study in Science and Technology, Vigyan Path, Garchuk, Paschim Boragaon, Guwahati, 781035, India
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Damm M, Hempel BF, Süssmuth RD. Old World Vipers-A Review about Snake Venom Proteomics of Viperinae and Their Variations. Toxins (Basel) 2021; 13:toxins13060427. [PMID: 34204565 PMCID: PMC8235416 DOI: 10.3390/toxins13060427] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/11/2021] [Accepted: 06/16/2021] [Indexed: 12/12/2022] Open
Abstract
Fine-tuned by millions of years of evolution, snake venoms have frightened but also fascinated humanity and nowadays they constitute potential resources for drug development, therapeutics and antivenoms. The continuous progress of mass spectrometry techniques and latest advances in proteomics workflows enabled toxinologists to decipher venoms by modern omics technologies, so-called ‘venomics’. A tremendous upsurge reporting on snake venom proteomes could be observed. Within this review we focus on the highly venomous and widely distributed subfamily of Viperinae (Serpentes: Viperidae). A detailed public literature database search was performed (2003–2020) and we extensively reviewed all compositional venom studies of the so-called Old-World Vipers. In total, 54 studies resulted in 89 venom proteomes. The Viperinae venoms are dominated by four major, four secondary, six minor and several rare toxin families and peptides, respectively. The multitude of different venomics approaches complicates the comparison of venom composition datasets and therefore we differentiated between non-quantitative and three groups of quantitative workflows. The resulting direct comparisons within these groups show remarkable differences on the intra- and interspecies level across genera with a focus on regional differences. In summary, the present compilation is the first comprehensive up-to-date database on Viperinae venom proteomes and differentiating between analytical methods and workflows.
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Affiliation(s)
- Maik Damm
- Department of Chemistry, Technische Universität Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany;
| | - Benjamin-Florian Hempel
- BIH Center for Regenerative Therapies, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, (BCRT), 10117 Berlin, Germany;
| | - Roderich D. Süssmuth
- Department of Chemistry, Technische Universität Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany;
- Correspondence: ; Tel.: +49-(0)30-314-24205
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Silva GM, Berto DH, Lima CA, Waitman KB, Lima CFG, Prezoto BC, Vieira ML, Rocha MMT, Gonçalves LRC, Andrade SA. Synergistic effect of serine protease inhibitors and a bothropic antivenom in reducing local hemorrhage and coagulopathy caused by Bothrops jararaca venom. Toxicon 2021; 199:87-93. [PMID: 34126124 DOI: 10.1016/j.toxicon.2021.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/05/2021] [Accepted: 06/10/2021] [Indexed: 01/11/2023]
Abstract
Snakebite accidents are a public health problem that affects the whole world, causing thousands of deaths and amputations each year. In Brazil, snakebite envenomations are caused mostly by snakes from the Bothrops genus. The local symptoms are characterized by pain, swelling, ecchymosis, and hemorrhages. Systemic disturbances can lead to necrosis and amputations. The present treatment consists of intravenous administration of bothropic antivenom, which is capable of reversing most of the systemic symptoms, while presenting limitations to treat the local effects, such as hemorrhage and to neutralize the snake venom serine protease (SVSP). In this context, we aimed to evaluate the activity of selective serine protease inhibitors (pepC and pepB) in combination with the bothropic antivenom in vivo. Further, we assessed their possible synergistic effect in the treatment of coagulopathy and hemorrhage induced by Bothrops jararaca venom. For this, we evaluated the in vivo activity in mouse models of local hemorrhage and a series of in vitro hemostasis assays. Our results showed that pepC and pepB, when combinated with the antivenom, increase its protective activity in vivo and decrease the hemostatic disturbances in vitro with high selectivity, possibly by inhibiting botropic proteases. These data suggest that the addition of serine protease inhibitor to the antivenom can improve its overall potential.
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Affiliation(s)
- G M Silva
- Laboratory of Pain and Signaling - Butantan Institute, São Paulo, Brazil.
| | - D H Berto
- Laboratory of Pain and Signaling - Butantan Institute, São Paulo, Brazil
| | - C A Lima
- Laboratory of Pain and Signaling - Butantan Institute, São Paulo, Brazil
| | - K B Waitman
- Laboratory of Pain and Signaling - Butantan Institute, São Paulo, Brazil
| | - C F G Lima
- Laboratory of Pain and Signaling - Butantan Institute, São Paulo, Brazil
| | - B C Prezoto
- Laboratory of Pharmacology - Butantan Institute, São Paulo, Brazil
| | - M L Vieira
- Department of Microbiology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - M M T Rocha
- Laboratory of Herpetology - Butantan Institute, São Paulo, Brazil
| | - L R C Gonçalves
- Laboratory of Pathophysiology - Butantan Institute, São Paulo, Brazil
| | - S A Andrade
- Laboratory of Pain and Signaling - Butantan Institute, São Paulo, Brazil
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30
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Faisal T, Tan KY, Tan NH, Sim SM, Gnanathasan CA, Tan CH. Proteomics, toxicity and antivenom neutralization of Sri Lankan and Indian Russell's viper ( Daboia russelii) venoms. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20200177. [PMID: 33995514 PMCID: PMC8092856 DOI: 10.1590/1678-9199-jvatitd-2020-0177] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/17/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The western Russell's viper (Daboia russelii) is widely distributed in South Asia, and geographical venom variation is anticipated among distant populations. Antivenoms used for Russell's viper envenomation are, however, raised typically against snakes from Southern India. The present study investigated and compared the venom proteomes of D. russelii from Sri Lanka (DrSL) and India (DrI), the immunorecognition of Indian VINS Polyvalent Antivenom (VPAV) and its efficacy in neutralizing the venom toxicity. METHODS The venoms of DrSL and DrI were decomplexed with C18 high-performance liquid chromatography and SDS-polyacrylamide gel electrophoresis under reducing conditions. The proteins fractionated were identified through nano-ESI-liquid chromatography-tandem mass spectrometry (LCMS/MS). The immunological studies were conducted with enzyme-linked immunosorbent assay. The neutralization of the venom procoagulant effect was evaluated in citrated human plasma. The neutralization of the venom lethality was assessed in vivo in mice adopting the WHO protocol. RESULTS DrSL and DrI venom proteomes showed comparable major protein families, with phospholipases A2 (PLA2) being the most abundant (> 60% of total venom proteins) and diverse (six protein forms identified). Both venoms were highly procoagulant and lethal (intravenous median lethal dose in mice, LD50 = 0.24 and 0.32 µg/g, for DrSL and DrI, respectively), while lacking hemorrhagic and anticoagulant activities. VPAV was immunoreactive toward DrSL and DrI venoms, indicating conserved protein antigenicity in the venoms. The high molecular weight venom proteins were, however, more effectively immunorecognized than small ones. VPAV was able to neutralize the coagulopathic and lethal effects of the venoms moderately. CONCLUSION Considering that a large amount of venom can be injected by Russell's viper during envenomation, the potency of antivenom can be further improved for optimal neutralization and effective treatment. Region-specific venoms and key toxins may be incorporated into the immunization procedure during antivenom production.
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Affiliation(s)
- Tasnim Faisal
- Department of Pharmacology, Faculty of Medicine, University of
Malaya, Kuala Lumpur, Malaysia
| | - Kae Yi Tan
- Department of Molecular Medicine, Faculty of Medicine, University of
Malaya, Kuala Lumpur, Malaysia
| | - Nget Hong Tan
- Department of Molecular Medicine, Faculty of Medicine, University of
Malaya, Kuala Lumpur, Malaysia
| | - Si Mui Sim
- Department of Pharmacology, Faculty of Medicine, University of
Malaya, Kuala Lumpur, Malaysia
| | | | - Choo Hock Tan
- Department of Pharmacology, Faculty of Medicine, University of
Malaya, Kuala Lumpur, Malaysia
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Modulation of Diverse Procoagulant Venom Activities by Combinations of Platinoid Compounds. Int J Mol Sci 2021; 22:ijms22094612. [PMID: 33924780 PMCID: PMC8124986 DOI: 10.3390/ijms22094612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 01/03/2023] Open
Abstract
Procoagulant snake venoms have been inhibited by the ruthenium containing compounds CORM-2 and RuCl3 separately, presumably by interacting with critical histidine or other sulfur-containing amino acids on key venom enzymes. However, combinations of these and other platinoid containing compounds could potentially increase, decrease or not affect the procoagulant enzyme function of venom. Thus, the purpose of this investigation was to determine if formulations of platinoid compounds could inhibit venom procoagulant activity and if the formulated compounds interacted to enhance inhibition. Using a human plasma coagulation kinetic model to assess venom activity, six diverse venoms were exposed to various combinations and concentrations of CORM-2, CORM-3, RuCl3 and carboplatin (a platinum containing compound), with changes in venom activity determined with thrombelastography. The combinations of CORM-2 or CORM-3 with RuCl3 were found to enhance inhibition significantly, but not in all venoms nor to the same extent. In sharp contrast, carboplatin-antagonized CORM-2 mediated the inhibition of venom activity. These preliminary results support the concept that platinoid compounds may inhibit venom enzymatic activity at the same or different molecular sites and may antagonize inhibition at the same or different sites. Further investigation is warranted to determine if platinoid formulations may serve as potential antivenoms.
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Kalita B, Saviola AJ, Mukherjee AK. From venom to drugs: a review and critical analysis of Indian snake venom toxins envisaged as anticancer drug prototypes. Drug Discov Today 2021; 26:993-1005. [DOI: 10.1016/j.drudis.2020.12.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/13/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022]
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Gopalakrishnan M, Yadav P, Mathur R, Midha N, Garg MK. Venom-Induced Consumption Coagulopathy Unresponsive to Antivenom After Echis carinatus sochureki Envenoming. Wilderness Environ Med 2021; 32:221-225. [PMID: 33781663 DOI: 10.1016/j.wem.2021.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 11/18/2020] [Accepted: 01/04/2021] [Indexed: 10/21/2022]
Abstract
Snakebite envenoming is a serious and life-threatening but neglected problem in the tropics. The focus in the Indian subcontinent is usually on the Indian cobra (Naja naja), common krait (Bungarus caeruleus), Russell's viper (Daboia russelii), and Indian saw-scaled viper (Echis carinatus). The Indian polyvalent antivenom contains hyperimmunized horse antibodies against only these 4 species. However, regional intraspecific variations are important in viper envenomings, leading to marked differences in clinical presentation and response to the available polyvalent antivenom. Echis carinatus sochureki, a subspecies of Echis carinatus, has been linked to serious morbidity in the Thar Desert regions of Rajasthan, although consistent reports are lacking. We report a patient with prolonged venom-induced consumption coagulopathy owing to Echis carinatus sochureki envenoming who did not respond to Indian polyvalent antivenom in Jodhpur, India. Features of local and hemotoxic envenoming resolved after a week with supportive care. Echis sochureki venom has been shown to be different from Echis carinatus in terms of composition and in vitro neutralization by antivenom. Clinicians in the tropical desert regions must suspect Echis sochureki envenoming in the setting of nonresponsiveness to Indian polyvalent antivenom. This will help optimize antivenom use in these patients, preventing potentially life-threatening antivenom associated reactions. Because the usefulness of Indian polyvalent antivenom appears to be limited in this setting, there is an urgent need to advocate for region-specific antivenom or monovalent antivenom for this area.
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Affiliation(s)
- Maya Gopalakrishnan
- Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India.
| | - Prakrati Yadav
- Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Rohit Mathur
- Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Naresh Midha
- Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Mahendra Kumar Garg
- Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
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Kaur N, Iyer A, Sunagar K. Evolution Bites - Timeworn Inefficacious Snakebite Therapy in the Era of Recombinant Vaccines. Indian Pediatr 2021; 58:219-223. [PMID: 33713055 PMCID: PMC7610842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Snakebite is a neglected tropical disease that inflicts severe socioeconomic burden on developing countries by primarily affecting their rural agrarian populations. India is a major snakebite hotspot in the world, as it accounts for more than 58,000 annual snakebite mortalities and over three times that number of morbidities. The only available treatment for snakebite is a commercially marketed polyvalent antivenom, which is manufactured exclusively against the 'big four' Indian snakes. In this review, we highlight the influence of ecology and evolution in driving inter- and intra-specific venom variations in snakes. We describe the repercussions of this molecular variation on the effectiveness of the current generation Indian antivenoms in mitigating snakebite pathologies. We highlight the disturbing deficiencies of the conventional animal-derived antivenoms, and review next-generation recombinant antivenoms and other promising therapies for the efficacious treatment of this disease.
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Affiliation(s)
- Navneet Kaur
- Evolutionary Venomics Lab, Centre for Ecological Sciences, Indian Institute of Science. Bangalore, Karnataka, India
| | - Ashwin Iyer
- Evolutionary Venomics Lab, Centre for Ecological Sciences, Indian Institute of Science. Bangalore, Karnataka, India
| | - Kartik Sunagar
- Evolutionary Venomics Lab, Centre for Ecological Sciences, Indian Institute of Science. Bangalore, Karnataka, India. Correspondence to: Dr Kartik Sunagar, Evolutionary Venomics Lab, Centre for Ecological Sciences, Indian Institute of Science. Bengaluru 560 012, Karnataka, India.
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35
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Matysiak J, Matuszewska E, Kowalski ML, Kosiński SW, Smorawska-Sabanty E, Matysiak J. Association between Venom Immunotherapy and Changes in Serum Protein-Peptide Patterns. Vaccines (Basel) 2021; 9:249. [PMID: 33809001 PMCID: PMC8001044 DOI: 10.3390/vaccines9030249] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 01/25/2023] Open
Abstract
Venom immunotherapy (VIT) is administered to allergic patients to reduce the risk of dangerous systemic reactions following an insect sting. To better understand the mechanism of this treatment and its impact on the human organism, we analysed serum proteomic patterns obtained at five time-points from Hymenoptera-venom-allergic patients undergoing VIT. For statistical analyses, patients were additionally divided into two groups (high responders and low responders) according to serum sIgG4 levels. VIT was found to be associated with changes in seven proteins: the fibrinogen alpha chain, complement C4-A, complement C3, filamin-B, kininogen-1, myosin-9 and inter-alpha-trypsin inhibitor heavy chain H1. The number of discriminative m/z (mass-to-charge ratio) features increased up to the 90th day of VIT, which may be associated with the development of immunity after the administration of increased venom doses. It may also suggest that during VIT, there may occur processes involved not only in protein synthesis but also in protein degradation (caused by proteolytic venom components). The results are consistent with measured serum sIgG4 levels, which increased from 2.04 mgA/I at baseline to 7.25 mgA/I at 90 days. Moreover, the major proteomic changes were detected separately in the high responder group. This may suggest that changes in protein-peptide profiles reflect the actual response to VIT.
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Affiliation(s)
- Joanna Matysiak
- Faculty of Health Sciences, The President Stanisław Wojciechowski State University of Applied Sciences in Kalisz, 62-800 Kalisz, Poland;
| | - Eliza Matuszewska
- Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, 60-780 Poznań, Poland;
| | - Marek L. Kowalski
- Department of Immunology and Allergy, Medical University of Lodz, 92-213 Łódź, Poland; (M.L.K.); (S.W.K.); (E.S.-S.)
| | - Sławomir W. Kosiński
- Department of Immunology and Allergy, Medical University of Lodz, 92-213 Łódź, Poland; (M.L.K.); (S.W.K.); (E.S.-S.)
| | - Ewa Smorawska-Sabanty
- Department of Immunology and Allergy, Medical University of Lodz, 92-213 Łódź, Poland; (M.L.K.); (S.W.K.); (E.S.-S.)
| | - Jan Matysiak
- Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, 60-780 Poznań, Poland;
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Patra A, Banerjee D, Dasgupta S, Mukherjee AK. The in vitro laboratory tests and mass spectrometry-assisted quality assessment of commercial polyvalent antivenom raised against the ‘Big Four’ venomous snakes of India. Toxicon 2021; 192:15-31. [DOI: 10.1016/j.toxicon.2020.12.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/06/2020] [Accepted: 12/27/2020] [Indexed: 12/22/2022]
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da Silva GM, de Souza DHB, Waitman KB, Ebram MC, Fessel MR, Zainescu IC, Portaro FC, Heras M, de Andrade SA. Design, synthesis, and evaluation of Bothrops venom serine protease peptidic inhibitors. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20200066. [PMID: 33488681 PMCID: PMC7810238 DOI: 10.1590/1678-9199-jvatitd-2020-0066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/12/2020] [Indexed: 12/20/2022] Open
Abstract
Background: In Central and South America, snakebite envenomation is mainly caused by
Bothrops spp. snakes, whose venoms feature significant
biochemical richness, including serine proteases. The available bothropic
antivenoms are efficient in avoiding fatalities, but do not completely
neutralize venom serine proteases, which are co-responsible for some
disorders observed during envenomation. Methods: In order to search for tools to improve the antivenom’s, 6-mer peptides were
designed based on a specific substrate for Bothrops
jararaca venom serine proteases, and then synthesized, with the
intention to selectively inhibit these enzymes. Results: Using batroxobin as a snake venom serine protease model, two structurally
similar inhibitor peptides were identified. When tested on B.
jararaca venom, one of the new inhibitors displayed a good
potential to inhibit the activity of the venom serine proteases. These
inhibitors do not affect human serine proteases as human factor Xa and
thrombin, due to their selectivity. Conclusion: Our study identified two small peptides able to inhibit bothropic serine
proteases, but not human ones, can be used as tools to enhance knowledge of
the venom composition and function. Moreover, one promising peptide (pepC)
was identified that can be explored in the search for improving
Bothrops spp. envenomation treatment.
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Affiliation(s)
| | | | - Karoline B Waitman
- Laboratory of Pain and Signaling, Butantan Institute, São Paulo, SP, Brazil
| | | | - Melissa R Fessel
- Laboratory of Molecular Biology, Butantan Institute, São Paulo, SP, Brazil
| | | | - Fernanda C Portaro
- Laboratory of Immunochemistry, Butantan Institute, São Paulo, SP, Brazil
| | - Montse Heras
- Laboratory of Innovation in Processes and Products of Organic Synthesis, Department of Chemistry, University of Girona, Montilivi Campus, Girona, Spain
| | - Sonia A de Andrade
- Laboratory of Pain and Signaling, Butantan Institute, São Paulo, SP, Brazil
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Albulescu LO, Xie C, Ainsworth S, Alsolaiss J, Crittenden E, Dawson CA, Softley R, Bartlett KE, Harrison RA, Kool J, Casewell NR. A therapeutic combination of two small molecule toxin inhibitors provides broad preclinical efficacy against viper snakebite. Nat Commun 2020; 11:6094. [PMID: 33323937 PMCID: PMC7738508 DOI: 10.1038/s41467-020-19981-6] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 11/11/2020] [Indexed: 01/21/2023] Open
Abstract
Snakebite is a medical emergency causing high mortality and morbidity in rural tropical communities that typically experience delayed access to unaffordable therapeutics. Viperid snakes are responsible for the majority of envenomings, but extensive interspecific variation in venom composition dictates that different antivenom treatments are used in different parts of the world, resulting in clinical and financial snakebite management challenges. Here, we show that a number of repurposed Phase 2-approved small molecules are capable of broadly neutralizing distinct viper venom bioactivities in vitro by inhibiting different enzymatic toxin families. Furthermore, using murine in vivo models of envenoming, we demonstrate that a single dose of a rationally-selected dual inhibitor combination consisting of marimastat and varespladib prevents murine lethality caused by venom from the most medically-important vipers of Africa, South Asia and Central America. Our findings support the translation of combinations of repurposed small molecule-based toxin inhibitors as broad-spectrum therapeutics for snakebite.
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Affiliation(s)
- Laura-Oana Albulescu
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK
| | - Chunfang Xie
- Division of BioAnalytical Chemistry, Amsterdam Institute of Molecular and Life Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
- Centre for Analytical Sciences Amsterdam (CASA), 1098 XH, Amsterdam, The Netherlands
| | - Stuart Ainsworth
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK
| | - Jaffer Alsolaiss
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK
| | - Edouard Crittenden
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK
| | - Charlotte A Dawson
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK
| | - Rowan Softley
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK
| | - Keirah E Bartlett
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK
| | - Robert A Harrison
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK
| | - Jeroen Kool
- Division of BioAnalytical Chemistry, Amsterdam Institute of Molecular and Life Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
- Centre for Analytical Sciences Amsterdam (CASA), 1098 XH, Amsterdam, The Netherlands
| | - Nicholas R Casewell
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK.
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK.
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Long C, Liu M, Tian H, Li Y, Wu F, Mwangi J, Lu Q, Mohamed Abd El-Aziz T, Lai R, Shen C. Potential Role of Platelet-Activating C-Type Lectin-Like Proteins in Viper Envenomation Induced Thrombotic Microangiopathy Symptom. Toxins (Basel) 2020; 12:E749. [PMID: 33260875 PMCID: PMC7760373 DOI: 10.3390/toxins12120749] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/11/2020] [Accepted: 11/20/2020] [Indexed: 12/12/2022] Open
Abstract
Envenomation by viperid snakes may lead to severe bleeding, consumption coagulopathy, and thrombotic microangiopathy symptoms. The exact etiology or toxins responsible for thrombotic microangiopathy symptoms after snake envenomation remain obscure. Snake C-type lectin-like proteins (snaclecs) are one of the main non-enzymatic protein constituents in viper venoms, of which a majority are considered as modulators of thrombosis and hemostasis. In this study, we demonstrated that two snaclecs (mucetin and stejnulxin), isolated and identified from Protobothrops mucrosquamatus and Trimeresurus stejnegeri venoms, directly induced platelet degranulation and clot-retraction in vitro, and microvascular thrombosis has been confirmed in various organs in vivo. These snaclecs reduced cerebral blood flow and impaired motor balance and spatial memories in mice, which partially represent the thrombotic microangiopathy symptoms in some snakebite patients. The functional blocking of these snaclecs with antibodies alleviated the viper venom induced platelet activation and thrombotic microangiopathy-like symptoms. Understanding the pathophysiology of thrombotic microangiopathy associated with snake envenoming may lead to emerging therapeutic strategies.
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Affiliation(s)
- Chengbo Long
- Key Laboratory of Bioactive Peptides of Yunnan Province/Key Laboratory of Animal Models and Human, Disease Mechanisms of Chinese Academy of Sciences, Kunming Institute of Zoology, KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China; (C.L.); (H.T.); (F.W.); (J.M.); (Q.L.); (R.L.)
- School of Life Sciences, University of Chinese Academy of Sciences, Beijing 100009, China
| | - Ming Liu
- Department of Molecular and Cell Biology, School of Life Sciences, University of Science and Technology of China, Hefei 230027, China;
| | - Huiwen Tian
- Key Laboratory of Bioactive Peptides of Yunnan Province/Key Laboratory of Animal Models and Human, Disease Mechanisms of Chinese Academy of Sciences, Kunming Institute of Zoology, KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China; (C.L.); (H.T.); (F.W.); (J.M.); (Q.L.); (R.L.)
| | - Ya Li
- Key Laboratory of Laboratory Medicine of Yunnan Province/Department of Clinical Laboratory, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China;
| | - Feilong Wu
- Key Laboratory of Bioactive Peptides of Yunnan Province/Key Laboratory of Animal Models and Human, Disease Mechanisms of Chinese Academy of Sciences, Kunming Institute of Zoology, KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China; (C.L.); (H.T.); (F.W.); (J.M.); (Q.L.); (R.L.)
- School of Life Sciences, University of Chinese Academy of Sciences, Beijing 100009, China
| | - James Mwangi
- Key Laboratory of Bioactive Peptides of Yunnan Province/Key Laboratory of Animal Models and Human, Disease Mechanisms of Chinese Academy of Sciences, Kunming Institute of Zoology, KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China; (C.L.); (H.T.); (F.W.); (J.M.); (Q.L.); (R.L.)
- School of Life Sciences, University of Chinese Academy of Sciences, Beijing 100009, China
| | - Qiumin Lu
- Key Laboratory of Bioactive Peptides of Yunnan Province/Key Laboratory of Animal Models and Human, Disease Mechanisms of Chinese Academy of Sciences, Kunming Institute of Zoology, KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China; (C.L.); (H.T.); (F.W.); (J.M.); (Q.L.); (R.L.)
- Key Laboratory of Cardiovascular Disease of Yunnan Province, Kunming 650051, China
| | - Tarek Mohamed Abd El-Aziz
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA;
- Zoology Department, Faculty of Science, Minia University, El-Minia 61519, Egypt
| | - Ren Lai
- Key Laboratory of Bioactive Peptides of Yunnan Province/Key Laboratory of Animal Models and Human, Disease Mechanisms of Chinese Academy of Sciences, Kunming Institute of Zoology, KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China; (C.L.); (H.T.); (F.W.); (J.M.); (Q.L.); (R.L.)
- Sino-African Joint Research Center, CAS, Kunming Institute of Zoology, Kunming 650223, China
| | - Chuanbin Shen
- Key Laboratory of Bioactive Peptides of Yunnan Province/Key Laboratory of Animal Models and Human, Disease Mechanisms of Chinese Academy of Sciences, Kunming Institute of Zoology, KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China; (C.L.); (H.T.); (F.W.); (J.M.); (Q.L.); (R.L.)
- Department of Laboratory Medicine, LKSKI-Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, University of Toronto, Toronto, ON M5B 1W8, Canada
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40
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Ghezellou P, Albuquerque W, Garikapati V, Casewell NR, Kazemi SM, Ghassempour A, Spengler B. Integrating Top-Down and Bottom-Up Mass Spectrometric Strategies for Proteomic Profiling of Iranian Saw-Scaled Viper, Echis carinatus sochureki, Venom. J Proteome Res 2020; 20:895-908. [PMID: 33225711 DOI: 10.1021/acs.jproteome.0c00687] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Saw-scaled or carpet vipers (genus Echis) are considered to cause a higher global snakebite mortality than any other snake. Echis carinatus sochureki (ECS) is a widely distributed snake species, also found across the thirteen provinces of Iran, where it is assumed to be responsible for the most snakebite envenomings. Here, we collected the Iranian specimens of ECS from three different geographically distinct populations, investigated food habits, and performed toxicity assessment and venom proteome profiling to better understand saw-scaled viper life. Our results show that the prey items most commonly found in all populations were arthropods, with scorpions from the family Buthidae particularly well represented. LD50 (median lethal dose) values of the crude venom demonstrate highly comparable venom toxicities in mammals. Consistent with this finding, venom characterization via top-down and bottom-up proteomics, applied to both crude venoms and size-exclusion chromatographic fractions, revealed highly comparable venom compositions among the different populations. By combining all proteomics data, we identified 22 protein families from 102 liquid chromatography and tandem mass spectrometry (LC-MS/MS) raw files, including the most abundant snake venom metalloproteinases (SVMPs, 29-34%); phospholipase A2 (PLA2s, 26-31%); snake venom serine proteinases (SVSPs, 11-12%); l-amino acid oxidases (LAOs, 8-11%), C-type lectins/lectin-like (CTLs, 7-9%) protein families, and many newly detected ones, e.g., renin-like aspartic proteases (RLAPs), fibroblast growth factors (FGFs), peptidyl-prolyl cis-trans isomerases (PPIs), and venom vasodilator peptides (VVPs). Furthermore, we identified and characterized methylated, acetylated, and oxidized proteoforms relating to the PLA2 and disintegrin toxin families and the site of their modifications. It thus seems that post-translational modifications (PTMs) of toxins, particularly target lysine residues, may play an essential role in the structural and functional properties of venom proteins and might be able to influence the therapeutic response of antivenoms, to be investigated in future studies.
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Affiliation(s)
- Parviz Ghezellou
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University Giessen, Giessen 35392, Germany
| | - Wendell Albuquerque
- Institute of Food Chemistry and Food Biotechnology, Justus Liebig University Giessen, Giessen 35392, Germany
| | - Vannuruswamy Garikapati
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University Giessen, Giessen 35392, Germany
| | - Nicholas R Casewell
- Centre for Snakebite Research & Interventions, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, U.K
| | - Seyed Mahdi Kazemi
- Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, Tehran 1983963113, Iran
| | - Alireza Ghassempour
- Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, Tehran 1983963113, Iran
| | - Bernhard Spengler
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University Giessen, Giessen 35392, Germany
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41
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Puzari U, Mukherjee AK. Recent developments in diagnostic tools and bioanalytical methods for analysis of snake venom: A critical review. Anal Chim Acta 2020; 1137:208-224. [DOI: 10.1016/j.aca.2020.07.054] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/18/2020] [Accepted: 07/20/2020] [Indexed: 01/19/2023]
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42
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Islam T, Majumder M, Kalita B, Bhattacharjee A, Mukhopadhyay R, Mukherjee AK. Transcriptomic, proteomic, and biochemical analyses reveal a novel neuritogenesis mechanism of
Naja naja
venom α‐elapitoxin post binding to TrkA receptor of rat pheochromocytoma cells. J Neurochem 2020; 155:612-637. [DOI: 10.1111/jnc.15153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 12/29/2022]
Affiliation(s)
- Taufikul Islam
- Microbial Biotechnology and Protein Research Laboratory Department of Molecular Biology and Biotechnology School of Sciences Tezpur University Tezpur Assam India
| | - Munmi Majumder
- Cellular, Molecular, and Environmental Biotechnology Laboratory Department of Molecular Biology and Biotechnology School of Sciences Tezpur University Tezpur Assam India
| | - Bhargab Kalita
- Microbial Biotechnology and Protein Research Laboratory Department of Molecular Biology and Biotechnology School of Sciences Tezpur University Tezpur Assam India
| | - Atanu Bhattacharjee
- Department of Biotechnology and Bioinformatics North Eastern Hill University Shillong Meghalaya India
| | - Rupak Mukhopadhyay
- Cellular, Molecular, and Environmental Biotechnology Laboratory Department of Molecular Biology and Biotechnology School of Sciences Tezpur University Tezpur Assam India
| | - Ashis K. Mukherjee
- Microbial Biotechnology and Protein Research Laboratory Department of Molecular Biology and Biotechnology School of Sciences Tezpur University Tezpur Assam India
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43
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Chanda A, Mukherjee AK. Quantitative proteomics to reveal the composition of Southern India spectacled cobra (Naja naja) venom and its immunological cross-reactivity towards commercial antivenom. Int J Biol Macromol 2020; 160:224-232. [DOI: 10.1016/j.ijbiomac.2020.05.106] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
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44
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Nerve growth factor from Indian Russell’s viper venom (RVV-NGFa) shows high affinity binding to TrkA receptor expressed in breast cancer cells: Application of fluorescence labeled RVV-NGFa in the clinical diagnosis of breast cancer. Biochimie 2020; 176:31-44. [DOI: 10.1016/j.biochi.2020.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/04/2020] [Accepted: 06/12/2020] [Indexed: 12/24/2022]
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45
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Ullah A, Masood R. The Sequence and Three-Dimensional Structure Characterization of Snake Venom Phospholipases B. Front Mol Biosci 2020; 7:175. [PMID: 32850964 PMCID: PMC7419708 DOI: 10.3389/fmolb.2020.00175] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/06/2020] [Indexed: 11/23/2022] Open
Abstract
Snake venom phospholipases B (SVPLBs) are the least studied enzymes. They constitute about 1% of Bothrops crude venoms, however, in other snake venoms, it is present in less than 1%. These enzymes are considered the most potent hemolytic agent in the venom. Currently, no structural information is available about these enzymes from snake venom. To better understand its three-dimensional structure and mechanisms of envenomation, the current work describes the first model-based structure report of this enzyme from Bothrops moojeni venom named as B. moojeni phospholipase B (PLB_Bm). The structure model of PLB_Bm was generated using model building software like I-TESSER, MODELLER 9v19, and Swiss-Model. The build PLB_Bm model was validated using validation tools (PROCHECK, ERRAT, and Verif3D). The analysis of the PLB_Bm modeled structure indicates that it contains 491 amino acid residues that form a well-defined four-layer αββα sandwich core and has a typical fold of the N-terminal nucleophile aminohydrolase (Ntn-hydrolase). The overall structure of PLB_Bm contains 18 β-strands and 17 α-helices with many connecting loops. The structure divides into two chains (A and B) after maturation. The A chain is smaller and contains 207 amino acid residues, whereas the B chain is larger and contains 266 amino acid residues. The sequence and structural comparison among homologous snake venom, bacterial, and mammals PLBs indicate that differences in the length and sequence composition may confer variable substrate specificity to these enzymes. Moreover, the surface charge distribution, average volume, and depth of the active site cavity also vary in these enzymes. The present work will provide more information about the structure-function relationship and mechanism of action of these enzymes in snakebite envenomation.
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Affiliation(s)
- Anwar Ullah
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Rehana Masood
- Department of Biochemistry, Shaheed Benazir Bhutto Women University Peshawar, Peshawar, Pakistan
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46
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Jenkins TP, Laustsen AH. Cost of Manufacturing for Recombinant Snakebite Antivenoms. Front Bioeng Biotechnol 2020; 8:703. [PMID: 32766215 PMCID: PMC7381290 DOI: 10.3389/fbioe.2020.00703] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/04/2020] [Indexed: 01/14/2023] Open
Abstract
Snakebite envenoming is a neglected tropical disease that affects millions of people across the globe. It has been suggested that recombinant antivenoms based on mixtures of human monoclonal antibodies, which target key toxins of medically important snake venom, could present a promising avenue toward the reduction of morbidity and mortality of envenomated patients. However, since snakebite envenoming is a disease of poverty, it is pivotal that next-generation therapies are affordable to those most in need; this warrants analysis of the cost dynamics of recombinant antivenom manufacture. Therefore, we present, for the first time, a bottom-up analysis of the cost dynamics surrounding the production of future recombinant antivenoms based on available industry data. We unravel the potential impact that venom volume, abundance of medically relevant toxins in a venom, and the molecular weight of these toxins may have on the final product cost. Furthermore, we assess the roles that antibody molar mass, manufacturing and purification strategies, formulation, antibody efficacy, and potential cross-reactivity play in the complex cost dynamics of recombinant antivenom manufacture. Notably, according to our calculations, it appears that such next-generation antivenoms based on cocktails of monoclonal immunoglobulin Gs (IgGs) could be manufacturable at a comparable or lower cost to current plasma-derived antivenoms, which are priced at USD 13-1120 per treatment. We found that monovalent recombinant antivenoms based on IgGs could be manufactured for USD 20-225 per treatment, while more complex polyvalent recombinant antivenoms based on IgGs could be manufactured for USD 48-1354 per treatment. Finally, we investigated the prospective cost of manufacturing for recombinant antivenoms based on alternative protein scaffolds, such as DARPins and nanobodies, and highlight the potential utility of such scaffolds in the context of low-cost manufacturing. In conclusion, the development of recombinant antivenoms not only holds a promise for improving therapeutic parameters, such as safety and efficacy, but could possibly also lead to a more competetive cost of manufacture of antivenom products for patients worldwide.
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Affiliation(s)
- Timothy Patrick Jenkins
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Lyngby, Denmark
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47
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Chanda A, Mukherjee AK. Mass spectrometric analysis to unravel the venom proteome composition of Indian snakes: opening new avenues in clinical research. Expert Rev Proteomics 2020; 17:411-423. [DOI: 10.1080/14789450.2020.1778471] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Abhishek Chanda
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, Assam, India
| | - Ashis K. Mukherjee
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, Assam, India
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48
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Comparative proteomics of geographically distinct saw-scaled viper ( Echis carinatus) venoms from India. Toxicon X 2020; 7:100048. [PMID: 32613195 PMCID: PMC7322182 DOI: 10.1016/j.toxcx.2020.100048] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/09/2020] [Accepted: 06/17/2020] [Indexed: 11/21/2022] Open
Abstract
Snakebite is a socio-economic problem in tropical countries and it is exacerbated by geographical venom variation of snakes. We investigated on venom variation in geographically distinct populations of Echis carinatus from three ecologically distinct regions: Tamil Nadu (ECVTN), Goa (ECVGO), and Rajasthan (ECVRAJ). Venom was fractionated by RP-HPLC, combined with SDS-PAGE, and subjected to tandem mass spectrometry. Toxins were identified, and their relative abundance was estimated. Using NCBI database of Echis genus, we queried the MS/MS spectra, and found 69, 38 and 38 proteins in ECVTN, ECVGO and ECVRAJ respectively, belonging to 8-10 different toxin families. The differences in the venom profiles were due to change in the relative composition of the toxin families. Snake venom metalloproteinase (svMP), Snaclecs and Phospholipase A2 (PLA2) were the major venom components in all the venoms. Heteromeric Disintegrins were found in ECVTN and absent in other venoms. ECVRAJ showed higher abundance of low-molecular-weight (>30 kDa) proteins than ECVTN and ECVGO. Cysteine-rich venom protein (CRISP) was highest in ECVRAJ (7.34%), followed by ECVTN (0.01%) and in ECVGO, it was not detected. These findings highlight the need for evaluating the efficacy of the polyvalent anti-venom to neutralize the toxins from geographically distinct venoms of E. carinatus.
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49
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Patra A, Mukherjee AK. Proteomic Analysis of Sri Lanka Echis carinatus Venom: Immunological Cross-Reactivity and Enzyme Neutralization Potency of Indian Polyantivenom. J Proteome Res 2020; 19:3022-3032. [DOI: 10.1021/acs.jproteome.0c00054] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Aparup Patra
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur 784028, Assam, India
| | - Ashis K. Mukherjee
- Microbial Biotechnology and Protein Research Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur 784028, Assam, India
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Albulescu LO, Hale MS, Ainsworth S, Alsolaiss J, Crittenden E, Calvete JJ, Evans C, Wilkinson MC, Harrison RA, Kool J, Casewell NR. Preclinical validation of a repurposed metal chelator as an early-intervention therapeutic for hemotoxic snakebite. Sci Transl Med 2020; 12:eaay8314. [PMID: 32376771 PMCID: PMC7116364 DOI: 10.1126/scitranslmed.aay8314] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/22/2020] [Accepted: 03/19/2020] [Indexed: 12/18/2022]
Abstract
Snakebite envenoming causes 138,000 deaths annually, and ~400,000 victims are left with permanent disabilities. Envenoming by saw-scaled vipers (Viperidae: Echis) leads to systemic hemorrhage and coagulopathy and represents a major cause of snakebite mortality and morbidity in Africa and Asia. The only specific treatment for snakebite, antivenom, has poor specificity and low affordability and must be administered in clinical settings because of its intravenous delivery and high rates of adverse reactions. This requirement results in major treatment delays in resource-poor regions and substantially affects patient outcomes after envenoming. Here, we investigated the value of metal ion chelators as prehospital therapeutics for snakebite. Among the tested chelators, dimercaprol (British anti-Lewisite) and its derivative 2,3-dimercapto-1-propanesulfonic acid (DMPS) were found to potently antagonize the activity of Zn2+-dependent snake venom metalloproteinases in vitro. Moreover, DMPS prolonged or conferred complete survival in murine preclinical models of envenoming against a variety of saw-scaled viper venoms. DMPS also considerably extended survival in a "challenge and treat" model, where drug administration was delayed after venom injection and the oral administration of this chelator provided partial protection against envenoming. Last, the potential clinical scenario of early oral DMPS therapy combined with a delayed, intravenous dose of conventional antivenom provided prolonged protection against the lethal effects of envenoming in vivo. Our findings demonstrate that the safe and affordable repurposed metal chelator DMPS can effectively neutralize saw-scaled viper venoms in vitro and in vivo and highlight the promise of this drug as an early, prehospital, therapeutic intervention for hemotoxic snakebite envenoming.
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Affiliation(s)
- Laura-Oana Albulescu
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA Liverpool, UK
| | - Melissa S Hale
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA Liverpool, UK
| | - Stuart Ainsworth
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA Liverpool, UK
| | - Jaffer Alsolaiss
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA Liverpool, UK
| | - Edouard Crittenden
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA Liverpool, UK
| | - Juan J Calvete
- Laboratorio de Venómica Estructural y Funcional, Instituto de Biomedicina de Valencia, CSIC, Valencia 46010, Spain
| | - Chloe Evans
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA Liverpool, UK
| | - Mark C Wilkinson
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA Liverpool, UK
| | - Robert A Harrison
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA Liverpool, UK
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA Liverpool, UK
| | - Jeroen Kool
- Amsterdam Institute for Molecules Medicines and Systems, Division of BioAnalytical Chemistry, Department of Chemistry and Pharmaceutical Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1083, 1081HV Amsterdam, Netherlands
| | - Nicholas R Casewell
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA Liverpool, UK.
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA Liverpool, UK
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