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Machado Marinho AC, Chapeaurouge A, Dutra BM, Quintela BCSF, Pereira SS, Fernandes CFC. The role of venom proteomics and single-domain antibodies for antivenoms: Progress in snake envenoming treatment. Drug Discov Today 2024; 29:103967. [PMID: 38555033 DOI: 10.1016/j.drudis.2024.103967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/14/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024]
Abstract
Single-domain antibodies (sdAbs) hold promise for developing new biopharmaceuticals to treat neglected tropical diseases (NTDs), including snakebites, which are severe and occur frequently. In addition, limitations of conventional snakebite treatments, especially in terms of local action, and the global antivenom crisis incentivize the use of this biotechnological tool to design next-generation snakebite antivenoms. Conventional antivenoms for snakebite treatment are usually composed of immunoglobulin G or F(ab')2 fragments derived from the plasma of immunized animals. sdAbs, the smallest antigen-binding fragments, are derived from the variable domains of camelid heavy-chain antibodies. sdAbs may have some advantages over conventional antivenoms for local toxicity, such as better penetration into tissues due to their small size, and high solubility and affinity for venom antigens due to their unique antigen-binding loops and ability to access cryptic epitopes. We present an overview of current antivenom therapy in the context of sdAb development for toxin neutralization. Furthermore, strategies are presented for identifying snake venom's major toxins as well as for developing antisnake toxin sdAbs by employing proteomic tools for toxin neutralization.
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Affiliation(s)
- Anna Carolina Machado Marinho
- Laboratório Multiusuário de Pesquisa e Desenvolvimento, Fundação Oswaldo Cruz Ceará, FIOCRUZ CE, Eusébio-CE, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Ceará, UFC, Fortaleza, Brazil
| | - Alexander Chapeaurouge
- Laboratório Multiusuário de Pesquisa e Desenvolvimento, Fundação Oswaldo Cruz Ceará, FIOCRUZ CE, Eusébio-CE, Brazil
| | - Brunheld Maia Dutra
- Laboratório Multiusuário de Pesquisa e Desenvolvimento, Fundação Oswaldo Cruz Ceará, FIOCRUZ CE, Eusébio-CE, Brazil
| | - Barbara Cibelle S F Quintela
- Laboratório Multiusuário de Pesquisa e Desenvolvimento, Fundação Oswaldo Cruz Ceará, FIOCRUZ CE, Eusébio-CE, Brazil
| | - Soraya S Pereira
- Laboratório de Engenharia de Anticorpos, Fundação Oswaldo Cruz Rondônia, FIOCRUZ RO, Porto Velho-RO, Brazil
| | - Carla Freire C Fernandes
- Laboratório Multiusuário de Pesquisa e Desenvolvimento, Fundação Oswaldo Cruz Ceará, FIOCRUZ CE, Eusébio-CE, Brazil; Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Ceará, UFC, Fortaleza, Brazil
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Taylor E, Aguilar-Ancori EG, Banyard AC, Abel I, Mantini-Briggs C, Briggs CL, Carrillo C, Gavidia CM, Castillo-Neyra R, Parola AD, Villena FE, Prada JM, Petersen BW, Falcon Perez N, Cabezas Sanchez C, Sihuincha M, Streicker DG, Maguina Vargas C, Navarro Vela AM, Vigilato MAN, Wen Fan H, Willoughby R, Horton DL, Recuenco SE. The Amazonian Tropical Bites Research Initiative, a hope for resolving zoonotic neglected tropical diseases in the One Health era. Int Health 2023; 15:216-223. [PMID: 35896028 PMCID: PMC9384559 DOI: 10.1093/inthealth/ihac048] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/19/2022] [Accepted: 06/23/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) disproportionately affect populations living in resource-limited settings. In the Amazon basin, substantial numbers of NTDs are zoonotic, transmitted by vertebrate (dogs, bats, snakes) and invertebrate species (sand flies and triatomine insects). However, no dedicated consortia exist to find commonalities in the risk factors for or mitigations against bite-associated NTDs such as rabies, snake envenoming, Chagas disease and leishmaniasis in the region. The rapid expansion of COVID-19 has further reduced resources for NTDs, exacerbated health inequality and reiterated the need to raise awareness of NTDs related to bites. METHODS The nine countries that make up the Amazon basin have been considered (Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Peru, Surinam and Venezuela) in the formation of a new network. RESULTS The Amazonian Tropical Bites Research Initiative (ATBRI) has been created, with the aim of creating transdisciplinary solutions to the problem of animal bites leading to disease in Amazonian communities. The ATBRI seeks to unify the currently disjointed approach to the control of bite-related neglected zoonoses across Latin America. CONCLUSIONS The coordination of different sectors and inclusion of all stakeholders will advance this field and generate evidence for policy-making, promoting governance and linkage across a One Health arena.
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Affiliation(s)
- Emma Taylor
- University of Surrey, School of Veterinary Medicine, Daphne Jackson Road, Guildford, GU2 7AL, UK
| | - Elsa Gladys Aguilar-Ancori
- Instituto Universitario de Enfermedades Tropicales y Biomedicina de Cusco - Universidad Nacional de San Antonio Abad del Cusco, Cusco, 08003, Peru
| | - Ashley C Banyard
- Animal and PlantHealth Agency, WoodhamLane, New Haw, Weybridge, Surrey, KT15 3NB, United Kingdom
| | - Isis Abel
- Laboratório de Epidemiologia e Geoprocessamento, Instituto de MedicinaVeterinária, Universidade Federal do Pará, Castanhal, Pará, 68743-970, Brasil
| | - Clara Mantini-Briggs
- Berkeley Center for Social Medicine and the Institute for the Study of Societal Issues, University of California, Berkeley, 94720-5670, USA
| | - Charles L Briggs
- Berkeley Center for Social Medicine and the Department of Anthropology, University of California, Berkeley, 94720-5670, USA
| | - Carolina Carrillo
- Instituto de Ciencia y Tecnología Dr. Cesar Milstein, Fundación Pablo Cassará - ConsejoNacional de InvestigacionesCientíficas y Técnicas, Saladillo 2468 (C1440FFX) Ciudad de Buenos Aires, Argentina
| | - Cesar M Gavidia
- Facultad de MedicinaVeterinaria, Universidad Nacional Mayor de San Marcos, Lima, 15021, Perú
| | - Ricardo Castillo-Neyra
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, 19104-6021, USA
- One Health Unit, School of Public Health and Administration, Universidad PeruanaCayetano Heredia, Lima, 15102, Peru
| | - Alejandro D Parola
- Fundación Pablo Cassará. Instituto de Ciencia y Tecnología Dr. Cesar Milstein, Saladillo 2468 (C1440FFX) Ciudad de Buenos Aires, Argentina
| | - Fredy E Villena
- Asociaciónpara el Empleo y Bienestar Animal en Investigación y Docencia (ASOPEBAID), Lima, 15072, Peru
| | - Joaquin M Prada
- University of Surrey, School of Veterinary Medicine, Daphne Jackson Road, Guildford, GU2 7AL, UK
| | - Brett W Petersen
- Poxvirus and Rabies Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, 30333, USA
| | - Nestor Falcon Perez
- Facultad de MedicinaVeterinaria y Zootecnia, Universidad Peruana Cayetano Heredia, Lima, 15102, Perú
| | - Cesar Cabezas Sanchez
- Centro de InvestigacionesTecnologicas, Biomedicas y Medioambientales-CITBM, Universidad Nacional Mayor de San Marcos, Lima, 15081, Peru
| | | | - Daniel G Streicker
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK
- MRC-University of Glasgow Centre for Virus Research, Glasgow, G61 1QH, UK
| | - Ciro Maguina Vargas
- Instituto de Medicina Tropical Alexander Von Humbolt, Universidad Peruana Cayetano Heredia, Lima, 15102, Perú
| | | | - Marco A N Vigilato
- Pan American Center for Foot and Mouth Disease and Veterinary Public Health, Department of Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization, Rio de Janeiro, 25040-004, Brazil
| | - Hui Wen Fan
- Bioindustrial Center, InstitutoButantan, São Paulo, 05503-900, Brazil
| | | | - Daniel L Horton
- University of Surrey, School of Veterinary Medicine, Daphne Jackson Road, Guildford, GU2 7AL, UK
| | - Sergio E Recuenco
- Centro de InvestigacionesTecnologicas, Biomedicas y Medioambientales-CITBM, Universidad Nacional Mayor de San Marcos, Lima, 15081, Peru
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Patiño RSP, Salazar-Valenzuela D, Robles-Loaiza AA, Santacruz-Ortega P, Almeida JR. A retrospective study of clinical and epidemiological characteristics of snakebite in Napo Province, Ecuadorian Amazon. Trans R Soc Trop Med Hyg 2023; 117:118-127. [PMID: 35917814 DOI: 10.1093/trstmh/trac071] [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: 03/22/2022] [Revised: 05/31/2022] [Accepted: 07/07/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Snakebite envenoming remains a relevant public health problem in tropical and subtropical countries. In Ecuador, this is particularly true in an area of great diversity like the Amazon region. Nevertheless, there is scarce information about epidemiological and clinical characteristics of these accidents in this area. METHODS This was a descriptive and retrospective study of snakebite cases treated at a tertiary hospital in the Napo Province, Ecuadorian Amazon, from 2015 to 2019. We collected sociodemographic and snakebite-related information, clinical aspects and the use of antivenom and antibiotics from medical records. RESULTS Information from 133 snakebite accidents was reviewed in this time period. Reports of snakebite envenoming decreased over the years. In total, 67% of those bitten were from nearby indigenous communities, which were the most affected groups. When a species was identified, Bothrops atrox was responsible for the highest number of cases registered. Local clinical manifestations were more frequent than systemic signs, in keeping with the typical effects produced by bothropic venoms. Additionally, data showed that more antivenom vials were given than those suggested by the protocol of the Ecuadorian Ministry of Health, in proportion to the grade of severity. Finally, we identified a low incidence of adverse reactions with antivenom administration, as well as a frequent use of antibiotics. CONCLUSIONS The profile of snakebite accidents in the Napo Province is very similar to that described for other localities in the Amazon region of Ecuador and neighboring countries, with its challenges and limitations. Such aspects underlie the importance of establishing a robust and science-based public health program to respond to this frequent, but neglected, tropical disease.
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Affiliation(s)
- Ricardo S P Patiño
- Universidad Regional Amazónica Ikiam, Km 7 Via Muyuna, Tena, Napo 150150, Ecuador.,Escuela Superior Politécnica del Litoral (ESPOL), Centro Nacional de Acuicultura e Investigaciones Marinas (CENAIM), Guayaquil 090211, Ecuador
| | - David Salazar-Valenzuela
- Centro de Investigación de la Biodiversidad y Cambio Climático (BioCamb) e Ingeniería en Biodiversidad y Recursos Genéticos, Facultad de Ciencias de Medio Ambiente, Universidad Tecnológica Indoamérica, Quito 170103, Ecuador
| | | | - Paola Santacruz-Ortega
- Escola de Educação Permanente, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403010, Brasil
| | - José R Almeida
- Universidad Regional Amazónica Ikiam, Km 7 Via Muyuna, Tena, Napo 150150, Ecuador
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Romo E, Torres M, Martin-Solano S. Current situation of snakebites envenomation in the Neotropics: Biotechnology, a versatile tool in the production of antivenoms. BIONATURA 2022. [DOI: 10.21931/rb/2022.07.04.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Snakebite envenomation is a neglected tropical disease that affects millions of people around the world with a great impact on health and the economy. Unfortunately, public health programs do not include this kind of disease as a priority in their social programs. Cases of snakebite envenomations in the Neotropics are inaccurate due to inadequate disease management from medical records to the choice of treatments. Victims of snakebite envenomation are primarily found in impoverished agricultural areas where remote conditions limit the availability of antivenom. Antivenom serum is the only Food and Drug Administration-approved treatment used up to date. However, it has several disadvantages in terms of safety and effectiveness. This review provides a comprehensive insight dealing with the current epidemiological status of snakebites in the Neotropics and technologies employed in antivenom production. Also, modern biotechnological tools such as transcriptomic, proteomic, immunogenic, high-density peptide microarray and epitope mapping are highlighted for producing new-generation antivenom sera. These results allow us to propose strategic solutions in the Public Health Sector for managing this disease.
Keywords: antivenom, biotechnology, neglected tropical disease, omics, recombinant antibody.
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Affiliation(s)
- Elizabeth Romo
- Carrera de Ingeniería en Biotecnología, Departamento de Ciencias de la Vida y la Agricultura, Universidad de las Fuerzas Armadas-ESPE, Sangolquí, Ecuador
| | - Marbel Torres
- Carrera de Ingeniería en Biotecnología, Departamento de Ciencias de la Vida y la Agricultura, Universidad de las Fuerzas Armadas-ESPE, Sangolquí, Ecuador, Grupo de Investigación en Sanidad Animal y Humana (GISAH), Carrera de Ingeniería en Biotecnología, Departamento de Ciencias de la Vida y la Agricultura, Universidad de las Fuerzas Armadas-ESPE, Immunology and Virology Laboratory, Nanoscience and Nanotechnology Center, Universidad de las Fuerzas Armadas, ESPE, Sangolquí, Ecuador
| | - Sarah Martin-Solano
- Carrera de Ingeniería en Biotecnología, Departamento de Ciencias de la Vida y la Agricultura, Universidad de las Fuerzas Armadas-ESPE, Sangolquí, Ecuador, Grupo de Investigación en Sanidad Animal y Humana (GISAH), Carrera de Ingeniería en Biotecnología, Departamento de Ciencias de la Vida y la Agricultura, Universidad de las Fuerzas Armadas-ESPE, Grupo de Investigación en Biodiversidad, Zoonosis y Salud Pública, Universidad Central del Ecuador
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Snakebites in Rural Areas of Brazil by Race: Indigenous the Most Exposed Group. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179365. [PMID: 34501955 PMCID: PMC8431164 DOI: 10.3390/ijerph18179365] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/28/2021] [Accepted: 09/03/2021] [Indexed: 01/02/2023]
Abstract
Animal stings are environmental hazards that threaten millions annually and cause a significant socioeconomic impact. Snakebite envenoming affects 2.7 million people globally every year, mostly the poorest and rural communities, with approximately 27,000 annual cases in Brazil. This study’s objective is to identify the most exposed racial group for snakebites in rural areas of Brazil and analyze possible differences in the outcome of an accident. A retrospective epidemiological study was conducted using a database of rural snakebite cases from Brazil’s Ministry of Health (2017). Descriptive analysis and a regression model were performed to examine the association of bad outcomes after a snakebite with several covariables. While mixed-race individuals presented the highest number of cases (61.79%), indigenous and white populations were the racial groups with the highest and lowest exposure rates (194.3 and 34.1 per 100,000 population, respectively). The fatality rate was 3.5 times higher in the indigenous population compared to the white population. In the multivariable model, the number of hours between the accident and health care received and the case classification suggested an association with a bad outcome. Snakebite is prominent in Brazil, particularly among indigenous groups. Antivenom is available in the Brazilian Health System; however, efforts need to be made for decentralization.
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van Oirschot J, Ooms GI, Waldmann B, Kadam P. Snakebite incidents, prevention and care during COVID-19: Global key-informant experiences. Toxicon X 2021; 9-10:100075. [PMID: 34386765 PMCID: PMC8342778 DOI: 10.1016/j.toxcx.2021.100075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/22/2021] [Accepted: 07/08/2021] [Indexed: 11/28/2022] Open
Abstract
Snakebite envenoming is a long-neglected disease causing significant morbidity and mortality in snakebite endemic low- and middle-income countries (LMICs). Global awareness on snakebite was increasing steadily up to 2020, and an increasing number of countries began to acknowledge the issue, when coronavirus disease 2019 (COVID-19) started to have an unprecedented impact on societies and health systems. To better understand how snakebite incidents, prevention and care are being affected during this global emergency, we collected perspectives of snakebite community- and health system stakeholders in a qualitative key-informant study. An open-ended survey and semi-structured interviews were conducted to gather information on changes in snakebite occurrence and circumstances, community responses, access to care and health outcomes in LMICs since the COVID-19 pandemic. Forty-three informants from 21 countries participated in the study. Based on informants' experiences, in spite of COVID-19 lockdowns, exposure to snakes did not change in many rural agrarian communities, where incidences are usually highest. However, we did find several access to care issues relating to avoidance of formal care, transport barriers, overburdened healthcare systems and -providers, and antivenom manufacturing and supply disruptions, which were unique per context. On a brighter note, ventilator availability had increased in several countries, although not automatically benefitting snakebite patients directly. In conclusion, we found apparent effects of the COVID-19 pandemic on snakebite prevention and care, although its severity was highly context- and time-dependent. Interactions between the pandemic effects and snakebite incidents most severely impact remote rural communities, showing the need to invest in community-based prevention and care.
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Affiliation(s)
| | - Gaby I. Ooms
- Health Action International, Amsterdam, the Netherlands
- Utrecht Centre for Pharmaceutical Policy and Regulation, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
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