Background:
Antivenoms are the only validated treatment against snakebite envenoming.
Numerous drawbacks pertaining to their availability, safety and efficacy are
becoming increasingly evident due to low sustainability of current
productions. Technological innovation of procedures generating therapeutics
of higher purity and better physicochemical characteristics at acceptable
cost is necessary. The objective was to develop at laboratory scale a
compact, feasible and economically viable platform for preparation of equine
F(ab')
2
antivenom against
Vipera ammodytes
ammodytes
venom and to support it with efficiency data, to
enable estimation of the process cost-effectiveness.
Methods:
The principle of simultaneous caprylic acid precipitation and pepsin
digestion has been implemented into plasma downstream processing. Balance
between incomplete IgG breakdown, F(ab')
2
over-digestion and loss
of the active drug's protective efficacy was achieved by adjusting pepsin to
a 1:30 substrate ratio (
w
/
w
) and setting
pH at 3.2. Precipitation and digestion co-performance required 2 h-long
incubation at 21 °C. Final polishing was accomplished by a combination of
diafiltration and flow-through chromatography.
In vivo
neutralization potency of the F(ab')
2
product against the venom's
lethal toxicity was determined.
Results:
Only three consecutive steps, performed under finely tuned conditions, were
sufficient for preservation of the highest process recovery with the overall
yield of 74%, comparing favorably to others. At the same time, regulatory
requirements were met. Final product was aggregate- and pepsin-free. Its
composition profile was analyzed by mass spectrometry as a quality control
check. Impurities, present in minor traces, were identified mostly as
IgG/IgM fragments, contributing to active drug. Specific activity of the
F(ab')
2
preparation with respect to the plasma was increased
3.9-fold.
Conclusion:
A highly streamlined mode for production of equine F(ab')
2
antivenom was engineered. In addition to preservation of the highest process
yield and fulfillment of the regulatory demands, performance simplicity and
rapidity in the laboratory setting were demonstrated. Suitability for
large-scale manufacturing appears promising.