Diagnosis of Snakebite and the Importance of Immunological Tests in Venom Research

Abstract

In many cases of envenoming following snake bite, the snake responsible for the accident remains unidentified; this frequently results in difficulty deciding which antivenom to administer to the systemically-envenomed victim, especially when only monospecific antivenoms are available. Normally the specific diagnosis of snake bite can be conveniently made using clinical and laboratory methods. Where clinical diagnosis depends upon the recognition of specific signs of envenoming in the patient, laboratory diagnosis is based on the changes which occur in envenomed victims including the detection of abnormalities in blood parameters, presence/absence of myoglobinuria, changes in certain enzyme levels, presence/absence of neurotoxic signs and the detection in the blood of specific venom antigens using immunologically-based techniques, such as enzyme immunoassay. It is the latter which is the main subject of this review, together with the application of techniques currently used to objectively assess the effectiveness of new and existing antivenoms, to assess first aid measures, to investigate the possible use of such methods in epidemiological studies, and to detect individual venom components. With this in mind, we have discussed in some detail how such techniques were developed and how they have helped in the treatment of envenoming particularly and in venom research in general.

Drugs Containing Snake Venom: History of Development, Nomenclature, Identification

“…Иммунологические методы уступают инструментальным в точности и информативности, поскольку их применение не гарантирует в полной мере исключение ложноположительных или ложноотрицательных результатов [11,29]. Однако их относительная простота для выполнения анализа, доступность и возможность обойтись без дорогостоящего оборудования делают иммунологические методы, и в частности метод иммунодиффузии, предпочтительными при определении подлинности змеиных ядов в биологических средах, а также в лекарственных средствах.…”

Antigenic cross-reactivity and species-specific identification of Pseudocerastes persicus fieldi snake venom

“…Few exceptions, however, have been reported in some species as Vipera xanthine palestinae (Gitter et al, 1959), Pf (Gitter et al, 1962), and Crotalus durissus terrificus (Theakston and Laing, 2014) venoms, where strong neurotoxic manifestations predominate. Gitter et al (1962) reported that mice injected with Pf venom showed no hematological abnormalities.…”

“…Haemorrhagic activity is generally a characteristic feature of venoms from family Viperadae, whereas elapid venoms are mainly neurotoxic (Theakston and Laing, 2014). Few exceptions, however, have been reported in some species as Vipera xanthine palestinae (Gitter et al, 1959), Pf (Gitter et al, 1962), and Crotalus durissus terrificus (Theakston and Laing, 2014) venoms, where strong neurotoxic manifestations predominate.…”

“…In snake bites, it is often difficult for clinicians treating patients to accurately identify the species responsible for envenoming (Theakston and Laing, 2014). The presence of certain antigenic components in snake venoms appear to be common in several snake species, genera and families (Marshall and Hermann, 1984;Russell, 1988) and antivenoms cross-reacted along them (Dong et al, 2003;Wahby and Ibrahim, 2008;Gao et al, 2013).…”

Probing the Key Binding Sequence and Improvement of the Stability of a β‐Bungarotoxin‐binding Aptamer in Snake Venom

“…7 In addition, difficulties in identification of the snake species remain a hurdle in effective treatment of snakebite victims by the administration of specific antivenom. 8,9 Aptamers are short oligonucleotide sequences, RNA or single-stranded DNA, which have high affinity and specificity for a wide range of target molecules, such as proteins, small compounds, or whole cells. [10][11][12] During the last two decades, aptamers have found tremendous potential as therapeutic drugs, 13 drug delivery vehicles, 14 diagnostic agents, 15 and molecular imaging probes.…”