Preclinical evaluation of three polyspecific antivenoms against the venom of Echis ocellatus: Neutralization of toxic activities and antivenomics

Preclinical Evaluation of the Efficacy of Antivenoms for Snakebite Envenoming: State-of-the-Art and Challenges Ahead

“…The case of neutralization of in vitro coagulant activity illustrates this point. When expressed in terms of mg venom neutralized per mL antivenom, the most effective antivenom had an ED 50 of 12.88 ± 0.09 mg/mL, whereas the antivenom with the lowest efficacy had an ED 50 of 0.1 ± 0.01 mg/mL, a 128 fold difference [91]. …”

“…However, there are other regions in the world, such as sub-Saharan Africa, in which no parameters for antivenom acceptance have been defined yet. Consequently, antivenoms of highly variable potencies are distributed [91,93]. Hence, there is a need to establish acceptable limits of potency of antivenoms at the preclinical level, a task that demands the concerted work of laboratory scientists, clinical researchers, regulatory agencies, antivenom manufacturers, and the WHO and its regional offices.…”

“…Maximum binding capacity of an antivenom for the different venom antigens can be estimated through a series of experiments where the amount of venom pumped through the immunoaffinity column is varied to estimate the µg of each venom component per mg antivenom protein that saturates their specific antibody binding sites [91]. …”

Third Generation Antivenomics: Pushing the Limits of the In Vitro Preclinical Assessment of Antivenoms

“…Despite more than 45 commercial or government antivenom producers existing around the world [6], the shortage of independently validated, demonstrably safe, effective, and affordable snake antivenoms in many affected regions [7,8] is an important contributor to this tropical disease burden [9]. To complicate matters, there is growing evidence suggesting that some marketed antivenoms are clinically ineffective [10,11]. Although necessarily multicomponent in nature, strategies to address this neglect should include the improvement of antivenom availability and the preclinical testing of antivenom efficacy [5,12].…”

Priority Actions and Progress to Substantially and Sustainably Reduce the Mortality, Morbidity and Socioeconomic Burden of Tropical Snakebite

“…Examples include studies on the neutralization of venoms of the saw-scaled viper, Echis ocellatus from various regions [29,30,31] and of the black mamba, Dendroaspis polylepis [32]. It was agreed that the acknowledged usefulness of these independent research activities would be substantially enhanced by greater coordination and division of the work load to ensure continent-wide antivenom quality control (QC) testing.…”