Rapid and selective detection of experimental snake envenomation – Use of gold nanoparticle based lateral flow assay

Pawade, Balasaheb S.; Salvi, Nitin; Shaikh, Innus K.; Waghmare, A.B.; Jadhav, Nitin D.; Wagh, Vishal B.; Pawade, Abhilasha S.; Waykar, Indrasen G.; Potnis-Lele, Mugdha

doi:10.1016/j.toxicon.2016.06.023

Cited by 25 publications

(17 citation statements)

References 28 publications

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“…However, creating a pool of monoclonal antibodies against all toxin families do not work for snake venoms due to their complex protein composition. Some studies have designed snake envenomation detection strips by using a species-specific antibody (SSAb), which is an ultra-specific antibody, to improve its sensitivity and specificity [44,45]. However, multistep purification would not only cause the loss of more specific antibodies but also increase the cost of the device.…”

Section: Discussionmentioning

confidence: 99%

A Rapid and International Applicable Diagnostic Device for Cobra (Genus Naja) Snakebites

Lin

Sung

Liao

et al. 2020

Toxins

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Cobra snakes (genus Naja) are some of the most dangerous snake species in Asia and Africa, as their bites cause severe life-threatening respiratory failure and local tissue destruction, especially in the case of late diagnosis. The differential diagnosis of snakebite envenomation still mainly relies upon symptomatology, the patient’s description, and the experience of physicians. We have designed a rapid test, immunochromatographic test of cobra (ICT-Cobra), which obtained fair results in improving the diagnosis and treatment of Naja (N.) atra snakebites in Taiwan. In this study, we further investigated the feasibility of applying the kit for the detection of other cobra venoms based on the potential interspecies similarity. We firstly demonstrated the cross-reactivity between eight venoms of medically important cobra species and the rabbit anti-N. atra IgG that was used in ICT-Cobra by Western blotting and sandwich enzyme-linked immunosorbent assay. Then, ICT-Cobra was used to detect various concentrations of the eight venoms to elucidate its performance. Noticeable correlations between the cross-reactivity of venoms from genus Naja snakes and existing geographical characteristics were found. ICT-Cobra could detect venoms from other Asian cobras with variable detection limits comparable to those observed for N. atra, but the kit was less successful in the detection of venom from African cobras. The similar but slightly different venom components and the interaction between venom and rabbit anti-N. atra IgG led to variations in the detection limits. The transcontinental usage of ICT-Cobra might be possible due to the cross-reactivity of antibodies and similarities among the larger-sized proteins. This study showed that the close immunological relationships in the genus Naja could be used to develop a venom detection kit for the diagnosis of cobra envenomation in both Asian and African regions. Additional clinical studies and technical adjustments are still needed to improve the efficacy and broadening the application of ICT-Cobra in the future.

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Section: Discussionmentioning

confidence: 99%

A Rapid and International Applicable Diagnostic Device for Cobra (Genus Naja) Snakebites

Lin

Sung

Liao

et al. 2020

Toxins

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“…In addition to the more established laboratory tests and novel biomarkers of envenoming described above, several assays capable of detecting venom components in patient samples have been developed. Many of these are immunoassays, e.g., in the form of enzyme-linked immunosorbent assays (ELISAs) [ 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 ], lateral flow assays (LFAs) [ 86 , 87 ], impedimetric immunoassays [ 88 ], and others [ 89 , 90 , 91 , 92 ]. Other researchers have instead explored the potential of utilizing technologies, such as polymerase chain reactions (PCRs) [ 93 , 94 , 95 ] and enzymatic assays [ 96 ], for diagnosis of snakebite envenoming.…”

Section: Diagnosis Of Snake Dry Bitesmentioning

confidence: 99%

Current Knowledge on Snake Dry Bites

Pucca

Knudsen

Oliveira

et al. 2020

Toxins

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Snake ‘dry bites’ are characterized by the absence of venom being injected into the victim during a snakebite incident. The dry bite mechanism and diagnosis are quite complex, and the lack of envenoming symptoms in these cases may be misinterpreted as a miraculous treatment or as proof that the bite from the perpetrating snake species is rather harmless. The circumstances of dry bites and their clinical diagnosis are not well-explored in the literature, which may lead to ambiguity amongst treating personnel about whether antivenom is indicated or not. Here, the epidemiology and recorded history of dry bites are reviewed, and the clinical knowledge on the dry bite phenomenon is presented and discussed. Finally, this review proposes a diagnostic and therapeutic protocol to assist medical care after snake dry bites, aiming to improve patient outcomes.

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“…The lateral flow strip assay is a sandwich-based immunostrip used to rapidly (5–20 min) examine whether target molecules are present in a sample [53]. This type of assay is appropriate for use in snakebite detection and diagnosis, and can offer guidance to physicians in administering antivenom [22, 23]. Furthermore, the visual diagnosis format of this assay is simple, making it desirable for use in developing countries, where snakebites are most prevalent.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to immunoassays, immunology-based biosensors have been explored for detection of snakebite [20, 21]. ELISAs and lateral flow assays [22, 23] are arguably the best choice of immunoassays for snakebite identification. ELISAs, the most common and general immunoassays in clinical use, are sensitive to their target at pictogram per milliliter levels [18].…”

Section: Introductionmentioning

confidence: 99%

Development of sandwich ELISA and lateral flow strip assays for diagnosing clinically significant snakebite in Taiwan

Liu

Wang

et al. 2018

PLoS Negl Trop Dis

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Taiwan is an island located in the south Pacific, a subtropical region that is home to 61 species of snakes. Of these snakes, four species—Trimeresurus stejnegeri, Protobothrops mucrosquamatus, Bungarus multicinctus and Naja atra—account for more than 90% of clinical envenomation cases. Currently, there are two types of bivalent antivenom: hemorrhagic antivenom against the venom of T. stejnegeri and P. mucrosquamatus, and neurotoxic antivenom for treatment of envenomation by B. multicinctus and N. atra. However, no suitable detection kits are available to precisely guide physicians in the use of antivenoms. Here, we sought to develop diagnostic assays for improving the clinical management of snakebite in Taiwan. A two-step affinity purification procedure was used to generate neurotoxic species-specific antibodies (NSS-Abs) and hemorrhagic species-specific antibodies (HSS-Abs) from antivenoms. These two SSAbs were then used to develop a sandwich ELISA (enzyme-linked immunosorbent assay) and a lateral flow assay comprising two test lines. The resulting ELISAs and lateral flow strip assays could successfully discriminate between neurotoxic and hemorrhagic venoms. The limits of quantification (LOQ) of the ELISA for neurotoxic venoms and hemorrhagic venoms were determined to be 0.39 and 0.78 ng/ml, respectively, and the lateral flow strips were capable of detecting neurotoxic and hemorrhagic venoms at concentrations lower than 5 and 50 ng/ml, respectively, in 10–15 min. Tests of lateral flow strips in 21 clinical snakebite cases showed 100% specificity and 100% sensitivity for neurotoxic envenomation, whereas the sensitivity for detecting hemorrhagic envenomation samples was 36.4%. We herein presented a feasible strategy for developing a sensitive sandwich ELISA and lateral flow strip assay for detecting and differentiating venom proteins from hemorrhagic and neurotoxic snakes. A useful snakebite diagnostic guideline according to the lateral flow strip results and clinical symptoms was proposed to help physicians to use antivenoms appropriately. The two-test-line lateral flow strip assay could potentially be applied in an emergency room setting to help physicians diagnose and manage snakebite victims.

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Rapid and selective detection of experimental snake envenomation – Use of gold nanoparticle based lateral flow assay

Cited by 25 publications

References 28 publications

A Rapid and International Applicable Diagnostic Device for Cobra (Genus Naja) Snakebites

A Rapid and International Applicable Diagnostic Device for Cobra (Genus Naja) Snakebites

Current Knowledge on Snake Dry Bites

Development of sandwich ELISA and lateral flow strip assays for diagnosing clinically significant snakebite in Taiwan

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