Calvete Juan J, Sanz Libia, Pla Davinia, Lomonte Bruno, Gutiérrez José María
Structural and Functional Venomics Lab, Instituto de Biomedicina de Valencia (CSIC), Valencia 46010, Spain.
Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José 11501, Costa Rica.
Toxins (Basel). 2014 Dec 15;6(12):3388-405. doi: 10.3390/toxins6123388.
Snakebite envenoming represents a neglected tropical disease that has a heavy public health impact worldwide, mostly affecting poor people involved in agricultural activities in Africa, Asia, Latin America and Oceania. A key issue that complicates the treatment of snakebite envenomings is the poor availability of the only validated treatment for this disease, antivenoms. Antivenoms can be an efficacious treatment for snakebite envenoming, provided they are safe, effective, affordable, accessible and administered appropriately. The shortage of antivenoms in various regions, particularly in Sub-Saharan Africa and some parts of Asia, can be significantly alleviated by optimizing the use of current antivenoms and by the generation of novel polyspecific antivenoms having a wide spectrum of efficacy. Complementing preclinical testing of antivenom efficacy using in vivo and in vitro functional neutralization assays, developments in venomics and antivenomics are likely to revolutionize the design and preclinical assessment of antivenoms by being able to test new antivenom preparations and to predict their paraspecific neutralization to the level of species-specific toxins.
蛇咬伤中毒是一种被忽视的热带疾病,在全球范围内对公共卫生造成严重影响,主要影响非洲、亚洲、拉丁美洲和大洋洲从事农业活动的贫困人口。使蛇咬伤中毒治疗变得复杂的一个关键问题是,针对这种疾病唯一经过验证的治疗方法——抗蛇毒血清的供应不足。抗蛇毒血清如果安全、有效、可负担、可获取且使用得当,对蛇咬伤中毒可以是一种有效的治疗方法。通过优化现有抗蛇毒血清的使用以及研发具有广泛疗效的新型多特异性抗蛇毒血清,各地区尤其是撒哈拉以南非洲和亚洲一些地区抗蛇毒血清短缺的情况可得到显著缓解。除了使用体内和体外功能中和试验对抗蛇毒血清疗效进行临床前测试外,毒液组学和抗毒液组学的发展很可能会彻底改变抗蛇毒血清的设计和临床前评估,因为它们能够测试新的抗蛇毒血清制剂,并预测其对物种特异性毒素水平的交叉特异性中和作用。