Sánchez Andrés, Segura Álvaro, Vargas Mariángela, Herrera María, Villalta Mauren, Estrada Ricardo, Wu Francisco, Litschka-Koen Thea, Perry Michael Alfred, Alape-Girón Alberto, León Guillermo
Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica; Sección de Química Analítica, Escuela de Química, Universidad de Costa Rica, San José, Costa Rica.
Toxicon. 2017 Jan;125:59-64. doi: 10.1016/j.toxicon.2016.11.259. Epub 2016 Nov 24.
EchiTAb-plus-ICP is an antivenom prepared from plasma of horses hyperimmunized with the venoms of the carpet viper (Echis ocellatus), the puff adder (Bitis arietans) and the black-necked spitting cobra (Naja nigricollis). Therefore, the use of this antivenom has been limited to Western Africa. In order to expand the neutralization scope of EchiTAb-plus-ICP, we supplemented the immunogenic mixture with the venoms of B. arietans, the black mamba (Dendroaspis polylepis), the Mozambique spitting cobra (Naja mossambica), the snouted cobra (N. annulifera), and the rinkhals (Hemachatus haemachatus) from Swaziland. The ability of the expanded-scope antivenom, hereby named EchiTAb + ICP, to neutralize the venoms of B. arietans, D. polylepis, N. mossambica and H. haemachatus was similar to those of FAV Afrique and the SVA African antivenoms. In comparison to the SAIMR antivenom, the expanded-scope EchiTAb + ICP had lower ability to neutralize the venom of B. arietans, but similar ability to neutralize the venoms of D. polylepis, N. mossambica and H. haemachatus. Owing to its low protein concentration, the expanded-scope EchiTAb + ICP had lower ability to neutralize the venom of N. annulifera than FAV Afrique and the SAIMR antivenoms. However, when formulated at a protein concentration as high as FAV Afrique and SAIMR antivenoms, the expanded-scope EchiTAb + ICP showed similar capacity to neutralize this poorly immunogenic venom. Our results encourage the transition to the new EchiTAb + ICP antivenom, with an expanded neutralization scope that includes venoms of some of the most medically important elapids from Southern Africa. Clinical trials are required to determine the minimum effective-safe dose of the new EchiTAb + ICP for each type of envenomation.
EchiTAb-plus-ICP是一种抗蛇毒血清，由用地毯蝰蛇（锯鳞蝰）、鼓腹咝蝰和黑颈喷毒眼镜蛇的毒液对马匹进行超免疫后采集的血浆制备而成。因此，这种抗蛇毒血清的使用仅限于西非地区。为了扩大EchiTAb-plus-ICP的中和范围，我们在免疫原混合物中补充了来自斯威士兰的鼓腹咝蝰、黑曼巴蛇、莫桑比克喷毒眼镜蛇、环纹眼镜蛇和喙眼镜蛇的毒液。这种扩大范围的抗蛇毒血清（现命名为EchiTAb + ICP）中和鼓腹咝蝰、黑曼巴蛇毒、莫桑比克喷毒眼镜蛇毒和喙眼镜蛇毒的能力与非洲蛇毒冻干剂和南非毒蛇抗毒血清相似。与南非医学研究所抗蛇毒血清相比，扩大范围的EchiTAb + ICP中和鼓腹咝蝰毒液的能力较低，但中和黑曼巴蛇毒、莫桑比克喷毒眼镜蛇毒和喙眼镜蛇毒的能力相似。由于其蛋白质浓度较低，扩大范围的EchiTAb + ICP中和环纹眼镜蛇毒液的能力低于非洲蛇毒冻干剂和南非医学研究所抗蛇毒血清。然而，当以与非洲蛇毒冻干剂和南非医学研究所抗蛇毒血清一样高的蛋白质浓度配制时，扩大范围的EchiTAb + ICP显示出中和这种免疫原性较差毒液的相似能力。我们的研究结果促使人们转而使用新的EchiTAb + ICP抗蛇毒血清，其扩大的中和范围包括一些来自南部非洲的、在医学上最重要的眼镜蛇科蛇类的毒液。需要进行临床试验来确定新的EchiTAb + ICP针对每种类型蛇伤中毒的最低有效安全剂量。
