Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan.
Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan.
PLoS Negl Trop Dis. 2024 Mar 25;18(3):e0012070. doi: 10.1371/journal.pntd.0012070. eCollection 2024 Mar.
Snakebite envenomation is a significant global health issue that requires specific antivenom treatments. In Taiwan, available antivenoms target a variety of snakes, but none specifically target Trimeresurus gracilis, an endemic and protected species found in the high mountain areas of Taiwan. This study evaluated the effectiveness of existing antivenoms against T. gracilis venom, focusing on a bivalent antivenom developed for Trimeresurus stejnegeri and Protobothrops mucrosquamatus (TsPmAV), as well as monovalent antivenoms for Deinagkistrodon acutus (DaAV) and Gloydius brevicaudus (GbAV). Our research involved in vivo toxicity testing in mice and in vitro immunobinding experiments using (chaotropic) enzyme-linked immunosorbent assays, comparing venoms from four pit viper species (T. gracilis, T. stejnegeri, P. mucrosquamatus, and D. acutus) with three types of antivenoms. These findings indicate that TsPmAV partially neutralized T. gracilis venom, marginally surpassing the efficacy of DaAV. In vitro tests revealed that GbAV displayed higher binding capacities toward T. gracilis venom than TsPmAV or DaAV. Comparisons of electrophoretic profiles also reveal that T. gracilis venom has fewer snake venom C-type lectin like proteins than D. acutus, and has more P-I snake venom metalloproteases or fewer phospholipase A2 than G. brevicaudus, T. stejnegeri, or P. mucrosquamatus. This study highlights the need for antivenoms that specifically target T. gracilis, as current treatments using TsPmAV show limited effectiveness in neutralizing local effects in patients. These findings provide crucial insights into clinical treatment protocols and contribute to the understanding of the evolutionary adaptation of snake venom, aiding in the development of more effective antivenoms for human health.
蛇伤是一个严重的全球健康问题，需要特定的抗蛇毒血清治疗。在台湾，现有的抗蛇毒血清针对多种蛇类，但没有专门针对台湾高山地区特有的 Trimeresurus gracilis 的抗蛇毒血清。本研究评估了现有的抗蛇毒血清对 T. gracilis 毒液的有效性，重点是针对 Trimeresurus stejnegeri 和 Protobothrops mucrosquamatus（TsPmAV）开发的二价抗蛇毒血清，以及针对 Deinagkistrodon acutus（DaAV）和 Gloydius brevicaudus（GbAV）的单价抗蛇毒血清。我们的研究包括在体内毒性试验在小鼠和体外免疫结合实验中使用（离液剂）酶联免疫吸附试验，比较来自四种烙铁头蛇种（T. gracilis、T. stejnegeri、P. mucrosquamatus 和 D. acutus）的毒液与三种类型的抗蛇毒血清。这些发现表明，TsPmAV 部分中和了 T. gracilis 毒液，其效果略优于 DaAV。体外试验显示，GbAV 对 T. gracilis 毒液的结合能力高于 TsPmAV 或 DaAV。电泳图谱的比较也表明，T. gracilis 毒液中的蛇毒 C 型凝集素样蛋白比 D. acutus 少，而 P-I 型蛇毒金属蛋白酶比 G. brevicaudus、T. stejnegeri 或 P. mucrosquamatus 少，磷脂酶 A2 多。本研究强调需要针对 T. gracilis 的抗蛇毒血清，因为目前使用 TsPmAV 的治疗方法在中和患者局部效应方面效果有限。这些发现为临床治疗方案提供了重要的见解，并有助于了解蛇毒的进化适应，为人类健康开发更有效的抗蛇毒血清做出贡献。
