Sjostrom L, Karlson-Stiber C, Persson H, Al-Abdulla I H, Smith D C
Therapeutic Antibodies Ltd, Medical College of St Bartholomew's Hospital, London.
Toxicon. 1996 Jan;34(1):91-8. doi: 10.1016/0041-0101(95)00110-7.
An ovine affinity purified Fab antivenom was used in a clinical trial in Sweden to treat European adder (Vipera berus berus) envenoming. Immunoassays were developed to measure V. b. berus venom and antivenom concentrations in clinical samples to help assess the efficacy of treatment. A radioimmunoassay (RIA) was developed, optimized and validated to measure plasma levels of V. b. berus venom and compared with a conventional ELISA. Both showed a similar variation of zero binding in biological samples and the results obtained correlated closely. However, the ELISA was quicker and more sensitive (0.8 compared with 2 micrograms/litre). Before administration of antivenom, V. b. berus venom concentrations in plasma ranged from 10 to 53 micrograms/litre; 12 hr after the Fab infusion, no patient had measurable levels. However, two patients had low venom levels 24 hr after treatment. ELISA and RIA were also developed, optimized and used to measure concentrations of free Fab in plasma. There was a biexponential fall of Fab concentration with a fast distribution phase (t 1/2 = 0.9 hr) and a slower elimination phase (t 1/2 = 18 hr). The amount of Fab excreted in urine was low.
一种绵羊亲和纯化的Fab抗蛇毒血清在瑞典的一项临床试验中用于治疗欧洲蝰蛇（极北蝰）咬伤。开发了免疫测定法来测量临床样本中极北蝰毒液和抗蛇毒血清的浓度，以帮助评估治疗效果。开发、优化并验证了一种放射免疫测定法（RIA）来测量极北蝰毒液的血浆水平，并与传统酶联免疫吸附测定（ELISA）进行比较。两者在生物样本中均显示出类似的零结合变化，所得结果密切相关。然而，ELISA更快且更灵敏（检测限分别为0.8微克/升和2微克/升）。在给予抗蛇毒血清之前，血浆中极北蝰毒液浓度范围为10至53微克/升；Fab输注12小时后，没有患者的毒液水平可检测到。然而，两名患者在治疗24小时后毒液水平较低。还开发、优化了ELISA和RIA并用于测量血浆中游离Fab的浓度。Fab浓度呈双指数下降，快速分布期（t1/2 = 0.9小时）和较慢消除期（t1/2 = 18小时）。尿液中排出的Fab量较低。
