title: Development of a new polyspecific antivenom for snakebite envenoming in Sri Lanka: Analysis of its preclinical efficacy as compared to a currently available antivenom.
abstract: A new whole IgG, freeze-dried, polyspecific antivenom was prepared from the plasma of horses immunized with the venoms of the snakes Daboia russelii, Echis carinatus, Hypnale hypnale, and Naja naja from Sri Lanka. The preclinical neutralizing ability of this antivenom against several toxic and enzymatic activities of these four venoms was analyzed, and compared with that of a batch of VINS antivenom (India) being currently used in Sri Lanka. The activities tested were: lethality, hemorrhagic, in vitro coagulant, proteinase and phospholipase A2. Both antivenoms neutralized, to a different extent, these activities of the venom of D. russelii, E. carinatus, and N. naja. In general, the polyspecific Sri Lankan antivenom was more effective than the Indian antivenom in the neutralization of the venoms of D. russelii and E. carinatus, whereas the Indian antivenom showed a higher efficacy against the venom of N. naja. Regarding H. hypnale, the new Sri Lankan antivenom was effective in the neutralization of all activities tested, whereas the Indian antivenom neutralized lethality but not hemorrhagic, coagulant, proteinase and PLA2activities, in agreement with the fact that this venom is not included in the immunization mixture for this antivenom. Results suggest that the new polyspecific Sri Lankan antivenom has a satisfactory preclinical neutralizing profile and compares favorably with the Indian antivenom. This is ready to be tested in a clinical trial to evaluate its efficacy and safety in human victims of snakebite envenomings by D. russelii, E. carinatus and H. hypnale in Sri Lanka.
authors.affiliation: Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
authors.forename: Mauren
authors.initials: M
authors.lastname: Villalta
authors.affiliation: Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
authors.forename: Andrés
authors.initials: A
authors.lastname: Sánchez
authors.affiliation: Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
authors.forename: María
authors.initials: M
authors.lastname: Herrera
authors.affiliation: Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
authors.forename: Mariángela
authors.initials: M
authors.lastname: Vargas
authors.affiliation: Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Segura
authors.affiliation: Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
authors.forename: Maykel
authors.initials: M
authors.lastname: Cerdas
authors.affiliation: Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Estrada
authors.affiliation: Faculty of Medicine, University of Peradeniya, Sri Lanka.
authors.forename: Indika
authors.initials: I
authors.lastname: Gawarammana
authors.affiliation: Animal Venom Research International, Moreno Valley, CA, USA; Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Dan E
authors.initials: DE
authors.lastname: Keyler
authors.affiliation: Animal Venom Research International, Moreno Valley, CA, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: McWhorter
authors.affiliation: Animal Venom Research International, Moreno Valley, CA, USA.
authors.forename: Roy
authors.initials: R
authors.lastname: Malleappah
authors.affiliation: Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
authors.forename: Alberto
authors.initials: A
authors.lastname: Alape-Girón
authors.affiliation: Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
authors.forename: Guillermo
authors.initials: G
authors.lastname: León
authors.affiliation: Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica. Electronic address: jose.gutierrez@ucr.ac.cr.
authors.forename: José María
authors.initials: JM
authors.lastname: Gutiérrez
mesh_terms: D000818:Animals; D000997:Antivenins / Q000276:immunology / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D013188:Sri Lanka
chemical_list: D000997:Antivenins
keywords: Antivenoms; Daboia russelii; Echis carinatus; Hypnale hypnale; Naja naja; Neutralization; Snake venoms; Sri Lanka