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Related Experiment Videos

Antivenoms.

R D Theakston1, D C Smith

  • 1World Health Organization Collaborating Centre for the Control of Antivenoms, Liverpool School of Tropical Medicine, Liverpool, England.

Biodrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
|May 1, 1997
PubMed
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The evolution of antivenoms from IgG to F(ab'' )(2) and Fab fragments has improved efficacy but introduced challenges like anaphylactic reactions and shorter clearance times. Ovine Fab antivenoms offer potential advantages for treating snakebites, especially in tropical regions.

Area of Science:

  • Immunotherapy and Toxinology
  • Pharmacology and Drug Development

Background:

  • Initial antivenoms used crude IgG, leading to salt precipitation.
  • Development of F(ab")(2) antivenoms via pepsin digestion improved specificity by removing the Fc portion.
  • F(ab")(2) antivenoms, while effective, are associated with complement-mediated anaphylactic reactions.

Purpose of the Study:

  • To review the advancements in antivenom production and their clinical implications.
  • To compare the advantages and disadvantages of different antivenom formulations, including F(ab")(2) and Fab fragments.
  • To explore the potential of ovine-derived antivenoms for treating envenomation, particularly in resource-limited settings.

Main Methods:

  • Analysis of historical and current antivenom preparation techniques, including salt precipitation, pepsin digestion (F(ab")(2)), and papain digestion (Fab).

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  • Evaluation of antivenom characteristics such as specificity, immunogenicity, pharmacokinetics, and stability.
  • Consideration of production costs, purification methods (affinity chromatography), and formulation (lyophilized vs. liquid).

    • Main Results:

    • Ovine Fab antivenoms, produced by papain digestion, theoretically offer improved distribution and kinetics over F(ab")(2).
    • Fab antivenoms have a shorter clearance time, potentially leading to inadequate venom neutralization.
    • Affinity purification enhances antivenom activity but increases costs, limiting accessibility in rural tropics.

    Conclusions:

    • Ovine-derived antivenoms present potential benefits, including reduced sensitivity reactions and suitability for tropical climates (lyophilized form).
    • Cost-effective production and formulation remain critical challenges for widespread antivenom accessibility.
    • Future research could explore combined ovine Fab/F(ab")(2) antivenoms and alternative immunotherapy approaches.