Researching nature's venoms and poisons

Area of Science:

• Clinical toxicology
• Pharmacology
• Environmental Health

Background:

• Clinical toxinology focuses on understanding and treating poisonings from environmental agents.
• Yellow oleander (Thevetia peruviana), known as 'kaneru' in Sri Lanka, is a common ornamental plant containing toxic glycosides.
• Therapeutic antibodies have been developed for foxglove glycoside toxicity, showing promise for similar plant toxins.

Observation:

• A randomized placebo-controlled trial demonstrated the efficacy of specific antibodies in reversing kaneru cardiotoxicity.
• Previous studies suggested benefits of multiple-dose activated charcoal for plant glycoside poisoning, but recent trials have yielded inconclusive results.
• A severe case of Russell's viper (Daboia siamensis) envenomation in a young rice farmer presented with multi-organ dysfunction, including shock, coagulopathy, renal failure, and hypoglycaemia.

Findings:

• Therapeutic antibodies proved effective in reversing yellow oleander-induced cardiotoxicity.
• The study highlights the complex pathophysiology of Russell's viper venom, affecting multiple organ systems.
• While antivenom corrected haemostatic issues, it did not fully reverse other systemic effects of the venom.

Implications:

• This research supports the development of targeted antibody therapies for plant-derived poisonings.
• Understanding the systemic effects of Russell's viper venom is crucial for improving patient outcomes.
• Further research is needed to develop comprehensive treatments for complex envenomations.