Snake venoms in science and clinical medicine. 2. Applied immunology in snake venom research

Enzyme-linked immunosorbent assay (ELISA) is a very important tool for studying both the epidemiology and clinical effects of snake bite in man. For epidemiology ELISA depends on the development and persistence of specific humoral venom antibody in previous snake bite victims. In the Nigerian savanna 63% of previous bite victims possessed specific venom antibodies against Echis carinatus venom; in Ecuador, where there is a 5% annual mortality due to snake bite in a population of Waorani Indians, venom antibodies against a wide range of different venoms were identified in previous bite victims using ELISA. In certain areas it is often not possible, using the symptoms of envenoming, to determine which species of snake has bitten the patient. Field studies using ELISA in Nigeria and Thailand have been successful in establishing the species responsible for envenoming. Current studies are in progress on the development of a rapid immunoassay which should be capable of detecting the biting species within 5-10 min of sampling from the admission patient. This will be useful for the clinician as it will enable the rapid detection of the species responsible for envenoming and, therefore, the use of the correct antivenom. Experimental work on the development of new methods of antivenom production includes immunization of experimental animals with venom/liposome preparations, the preparation of venom antigens using monoclonal antibodies on affinity columns, and recombinant deoxyribonucleic acid technology. Liposomal immunization requires only a single injection of venom to obtain a rapid, high level and protective immune response. Venom liposomes may also be given orally resulting in a serum immunoglobulin G immune response in experimental animals. Use of such a system may eventually result in immunization of man in areas of high snake bite incidence and mortality.