Sodium silicate complex reduces subdermal hemorrhage and prolongs survival after envenomation by Trimeresurus...

Snakebites from Trimeresurus stejnegeri stejnegeri (TS) and Protobothrops mucrosquamatus (PM) pose significant clinical challenges in Taiwan. Although bivalent antivenom antibodies targeting TS and PM have been developed, timely treatment for victims is often hindered by prolonged patient transfer to medical facilities or shortages of snake-specific antivenom. Therefore, there is still a need to develop a cost-effective and thermostable reagent for individuals at high risk of snakebites. Our prior research suggested that sodium silicate complex (SSC) could enhance antivenom therapy by inhibiting the proteolytic and hemolytic activities of PM venom. In this study, we extend the therapeutic potential of SSC by testing its efficacy against TS venom. In vitro, SSC significantly reduced TS venom's proteolytic activity and cytotoxicity on human umbilical vein endothelial cells (HUVECs). In vivo, SSC administration to mice reduced subdermal hemorrhage caused by TS venom intradermal injection, showing similar efficacy to the bivalent antivenom in mitigating the effects of TS venom. Notably, pre-mixing TS venom with a 32-fold dilution of SSC extended the survival of two out of three mice to 48 h following intraperitoneal injection, whereas all mice in the venom-only group died within 24 h. Overall, SSC was effective in inhibiting proteolytic activity and local hemorrhage. Importantly, SSC treatment can provide critical time before administering bivalent antivenom therapy, helping to reduce venom-induced complications and potentially prevent death. The findings suggest that SSC could be a promising first-aid therapy for snakebites, though further research is needed to optimize its use.