Abstract
Cobra snakes (genus Naja) are some of the most dangerous snake species in Asia and Africa, as their bites cause severe life-threatening respiratory failure and local tissue destruction, especially in the case of late diagnosis. The differential diagnosis of snakebite envenomation still mainly relies upon symptomatology, the patient’s description, and the experience of physicians. We have designed a rapid test, immunochromatographic test of cobra (ICT-Cobra), which obtained fair results in improving the diagnosis and treatment of Naja (N.) atra snakebites in Taiwan. In this study, we further investigated the feasibility of applying the kit for the detection of other cobra venoms based on the potential interspecies similarity. We firstly demonstrated the cross-reactivity between eight venoms of medically important cobra species and the rabbit anti-N. atra IgG that was used in ICT-Cobra by Western blotting and sandwich enzyme-linked immunosorbent assay. Then, ICT-Cobra was used to detect various concentrations of the eight venoms to elucidate its performance. Noticeable correlations between the cross-reactivity of venoms from genus Naja snakes and existing geographical characteristics were found. ICT-Cobra could detect venoms from other Asian cobras with variable detection limits comparable to those observed for N. atra, but the kit was less successful in the detection of venom from African cobras. The similar but slightly different venom components and the interaction between venom and rabbit anti-N. atra IgG led to variations in the detection limits. The transcontinental usage of ICT-Cobra might be possible due to the cross-reactivity of antibodies and similarities among the larger-sized proteins. This study showed that the close immunological relationships in the genus Naja could be used to develop a venom detection kit for the diagnosis of cobra envenomation in both Asian and African regions. Additional clinical studies and technical adjustments are still needed to improve the efficacy and broadening the application of ICT-Cobra in the future.
Highlights
Snake envenomation has always been a global health issue, especially in rural areas and areas with inadequate medical service in tropical and subtropical countries [1,2]
The absorbances of African cobra venoms recognized by anti-N. atra IgG were all below 0.4, even at a venom concentration of 50 ng/mL
No reactivity was observed between the rabbit anti-N. atra IgG and the venom of Ophiophagus (O.) hannah, Protobothrops (P.) mucrosquamatus, Daboia (D.) siamensis, and Bungarus (B.) multicinctus (Figure 1c)
Summary
Snake envenomation has always been a global health issue, especially in rural areas and areas with inadequate medical service in tropical and subtropical countries [1,2]. Envenomation is characterized by local necrosis, neurological paralysis, and chronic musculoskeletal disability [2,7,8]. These devastating injuries still challenge all healthcare providers [4,9]. Specific, and rapid diagnostic testing paves the way for effective snakebite treatment, and plays a critical role in preventing detrimental effects or complications in patients of cobra bite [2,6,12]
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