Abstract
BackgroundSnake bite is a common medical emergency in Papua New Guinea (PNG). The taipan, Oxyuranus scutellatus, inflicts a large number of bites that, in the absence of antivenom therapy, result in high mortality. Parenteral administration of antivenoms manufactured in Australia is the current treatment of choice for these envenomings. However, the price of these products is high and has increased over the last 25 years; consequently the country can no longer afford all the antivenom it needs. This situation prompted an international collaborative project aimed at generating a new, low-cost antivenom against O. scutellatus for PNG.Methodology/Principal FindingsA new monospecific equine whole IgG antivenom, obtained by caprylic acid fractionation of plasma, was prepared by immunising horses with the venom of O. scutellatus from PNG. This antivenom was compared with the currently used F(ab')2 monospecific taipan antivenom manufactured by CSL Limited, Australia. The comparison included physicochemical properties and the preclinical assessment of the neutralisation of lethal neurotoxicity and the myotoxic, coagulant and phospholipase A2 activities of the venom of O. scutellatus from PNG. The F(ab')2 antivenom had a higher protein concentration than whole IgG antivenom. Both antivenoms effectively neutralised, and had similar potency, against the lethal neurotoxic effect (both by intraperitoneal and intravenous routes of injection), myotoxicity, and phospholipase A2 activity of O. scutellatus venom. However, the whole IgG antivenom showed a higher potency than the F(ab')2 antivenom in the neutralisation of the coagulant activity of O. scutellatus venom from PNG.Conclusions/SignificanceThe new whole IgG taipan antivenom described in this study compares favourably with the currently used F(ab')2 antivenom, both in terms of physicochemical characteristics and neutralising potency. Therefore, it should be considered as a promising low-cost candidate for the treatment of envenomings by O. scutellatus in PNG, and is ready to be tested in clinical trials.
Highlights
Envenoming by snake bite is a common medical emergency in Papua New Guinea (PNG) [1,2,3]
In the southern lowlands of the country the majority of envenomings are inflicted by the taipan, Oxyuranus scutellatus
Horses were immunised with the venom of O. scutellatus from PNG and whole IgG was purified from the plasma of these animals by caprylic acid precipitation of non-immunoglobulin proteins
Summary
Envenoming by snake bite is a common medical emergency in Papua New Guinea (PNG) [1,2,3]. A study of snakebite admissions to the PMGH ICU between 1992 and 2001 revealed case fatality rates of 8.2% for adults and 14.6% for children [5]. The price of these products is high and has increased over the last 25 years; the country can no longer afford all the antivenom it needs. This situation prompted an international collaborative project aimed at generating a new, low-cost antivenom against O. scutellatus for PNG
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