Assessing the preclinical efficacy of antivenoms: From the lethality neutralization assay to antivenomics
The assessment of the capacity of antivenoms to neutralize the lethal activity of snake venoms is the gold standard in the preclinical analysis of antivenom efficacy, and is routinely performed by manufacturers and quality control laboratories. However, the complexity of snake venom composition a...
|Main Authors:||Gutiérrez, José María, Solano Trejos, María Gabriela, Pla Ferrer, Davinia, Herrera Vega, María, Segura Ruiz, Álvaro, Villalta Arrieta, Mauren, Vargas Arroyo, Mariángela, Sanz, Libia, Lomonte, Bruno, Calvete Chornet, Juan José, León Montero, Guillermo|
The assessment of the capacity of antivenoms to neutralize the lethal activity of snake
venoms is the gold standard in the preclinical analysis of antivenom efficacy, and is
routinely performed by manufacturers and quality control laboratories. However, the
complexity of snake venom composition and toxicological profile demands that, for many
venoms, such as those of viperid snakes and some elapids, the neutralization of lethality be
complemented with the analysis of the neutralization of other relevant toxic activities,
such as hemorrhagic, myotoxic, necrotizing, procoagulant and defibrinogenating effects.
This expanded protocol for preclinical testing of antivenoms should be used when a new
antivenom is developed or when an existing antivenom is introduced in a new
geographical setting for the neutralization of either homologous or heterologous venoms.
In recent years, the assessment of the immunological reactivity of antivenoms has been
enriched by the use of proteomic tools, with a methodology named ‘antivenomics’. This
allows the identification of venom components to which antivenoms have, or lack, antibodies,
and thus complements the data gathered in neutralization tests, paving the way for
a knowledge-based improvement of antivenom design and efficacy. International projects
involving participants of manufacturing, quality control and academic research groups
should be promoted in order to gain a deeper understanding on the preclinical neutralizing
spectrum of antivenoms.