[Role of antivenoms in the treatment of snake envenomation].

Abstract

The production of antivenoms, which were long deemed ineffective, dangerous and difficult to use, has improved dramatically. These antibodies (immunoglobulin G) are now fragmented, purified and controlled for their quality, leading to significantly better safety and facilitating their emergency use. Envenomation can result in various syndromes depending on the snake species: Viperidae venoms are highly inflammatory, hemorrhagic and necrotising, while Elapidae venoms can cause fatal respiratory paralysis. However, some Viperidae venoms can lead to asphyxiation similar to that observed in Elapidae envenomation while, conversely, Elapidae bites may be complicated by hemorrhage or necrosis, thus complicating etiologic diagnosis. Symptomatic treatment is complex, often insufficient, and frequently associated with adverse events. In contrast, antivenoms neutralize the venom and accelerate its clearance, thus providing an etiological treatment for envenomation, particularly in remote healthcare facilities in developing countries. Current formulations consist of polyvalent antivenoms covering most of the venomous species present in a specific region. The main limitation is their high cost, and the priority should be to develop new treatment strategies, including more affordable antivenoms, especially in developing countries where they are most needed.

• Authors: Jean-Philippe Chippaux
• Journal: Bulletin de l'Academie nationale de medecine (Bull Acad Natl Med) 2013 Apr-May Vol. 197 Issue 4-5 Pg. 993-1006; discussion 1006-8 ISSN: 0001-4079 [Print] Netherlands
• Vernacular Title: Place de l'immunothérapie dans le traitement actuel des envenimations ophidiennes.
• PMID: 25518165 (Publication Type: English Abstract, Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Antivenins
• Immunoglobulin Fragments
• Immunoglobulin G
• Snake Venoms

Topics

• Animals
• Antivenins (adverse effects, economics, immunology, isolation & purification, therapeutic use)
• Global Health
• Humans
• Immunization, Passive (economics, methods)
• Immunoglobulin Fragments (immunology, therapeutic use)
• Immunoglobulin G (immunology, isolation & purification, therapeutic use)
• Pharmacovigilance
• Snake Bites (economics, epidemiology, immunology, therapy)
• Snake Venoms (immunology)