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The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites
Snakebite envenoming (SBE) is a priority neglected tropical disease, which kills in excess of 100,000 people per year. Additionally, many millions of survivors also suffer through disabilities and long-term health consequences. The only treatment for SBE, antivenom, has a number of major associated...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628419/ https://www.ncbi.nlm.nih.gov/pubmed/31226842 http://dx.doi.org/10.3390/toxins11060363 |
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author | Williams, Harry F. Layfield, Harry J. Vallance, Thomas Patel, Ketan Bicknell, Andrew B. Trim, Steven A. Vaiyapuri, Sakthivel |
author_facet | Williams, Harry F. Layfield, Harry J. Vallance, Thomas Patel, Ketan Bicknell, Andrew B. Trim, Steven A. Vaiyapuri, Sakthivel |
author_sort | Williams, Harry F. |
collection | PubMed |
description | Snakebite envenoming (SBE) is a priority neglected tropical disease, which kills in excess of 100,000 people per year. Additionally, many millions of survivors also suffer through disabilities and long-term health consequences. The only treatment for SBE, antivenom, has a number of major associated problems, not least, adverse reactions and limited availability. This emphasises the necessity for urgent improvements to the management of this disease. Administration of antivenom is too frequently based on symptomatology, which results in wasting crucial time. The majority of SBE-affected regions rely on broad-spectrum polyvalent antivenoms that have a low content of case-specific efficacious immunoglobulins. Research into small molecular therapeutics such as varespladib/methyl-varespladib (PLA(2) inhibitors) and batimastat/marimastat (metalloprotease inhibitors) suggest that such adjunctive treatments could be hugely beneficial to victims. Progress into toxin-specific monoclonal antibodies as well as alternative binding scaffolds such as aptamers hold much promise for future treatment strategies. SBE is not implicit during snakebite, due to venom metering. Thus, the delay between bite and symptom presentation is critical and when symptoms appear it may often already be too late to effectively treat SBE. The development of reliable diagnostical tools could therefore initiate a paradigm shift in the treatment of SBE. While the complete eradication of SBE is an impossibility, mitigation is in the pipeline, with new treatments and diagnostics rapidly emerging. Here we critically review the urgent necessity for the development of diagnostic tools and improved therapeutics to mitigate the deaths and disabilities caused by SBE. |
format | Online Article Text |
id | pubmed-6628419 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-66284192019-07-23 The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites Williams, Harry F. Layfield, Harry J. Vallance, Thomas Patel, Ketan Bicknell, Andrew B. Trim, Steven A. Vaiyapuri, Sakthivel Toxins (Basel) Review Snakebite envenoming (SBE) is a priority neglected tropical disease, which kills in excess of 100,000 people per year. Additionally, many millions of survivors also suffer through disabilities and long-term health consequences. The only treatment for SBE, antivenom, has a number of major associated problems, not least, adverse reactions and limited availability. This emphasises the necessity for urgent improvements to the management of this disease. Administration of antivenom is too frequently based on symptomatology, which results in wasting crucial time. The majority of SBE-affected regions rely on broad-spectrum polyvalent antivenoms that have a low content of case-specific efficacious immunoglobulins. Research into small molecular therapeutics such as varespladib/methyl-varespladib (PLA(2) inhibitors) and batimastat/marimastat (metalloprotease inhibitors) suggest that such adjunctive treatments could be hugely beneficial to victims. Progress into toxin-specific monoclonal antibodies as well as alternative binding scaffolds such as aptamers hold much promise for future treatment strategies. SBE is not implicit during snakebite, due to venom metering. Thus, the delay between bite and symptom presentation is critical and when symptoms appear it may often already be too late to effectively treat SBE. The development of reliable diagnostical tools could therefore initiate a paradigm shift in the treatment of SBE. While the complete eradication of SBE is an impossibility, mitigation is in the pipeline, with new treatments and diagnostics rapidly emerging. Here we critically review the urgent necessity for the development of diagnostic tools and improved therapeutics to mitigate the deaths and disabilities caused by SBE. MDPI 2019-06-20 /pmc/articles/PMC6628419/ /pubmed/31226842 http://dx.doi.org/10.3390/toxins11060363 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Williams, Harry F. Layfield, Harry J. Vallance, Thomas Patel, Ketan Bicknell, Andrew B. Trim, Steven A. Vaiyapuri, Sakthivel The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites |
title | The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites |
title_full | The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites |
title_fullStr | The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites |
title_full_unstemmed | The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites |
title_short | The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites |
title_sort | urgent need to develop novel strategies for the diagnosis and treatment of snakebites |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628419/ https://www.ncbi.nlm.nih.gov/pubmed/31226842 http://dx.doi.org/10.3390/toxins11060363 |
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