BOSTON, Massachusetts — In 2018, The World Health Organization (WHO) declared snakebite envenoming a “global health priority” and one of the world’s most neglected tropical diseases. Snakebite envenoming, otherwise known as snakebite poisoning, occurs when snakes transmit venom through their bites. Around 50 to 70% of snakebites result in envenoming. Snakes choose how much venom they release with each bite, and bites without the transmission of venom are known as dry bites.
Snakes bite over 5 million people each year, leaving on average 100,000 people dead and 400,000 permanently injured. Up until 2018, global health organizations did little to prioritize improvements in snakebite treatment. Snakebite envenoming occurs largely in poor, rural populations across South Asia, South-East Asia and Sub-Saharan Africa. High-risk populations include those living in inadequate housing with limited access to education and health care, particularly women without medical care and pregnant women. Other vulnerable populations include rural farmers, herders, fishermen, hunters and working children, due to the time they spend outside, often without safe shoes.
Since 2018, awareness and acknowledgment of snakebites have encouraged governments and researchers to develop improvements in snakebite treatment. Technological advancements as recent as 2022 and 2023 are furthering the global effort to prevent snake bite fatalities among the global poor. They offer promising new perspectives for the future of snakebite treatment.
The 2554_01_D11 Antibody
The most effective treatment for snakebite envenoming is the administration of antivenom, which strengthens immune system response. Traditionally, antivenom is derived from injecting donor animals, often horses or sheep, with snake venom to produce plasma-derived antibodies.
Unfortunately, inadequate research and poor regulation lessen the efficacy of plasma-derived antibodies, and may even pose additional risks. Production and storage must remain in accordance with rigorous quality control, often involving refrigeration. Regions where snakebite envenoming is most prevalent often lack local antivenom production and are not adept to train health workers or store antivenoms in properly refrigerated locations.
Furthermore, not all antivenoms are broad-spectrum, meaning they are limited to only treating the bites of specific snake species. Most health care workers are unfit to identify snake species based on the bite, further complicating how snakebites are best treated.
Fortunately, the development of the 2554_01_D11 antibody is one of many new improvements in snakebite treatment. 2554_01_D11 is a potent, broad-spectrum and human-derived antibody. Researchers from the University of Cambridge tested the antibody against the venom of many deadly snake species, including different cobras, mambas and kraits. Not only is it effective in delaying death, but for some species, such as the monocled cobra, it prevents death altogether. Additionally, since the antibody is human-derived, it is safer and more tolerable within human patients than its plasma-derived antibodies, produced from the immune systems of horses or sheep. Researchers plan to continue testing the antibody’s effectiveness beyond 2023.
Additional Improvements in Snakebite Treatment
Researchers are also immunizing camels, leading to further improvements in snakebite treatment. Camelid antibodies are smaller than the antibodies of horses or humans, meaning they diffuse quicker throughout a human body. A topical medication from camel antibodies treats tissue damage from snake bites. Although camelid antibodies are not broad-spectrum, and rather specific to different types of venom, researchers tested the efficacy of the topical medication in high temperatures and found that it still neutralized snake venom without refrigeration. The treatment’s efficacy despite high temperatures offers significant potential benefit to communities where adequate refrigeration is not always readily available.
Furthermore, researchers believe that small molecule drugs may also help treat snake envenoming. Administered orally, small molecule drugs target entire families of toxins, rather than specific proteins in venom, suggesting that they may treat snake bites from a variety of deadly snake species. They are also quick-acting, meaning they offer significant benefits to rural populations requiring extra travel time to health care facilities to receive further care.
Moving Forward
The 2554_01_D11 antibody, topical medications derived from camelid antibodies and oral medications derived from small molecule drugs reveal significant improvements in snakebite treatment. Moving forward, global health organizations must continue to ensure that researchers improve treatments and access to snakebite treatment across poor and rural communities in need of them most. Fortunately, new improvements in snakebite treatment offer respite from snakebite envenoming even in communities lacking adequate health care access, staff and infrastructure.
– Ben Hofmann
Photo: Flickr