Commercial monovalent antivenoms in Australia are polyvalent

M O'LEARY, Geoffrey Isbister

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Monovalent antivenoms have a lower volume of specific antibodies that may reduce reactions but require accurate snake identification to be used. Polyvalent antivenoms are larger volume and may have a higher reaction rate. However, they avoid the problem of snake identification and may be more cost-effective to manufacture. We have previously shown cross-neutralisation of two Australian elapid venoms, tiger snake (Notechis scutatus) and brown snake (Pseudonaja textilis) venoms, by their respective monovalent antivenoms. In this study enzyme immunoassays were used to quantify the amount of monovalent antivenom (quantity of monovalent antibodies to a specific snake venom) in vials of commercially produced antivenom in Australia. All antivenoms tested appeared to be polyvalent and contain varying amounts of all five terrestrial snake monovalent antibodies based on their binding to the five representative venoms. Redback spider antivenom did not have any measurable binding affinity for any of the five snake venoms, showing that the observed binding is not due to non-specific interactions with equine protein. The antivenoms had expiry dates over a 15 year period, suggesting that the antivenoms have been mixtures for at least this time. This study cannot be used to rationalise hospital stocks of antivenom in Australia because there is no guarantee that the antivenoms will remain as mixtures. However, it would be possible for the manufacturer to reduce the number of types of snake antivenoms available in Australia to two polyvalent antivenoms which would simplify treatment of snakebite. Crown Copyright � 2009.
    Original languageEnglish
    Pages (from-to)192-195
    Number of pages4
    JournalToxicon
    Volume54
    Issue number2
    Publication statusPublished - 2009

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    Antivenins
    Snakes
    Snake Venoms
    Venoms
    Antibodies
    Elapid Venoms
    Snake Bites
    Spiders
    Crowns
    Immunoenzyme Techniques
    Horses
    Reaction rates

    Cite this

    O'LEARY, M., & Isbister, G. (2009). Commercial monovalent antivenoms in Australia are polyvalent. Toxicon, 54(2), 192-195.
    O'LEARY, M ; Isbister, Geoffrey. / Commercial monovalent antivenoms in Australia are polyvalent. In: Toxicon. 2009 ; Vol. 54, No. 2. pp. 192-195.
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    O'LEARY, M & Isbister, G 2009, 'Commercial monovalent antivenoms in Australia are polyvalent', Toxicon, vol. 54, no. 2, pp. 192-195.

    Commercial monovalent antivenoms in Australia are polyvalent. / O'LEARY, M; Isbister, Geoffrey.

    In: Toxicon, Vol. 54, No. 2, 2009, p. 192-195.

    Research output: Contribution to journalArticleResearchpeer-review

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    AB - Monovalent antivenoms have a lower volume of specific antibodies that may reduce reactions but require accurate snake identification to be used. Polyvalent antivenoms are larger volume and may have a higher reaction rate. However, they avoid the problem of snake identification and may be more cost-effective to manufacture. We have previously shown cross-neutralisation of two Australian elapid venoms, tiger snake (Notechis scutatus) and brown snake (Pseudonaja textilis) venoms, by their respective monovalent antivenoms. In this study enzyme immunoassays were used to quantify the amount of monovalent antivenom (quantity of monovalent antibodies to a specific snake venom) in vials of commercially produced antivenom in Australia. All antivenoms tested appeared to be polyvalent and contain varying amounts of all five terrestrial snake monovalent antibodies based on their binding to the five representative venoms. Redback spider antivenom did not have any measurable binding affinity for any of the five snake venoms, showing that the observed binding is not due to non-specific interactions with equine protein. The antivenoms had expiry dates over a 15 year period, suggesting that the antivenoms have been mixtures for at least this time. This study cannot be used to rationalise hospital stocks of antivenom in Australia because there is no guarantee that the antivenoms will remain as mixtures. However, it would be possible for the manufacturer to reduce the number of types of snake antivenoms available in Australia to two polyvalent antivenoms which would simplify treatment of snakebite. Crown Copyright � 2009.

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    O'LEARY M, Isbister G. Commercial monovalent antivenoms in Australia are polyvalent. Toxicon. 2009;54(2):192-195.