Preclinical efficacy evaluation of two commercially available anti-snake venom against Naja nigricollis induced envenomation
Keywords:
EchiTab Plus-ICP, Naja nigricollis, Premium Antivenom, Snakebite, VenomAbstract
Background: The biochemical and immunological variations of snake venom components lead to many challenges in manufacturing appropriate anti snake venom (ASV). These variations have negatively impacted clinical outcomes due to the availability of ineffffective ASVs in countries where the manufacturing venom does not originate. There are reports of ineffffective ASVs exported to some African countries with public health and economic consequences on the already debilitating crisis. Recently, there have been calls and publications to draw the attention of policymakers and regional regulators on the need for preclinical and clinical data related to ASV, especially when manufactured from other regions. We therefore, screened the two most commercially available antisnake venom in Northern Nigeria against the most medically important cobra venom (N. nigricollis).
Methods: N. nigricollis venom was manually milked from fifive N. nigricollis captured from the wild and the LD50 of venom was determined using probit analysis. The effiffifficacy evaluation was conducted using the classical world health organization's preclinical mixing of venom/ASV methods on the lethal, hemorrhagic, hemolytic and necrotic effffect of the venom in mice and rabbit blood.
Result: The median lethal dose (LD50) of Naja nigricollis venom was estimated to be 1.0 mg/kg as calculated using Probit analysis. The two ASVs used for this study; EchiTab Plus-ICP and Premium Antivenom (PAV), provided protection (100%) against venom-induced lethality in mice except at the dose of 100l/mouse, where the PAV provided only 33% protection. All the administered doses of both EchiTab-Plus-ICP and PAV showed statistically signifificant reduction (p<0.001) in the mean hemorrhagic diameter when compared with the control group (19.12±1.95 mm). There was also signifificant reduction (p<0.001) in the mean necrotic diameter in all the groups compared to the control group (8.58±1.33 ml). Two dilutions of EchiTab-Plus-ICP (100 and 200 l) were able to signifificantly reduce (>50%) venom-induced hemolysis by 58 and 62% respectively, compared with the venom control group. On the other hand, such reduction was not observed with PAV.
Conclusion: The two most commercially available ASV in Northern Nigeria, EchiTab Plus-ICP and Premium Antivenom, were signifificantly (P > 0.01) effffective against lethality and venom-induced pathological parameters from Naja nigricollis envenoming, including; hemolysis, hemorrhagic and necrotic lesions, with EchiTab Plus-ICPshowing better activity.
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