Species-Specific and region-specific antivenoms are needed for improving treatment of monocled cobra bites, according to a new study.

The Monocled Cobra (Naja kaouthia), an Elapidae snake, inhabits eastern and northeastern India, Nepal, Bangladesh, Myanmar, Thailand, Vietnam, Malaysia, and southern China. Neurotoxicity and regional tissue destruction are the chief symptoms of N. kaouthia (NK) envenomation, which is a severe medical condition.

Unfortunately, NK envenomation data is scarce due to poor record-keeping, lack of diagnostic kits, and poorly coordinated epidemiological investigations across regions.

A group of scientists led by Prof. Ashish K. Mukherjee, Director, Institute of Advanced Study in Science and Technology (IASST), Guwahati, an autonomous institute of Department of Science and Technology, Mr. Hirakjyoti Kakati from Tezpur University and Dr. Aparup Patra from Amrita Vishwa Vidyapeetham carried out proteomic and biochemical investigations to explore the diversity in NK venom (NKV) composition across different geographic regions.

They found that the variability in lethality and pathophysiological presentation resulting from the qualitative and quantitative variations in toxin isoforms (proteins with similar amino acid sequences) may constrain the efficacy of antivenom therapy.

The researchers measured venom-specific antibodies in commercial antivenoms and found lack of such antibodies against NKV in the commercial samples. Hence the lethality and toxicity of different NKV samples were not effectively neutralized by commercial polyvalent antivenom (PAV).

The study published in the Elsevier journal Toxicon, has recommended inclusion of species specific and region-specific antibodies against NKV in commercial PAV mixture for better management of NK envenomation.

Besides, the researchers have also suggested clinical investigations on NK envenomation in areas where the snake is commonly found and assessment of the relationship between this information and the local NKV composition.

Improvement of the current immunization protocol to promote the production of antibodies against less immunogenic venom components of this snake as well as better and more effective hospital management of NK envenomation could help improve measures for treating snake bites.

Publication Link: https://doi.org/10.1016/j.toxicon.2024.108056

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