Practical progress towards the development of recombinant antivenoms for snakebite envenoming.

Abstract

Introduction: Snakebite envenoming is a neglected tropical disease that affects millions globally each year. In recent years, research into the potential production of recombinant antivenoms, formulated using mixtures of highly defined anti-toxin monoclonal antibodies, has rapidly moved from a theoretical concept to demonstrations of practical feasibility.

Areas covered: This article examines the significant practical advancements in transitioning recombinant antivenoms from concept to potential clinical translation. The authors have based their review on literature obtained from Google Scholar and PubMed between September and November 2024. Coverage includes the development and validation of recombinant antivenom antibody discovery strategies, the characterization of the first broadly neutralizing toxin class antibodies, and recent translational proof-of-concept experiments.

Expert opinion: The transition of recombinant antivenoms from a 'concept' to the current situation where high-throughput anti-venom mAb discovery is becoming routine, accompanied by increasing evidence of their broad neutralizing capacity in vivo, has been extraordinary. It is now important to build on this momentum by expanding the discovery of broadly neutralizing mAbs to encompass as many toxin classes as possible. It is anticipated that key demonstrations of whether recombinant antivenoms can match or surpass existing conventional polyvalent antivenoms in terms of neutralizing scope and capacity will be achieved in the next few years.