King Cobra and snakebite envenomation: on the natural history, human-snake relationship and medical importance of Ophiophagus hannah.

IF 1.8 3区 医学 Q4 TOXICOLOGY
Choo Hock Tan, Aymeric Bourges, Kae Yi Tan
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引用次数: 4

Abstract

King Cobra (Ophiophagus hannah) has a significant place in many cultures, and is a medically important venomous snake in the world. Envenomation by this snake is highly lethal, manifested mainly by neurotoxicity and local tissue damage. King Cobra may be part of a larger species complex, and is widely distributed across Southeast Asia, southern China, northern and eastern regions as well as the Western Ghats of India, indicating potential geographical variation in venom composition. There is, however, only one species-specific King Cobra antivenom available worldwide that is produced in Thailand, using venom from the snake of Thai origin. Issues relating to the management of King Cobra envenomation (e.g., variation in the composition and toxicity of the venom, limited availability and efficacy of antivenom), and challenges faced in the research of venom (in particular proteomics), are rarely addressed. This article reviews the natural history and sociocultural importance of King Cobra, cases of snakebite envenomation caused by this species, current practice of management (preclinical and clinical), and major toxinological studies of the venom with a focus on venom proteomics, toxicity and neutralization. Unfortunately, epidemiological data of King Cobra bite is scarce, and venom proteomes reported in various studies revealed marked discrepancies in details. Challenges, such as inconsistency in snake venom sampling, varying methodology of proteomic analysis, lack of mechanistic and antivenomic studies, and controversy surrounding antivenom use in treating King Cobra envenomation are herein discussed. Future directions are proposed, including the effort to establish a standard, comprehensive Pan-Asian proteomic database of King Cobra venom, from which the venom variation can be determined. Research should be undertaken to characterize the toxin antigenicity, and to develop an antivenom with improved efficacy and wider geographical utility. The endeavors are aligned with the WHO´s roadmap that aims to reduce the disease burden of snakebite by 50% before 2030.

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眼镜王蛇与蛇咬伤中毒:论眼镜蛇的自然史、人蛇关系及医学意义。
眼镜王蛇(Ophiophagus hannah)在许多文化中都有重要的地位,是世界上重要的医学毒蛇。这种蛇的中毒是高度致命的,主要表现为神经毒性和局部组织损伤。眼镜王蛇可能是一个更大的物种群的一部分,广泛分布在东南亚、中国南部、北部和东部地区以及印度的西高止山脉,表明毒液成分可能存在地理差异。然而,世界上只有一种特定种类的眼镜王蛇抗蛇毒血清是在泰国生产的,使用的是原产于泰国的蛇的毒液。与眼镜王蛇中毒管理有关的问题(例如,毒液成分和毒性的变化,抗蛇毒血清的有限可用性和有效性),以及毒液研究(特别是蛋白质组学)面临的挑战,很少得到解决。本文综述了眼镜王蛇的自然历史和社会文化重要性,该物种引起的蛇咬伤中毒病例,目前的管理实践(临床前和临床),以及毒液的主要毒理学研究,重点是毒液蛋白质组学,毒性和中和。不幸的是,眼镜王蛇咬伤的流行病学数据很少,各种研究报告的毒液蛋白质组在细节上显示出明显的差异。挑战,如蛇毒取样的不一致,蛋白质组学分析的不同方法,缺乏机制和抗蛇毒研究,以及围绕抗蛇毒用于治疗眼镜王蛇中毒的争议在此讨论。提出了今后的研究方向,包括努力建立一个标准的、全面的泛亚洲眼镜王蛇毒液蛋白质组学数据库,从中可以确定毒液的变异。研究应进行表征毒素抗原性,并开发抗蛇毒血清提高疗效和更广泛的地理效用。这些努力与世卫组织的路线图相一致,该路线图旨在在2030年之前将蛇咬伤的疾病负担减少50%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.80
自引率
8.30%
发文量
39
审稿时长
6-12 weeks
期刊介绍: Journal of Venomous Animals and Toxins including Tropical Diseases (JVATiTD) is a non-commercial academic open access publication dedicated to research on all aspects of toxinology, venomous animals and tropical diseases. Its interdisciplinary content includes original scientific articles covering research on toxins derived from animals, plants and microorganisms. Topics of interest include, but are not limited to:systematics and morphology of venomous animals;physiology, biochemistry, pharmacology and immunology of toxins;epidemiology, clinical aspects and treatment of envenoming by different animals, plants and microorganisms;development and evaluation of antivenoms and toxin-derivative products;epidemiology, clinical aspects and treatment of tropical diseases (caused by virus, bacteria, algae, fungi and parasites) including the neglected tropical diseases (NTDs) defined by the World Health Organization.
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