Venoms, antivenoms and immunotherapy

• Published in: Toxicon Vol. 36; no. 6; pp. 823 - 846
• Main Authors: Chippaux, J.-P., Goyffon, M.
• Format: Book Review Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.06.1998; Elsevier Science
• Subjects: Animal poisons toxicology. Antivenoms; Animals; Antivenins - immunology; Antivenins - isolation & purification; Antivenins - therapeutic use; Biological and medical sciences; Cross Reactions; Humans; Immunoglobulin Fab Fragments - immunology; Immunoglobulin Fab Fragments - therapeutic use; Medical sciences; Quality Control; Snake Bites - therapy; Snake Venoms - immunology; Toxicology; Human; Vertebrata; Antiserum; Treatment; Antivenom; Immunotherapy; Venom; Animal origin; Reptilia; Review; Neutralization; Ophidia
• ISSN: 0041-0101; 1879-3150
• DOI: 10.1016/S0041-0101(97)00160-8

A century after the discovery of antivenom and despite real progress undertaken in its manufacture, its use remains largely empirical. Recent studies of pharmacokinetics of envenoming permitted improved understanding of immunotherapy. Improved purification of the antivenom by using immunoglobulin fragments has lead to increased tolerance and efficiency of antivenom. The respective advantages and disadvantages of F(ab′) 2 and F(ab) are discussed in relation to neutralising efficacy and clearance from the circulation. Although the time during which the action of antivenom remains beneficial after the bite is unknown, the superiority of intravenous administration has now been proved. Although immunisation procedures and purification and use of IgG fragments can be improved using modern technology, the future of immunotherapy seems promising. It is vital that therapeutic protocols should be rigidly adhered to in order to optimise immunotherapy. The use of vaccination has yet to be explored.