Scientists from India and Denmark have developed an antivenom cocktail that offers broad protection against venom from diverse cobra species, a game-changer that could prevent thousands of deaths worldwide.
Cobra venom from different species contains different kinds of enzymes that attack nerves, blood, or tissues, that make it difficult to develop a unified treatment.
India alone sees nearly 50,000 deaths every year from snakebite, according to conservative estimates, which still make the figure the highest in the world.
Current antivenom delivered in hospitals across the world has drawbacks such as batch-to-batch variability, side effects, and limited species coverage.
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Antivenom production under current methods is costly and outdated, relying on venom milking and animal immunisation, with low yields of the active antidote.
To solve this problem, scientists have now engineered a mix of antibodies that would work against venom produced by various cobra species in India.
Unlike currently used antivenoms, which are produced by repeatedly immunising animals like horses, the newly engineered antibodies can be manufactured using microbial systems, researchers say.
The antibody components can also be added to expand protection to other medically important snakes, they say.
“Antivenom treatment has virtually not changed for over 100 years. This is the only next-generation antivenom we have now, which could tackle India’s snakebite problem,” said Kartik Sunagar, an author of the study published in the journal Science Translational Medicine.
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In the study, researchers exposed camelids, a group that includes alpacas and llamas, to venom from different cobra species in India.
Scientists found that the camelids’ blood soon contained antibodies that could neutralise related toxins in the venom.
These antibodies can be extracted and mass-produced by microbial cells in the lab, they found.
“This work provides a blueprint for how recombinant antivenoms can be tailored to different regions of the world by targeting the toxin families that drive disease in local snake species,” said Andreas Laustsen, another author of the study from the Technical University of Denmark.
Researchers developed a cocktail of five tiny antibody fragments called nanobodies that could bind to toxins in the various cobra species they tested.
This cocktail could neutralise venom activity and prevent the venom from binding to its targets in the body.
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The antibody cocktail protected mice injected with venom from spectacled cobras, monocled cobras, and both Indian king cobra species.
In some cases, the cocktail was able to save mice from death even 30 minutes after venom injection.
“Even mice that were paralysed or had typical neurotoxic symptoms would revert to a completely asymptomatic state,” Dr Sunagar said.
“Here, we showed that it is possible to neutralise venom using very small amounts of carefully selected and engineered antibodies. This could potentially help address some of the cost and safety concerns associated with administering large quantities of antibodies,” he said.