دورية أكاديمية
أعرض في EDS

African polyvalent antivenom can maintain pharmacological stability and ability to neutralise murine venom lethality for decades post-expiry: evidence for increasing antivenom shelf life to aid in alleviating chronic shortages.

التفاصيل البيبلوغرافية
العنوان: African polyvalent antivenom can maintain pharmacological stability and ability to neutralise murine venom lethality for decades post-expiry: evidence for increasing antivenom shelf life to aid in alleviating chronic shortages.
المؤلفون: Solano G; Instituto Clodomiro Picado, Universidad de Costa Rica, San Jose, Costa Rica., Cunningham S; Liverpool School of Tropical Medicine, Liverpool, UK., Edge RJ; Liverpool School of Tropical Medicine, Liverpool, UK.; Department of Infection Biology and Microbiomes, University of Liverpool, Liverpool, UK., Duran G; Instituto Clodomiro Picado, Universidad de Costa Rica, San Jose, Costa Rica., Sanchez A; Instituto Clodomiro Picado, Universidad de Costa Rica, San Jose, Costa Rica., Villalta M; Instituto Clodomiro Picado, Universidad de Costa Rica, San Jose, Costa Rica., Clare RH; Liverpool School of Tropical Medicine, Liverpool, UK., Wilkinson MC; Liverpool School of Tropical Medicine, Liverpool, UK., Marriott AE; Liverpool School of Tropical Medicine, Liverpool, UK.; Department of Infection Biology and Microbiomes, University of Liverpool, Liverpool, UK., Abada C; Liverpool School of Tropical Medicine, Liverpool, UK., Menzies SK; Liverpool School of Tropical Medicine, Liverpool, UK., Keen M; Liverpool School of Tropical Medicine, Liverpool, UK., Lalloo DG; Liverpool School of Tropical Medicine, Liverpool, UK.; Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi., Stienstra Y; Liverpool School of Tropical Medicine, Liverpool, UK.; Department of Internal Medicine/Infectious Diseases, University of Groningen, Groningen, The Netherlands., Abouyannis M; Liverpool School of Tropical Medicine, Liverpool, UK., Casewell NR; Liverpool School of Tropical Medicine, Liverpool, UK., León G; Instituto Clodomiro Picado, Universidad de Costa Rica, San Jose, Costa Rica., Ainsworth S; Liverpool School of Tropical Medicine, Liverpool, UK stuart.ainsworth@liverpool.ac.uk.; Department of Infection Biology and Microbiomes, University of Liverpool, Liverpool, UK.
المصدر: BMJ global health [BMJ Glob Health] 2024 Mar 13; Vol. 9 (3). Date of Electronic Publication: 2024 Mar 13.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101685275 Publication Model: Electronic Cited Medium: Print ISSN: 2059-7908 (Print) Linking ISSN: 20597908 NLM ISO Abbreviation: BMJ Glob Health Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BMJ Publishing Group Ltd, [2016]-
مواضيع طبية MeSH: Antivenins*/therapeutic use , Snake Bites*/drug therapy, Mice ; Humans ; Animals ; Venoms/therapeutic use
مستخلص: Introduction: Antivenom is a lifesaving medicine for treating snakebite envenoming, yet there has been a crisis in antivenom supply for many decades. Despite this, substantial quantities of antivenom stocks expire before use. This study has investigated whether expired antivenoms retain preclinical quality and efficacy, with the rationale that they could be used in emergency situations when in-date antivenom is unavailable.
Methods: Using WHO guidelines and industry test requirements, we examined the in vitro stability and murine in vivo efficacy of eight batches of the sub-Saharan African antivenom, South African Institute for Medical Research polyvalent, that had expired at various times over a period of 30 years.
Results: We demonstrate modest declines in immunochemical stability, with antivenoms older than 25 years having high levels of turbidity. In vitro preclinical analysis demonstrated all expired antivenoms retained immunological recognition of venom antigens and the ability to inhibit key toxin families. All expired antivenoms retained comparable in vivo preclinical efficacy in preventing the lethal effects of envenoming in mice versus three regionally and medically important venoms.
Conclusions: This study provides strong rationale for stakeholders, including manufacturers, regulators and health authorities, to explore the use of expired antivenom more broadly, to aid in alleviating critical shortages in antivenom supply in the short term and the extension of antivenom shelf life in the longer term.
Competing Interests: Competing interests: GS, GD, AS, MV and GL are all employees of Instituto Clodomiro Picado, University of Costa Rica, a public manufacturer of antivenom products, including for sub-Saharan Africa.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
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معلومات مُعتمدة: United Kingdom WT_ Wellcome Trust
فهرسة مساهمة: Keywords: Snake bite, stings and other envenoming
المشرفين على المادة: 0 (Antivenins)
0 (Venoms)
تواريخ الأحداث: Date Created: 20240314 Date Completed: 20240318 Latest Revision: 20240318
رمز التحديث: 20240318
مُعرف محوري في PubMed: PMC10941113
DOI: 10.1136/bmjgh-2023-014813
PMID: 38485142
قاعدة البيانات: MEDLINE
الوصف
تدمد:2059-7908
DOI:10.1136/bmjgh-2023-014813