Hong Kong Med J 2012;18:40–5 | Number 1, February 2012
Green pit viper antivenom from Thailand and Agkistrodon halys antivenom from China compared in treating Cryptelytrops albolabris envenomation of mice
HT Fung, WH Yung, Paul Crow, KK Lam, Kenny KW Ho, KS Tan, SK Lam, Y Ke, Alessandro Grioni, OF Wong, Gary Ades, CW Kam, ML Tse
Department of Accident and Emergency, Tuen Mun Hospital, Tuen Mun, Hong Kong
OBJECTIVE. To compare the relative efficacy of the green pit viper antivenom from Thailand and Agkistrodon halys antivenom from China.
DESIGN. In-vivo experimental study.
SETTING. A wildlife conservation organisation, a university, a poison information centre, and a regional hospital in Hong Kong.
MAIN OUTCOME MEASURES. Pre- and post-antivenom lethal dose 50 (LD50) of the Cryptelytrops albolabris venom, median effective dose (ED50) of green pit viper antivenom and Agkistrodon halys antivenom against a lethal dose of the venom.
SUBJECTS. Adult mice.
RESULTS. The intraperitoneal LD50 of the venom from locally caught Cryptelytrops albolabris was 0.14 microL. After post-exposure treatment with 10 microL of antivenom, it was elevated to 0.36 microL and 0.52 microL by the green pit viper antivenom and the Agkistrodon halys antivenom, respectively. The ED50 was 32.02 microL for green pit viper antivenom and 6.98 microL for Agkistrodon halys antivenom. Both green pit viper antivenom and Agkistrodon halys antivenom ameliorated the lethality of Cryptelytrops albolabris venom in mice.
CONCLUSION. The overall superior neutralisation capacity of Agkistrodon halys antivenom over green pit viper antivenom may be related to the geographic proximity of the venoms used for antivenom preparation. The results point towards the need for further comparison of the two antivenoms on protein or immunoglobulin weight basis, and with respect to non-lethal clinically significant toxicities.
Key words: Antivenins; Cross reactions; Crotalid venoms; Neutralization; Snake bites
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