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Evolution Bites — Timeworn Inefficacious Snakebite Therapy in the Era of Recombinant Vaccines

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Abstract

Snakebite is a neglected tropical disease that inflicts severe socioeconomic burden on developing countries by primarily affecting their rural agrarian populations. India is a major snakebite hotspot in the world, as it accounts for more than 58,000 annual snakebite mortalities and over three times that number of morbidities. The only available treatment for snakebite is a commercially marketed polyvalent antivenom, which is manufactured exclusively against the ‘big four’ Indian snakes. In this review, we highlight the influence of ecology and evolution in driving inter- and intra-specific venom variations in snakes. We describe the repercussions of this molecular variation on the effectiveness of the current generation Indian antivenoms in mitigating snakebite pathologies. We highlight the disturbing deficiencies of the conventional animal-derived antivenoms, and review next-generation recombinant antivenoms and other promising therapies for the efficacious treatment of this disease.

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Acknowledgements

RR Senji Laxme and Suyog Khochare (Evolutionary Venomics Lab, IISc) for their inputs.

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Authors and Affiliations

  1. From Evolutionary Venomics Lab, Centre for Ecological Sciences, Indian Institute of Science, Bangalore, Karnataka, 560 012, India

    Navneet Kaur, Ashwin Iyer & Kartik Sunagar

Authors
  1. Navneet Kaur
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  2. Ashwin Iyer
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  3. Kartik Sunagar
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Corresponding author

Correspondence to Kartik Sunagar.

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Contributors

All authors contributed equally to the manuscript.

Funding

KS: Department of Science and Technology (DST) INSPIRE Faculty Award, DST-FIST, DBT-IISc Partnership Program, and the DBT/Wellcome Trust India Alliance Fellowship.

Competing interest

None stated.

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Kaur, N., Iyer, A. & Sunagar, K. Evolution Bites — Timeworn Inefficacious Snakebite Therapy in the Era of Recombinant Vaccines. Indian Pediatr 58, 219–223 (2021). https://doi.org/10.1007/s13312-021-2158-x

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  • DOI: https://doi.org/10.1007/s13312-021-2158-x

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