Received: July 4, 2008.

Accepted: August 20, 2008.

Abstract published online: October 13, 2008.

Full paper published online: February 28, 2009.

SNAKE ANTIVENOMS: ADVERSE REACTIONS AND PRODUCTION TECHNOLOGY

Morais VM (1), Massaldi H (1)

(1) Department of Biotechnological Development and Production, Hygiene Institute, School of Medicine, Universidad de la República, Montevideo, Uruguay.

ABSTRACT: Antivenoms have been widely used for more than a century for treating snakebites and other accidents with poisonous animals. Despite their efficacy, the use of heterologous antivenoms involves the possibility of adverse reactions due to activation of the immune system. In this paper, alternatives for antivenom production already in use were evaluated in light of their ability to minimize the occurrence of adverse reactions. These effects were classified according to their molecular mechanism as: anaphylactic reactions mediated by IgE, anaphylactoid reactions caused by complement system activation, and pyrogenic reactions produced mainly by the presence of endotoxins in the final product. In the future, antivenoms may be replaced by humanized antibodies, specific neutralizing compounds or vaccination. Meanwhile, improvements in antivenom quality will be focused on the obtainment of a more purified and specific product in compliance with good manufacturing practices and at an affordable cost.

KEY WORDS: snake antivenom, anaphylactic reaction, complement system activation, endotoxins.

CONFLICTS OF INTEREST: There is no conflict.

CORRESPONDENCE TO:

VICTOR MORAIS, Departamento de Desarrollo Biotecnológico y Producción, Instituto de Higiene, Av. Alfredo Navarro 3051, 11300, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay. Phone: 5982 487 1288, ext. 1044. Email: vmorais@higiene.edu.uy.