Snakebite envenoming (SBE) is a priority neglected tropical disease, which kills in excess of 100,000 people per year. Additionally, many millions of survivors also suffer through disabilities and long-term health consequences. The only treatment for SBE, antivenom, has a number of major associated problems, not least, adverse reactions and limited availability. This emphasises the necessity for urgent improvements to the management of this disease. Administration of antivenom is too frequently based on symptomatology, which results in wasting crucial time. The majority of SBE-affected regions rely on broad-spectrum polyvalent antivenoms that have a low content of case-specific efficacious immunoglobulins. Research into small molecular therapeutics such as varespladib/methyl-varespladib (PLA2 inhibitors) and batimastat/marimastat (metalloprotease inhibitors) suggest that such adjunctive treatments could be hugely beneficial to victims. Progress into toxin-specific monoclonal antibodies as well as alternative binding scaffolds such as aptamers hold much promise for future treatment strategies. SBE is not implicit during snakebite, due to venom metering. Thus, the delay between bite and symptom presentation is critical and when symptoms appear it may often already be too late to effectively treat SBE. The development of reliable diagnostical tools could therefore initiate a paradigm shift in the treatment of SBE. While the complete eradication of SBE is an impossibility, mitigation is in the pipeline, with new treatments and diagnostics rapidly emerging. Here we critically review the urgent necessity for the development of diagnostic tools and improved therapeutics to mitigate the deaths and disabilities caused by SBE.

The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites.

Snakebite envenomation is a life-threatening disease that was recently re-included as a neglected tropical disease (NTD), affecting millions of people in tropical and subtropical areas of the world. Improvement in the therapeutic approaches to envenomation is required to palliate the morbidity and mortality effects of this NTD. The specific therapeutic treatment for this NTD uses snake antivenom immunoglobulins. Unfortunately, access to these vital drugs is limited, principally due to their cost. Different ethnic groups in the affected regions have achieved notable success in treatment for centuries using natural sources, especially plants, to mitigate the effects of snake envenomation. The ethnopharmacological approach is essential to identify the potential metabolites or derivatives needed to treat this important NTD. Here, the authors describe specific therapeutic snakebite envenomation treatments and conduct a review on different strategies to identify the potential agents that can mitigate the effects of the venoms. The study also covers an increased number of literature reports on the ability of natural sources, particularly plants, to treat snakebites, along with their mechanisms, drawbacks and future perspectives.

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Perspective on the Therapeutics of Anti-Snake Venom

Snake bite is a significant health concern, especially in rural populations of tropical and subtropical countries. In India, snake bites take a heavy toll of human lives, and therefore warrant urgent attention. High mortality is due to poor health services in rural areas and delay in getting the victim to a well-equipped health care facility, where anti snake venom can be administered. However, geographical and species variation, logistic, economic and production issues restrict the use of anti-snake venom. India has a large repository of medicinal herbs, which have been used in folk medicine for treatment of snake bites. Though numerous herbal remedies are scientifically unsubstantiated, yet they cannot be glossed over due to their inherent advantages. They are practiced by diverse social groups for long, offering unconditional benefits. In view of limited presence of modern medical avenues in far flung areas, such a resource needs to be harnessed, as herbals are cheap, acceptable and often at the disposal of victims. Exhaustive ethno botanical studies in different regions of the country can help to undertake well designed scientific studies, for establishing therapeutic efficacy of various herbals for treating snake bites. The present article highlights an assortment of herbal plants used in India for snake bites.

https://www.longdom.org/open-access/snake-bite-in-india-current-scenario-of-an-old-problem-2161-0495.1000-182.pdf

Snake Bite in India: Current Scenario of an Old Problem

Protective effect of Euphorbia hirta and its components against snake venom induced lethality

Design and test new polymers with clinical uses in mind, urge Nicholas A. Peppas and Ali Khademhosseini.

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Make better, safer biomaterials.

Snake envenomation is a global public health problem, with highest incidence in Southeast Asia. Inadequate health services, difficult transportation and consequent delay in antisnake venom administration are the main reasons for high mortality. Adverse drug reactions and inadequate storage conditions limit the use of antisnake venom. The medicinal plants, available locally and used widely by traditional healers, therefore need attention. A wide array of plants and their active principles have been evaluated for pharmacological properties. However, numerous unexplored plants claimed to be antidotes in folklore medicine need to be studied. The present article reviews the current status of various medicinal plants for the management of snake bite.

Y K Gupta

Papers

Do herbal medicines have potential for managing snake bite envenomation