Serine proteases (SVSPs) are known to play a major role in the haemotoxic actions of viper venom, but compared with those from other medically important vipers, the serine proteases of puff adder venoms have not been extensively characterised. To address this, we isolated, identified and characterised the bioactivity of the serine proteases within the venom of the Nigerian puff adder, which we had previously shown to be especially rich in this class of toxin. Two distinct groups were identified, each with different protein substrate specificities. Both had similar molecular weights of 52-62 kDa, with 4-6 N-glycans, but one group consisted of trypsin-like acidic SVSPs and the other of non-trypsin-like basic SVSPs with a specificity for aliphatic amino acids at the P1 position. Each acted differently on fibrinogen: the acidic SVSPs showed thrombin-like alpha/beta-fibrinogenase activity, whereas the basic forms were shown to be alpha-fibrinogenases. The acidic SVSPs acted on a chromogenic substrate commonly used to determine kallikrein-like activity but also possess strong gelatinase activity - a novel activity for SVSPs and the first example of an SVSP acting on proteins other than those of the haemostatic system. The basic SVSPs were able to specifically convert angiotensin I into the vasoconstrictor angiotensin 1-8. Analysis of the transcripts of each set of SVSPs revealed structural details of the substrate-binding sites that supported the experimental findings. The activity and sequences of the basic SVSPs show that they are very like the alpha-fibrinogenase ML-AF of M. lebetina, which until now was considered to be a unique SVSP. Thus, this basic SVSP and the acidic SVSP with its gelatinase activity can be considered to be atypical viper serine proteases. The levels of these SVSPs in venom were found to vary geographically and this, alongside the regional variation in the SVMP activities that we observed in a previous study, is discussed with reference to the potential implications on pathology of snakebite envenoming and the development of therapeutic interventions.
Among venomous animals, cnidarians represent the oldest metazoan lineage in which venom production and a specialized delivery system are defining synapomorphies. Cnidarians also represent the only venomous lineage for which mutualistic symbioses have evolved resulting in scenarios where mutualistic symbionts may also be targets of their venom. The most iconic example of this relationship is the mutualism between clownfish and their venomous sea anemone hosts. To investigate how symbiont presence and establishment influence toxin gene expression, we used a comparative TagSeq and RNA-Seq approach to quantify venom gene dynamics during the first 48 h of clownfish-anemone symbiosis establishment in five anemone species. Our taxonomic sampling included three typical hosting species (Entacmaea quadricolor, Radianthus crispa, and Stichodactyla haddoni), each representing distinct evolutionary lineages of clownfish hosts, and two atypical Caribbean species (Condylactis gigantea and Stichodactyla helianthus) that do not host clownfish in nature, but have reported to host within the aquarium trade. Tentacle samples were collected prior to hosting, approximately 12 h after initial symbiont establishment, and again 48 h after symbiosis establishment. Our analyses revealed that overall toxin assemblages remained relatively stable during the early establishment phase, with no significant changes in the most highly expressed toxin gene candidates. However, subtle transcript-level shifts occurred within multi-copy toxin gene families, including cytolytic actinoporins and Sea Anemone 8 (SA8)-like toxins. Notably, one C. gigantea actinoporin transcript exhibited a ∼600-fold increase in expression in a single individual, which coincided with two clownfish mortalities prior to successful association, which subsequently decreased after establishment. Comparative sequence alignments suggest that amino acid substitutions in this transcript may be functionally relevant to symbiosis intolerance, as the amino acid substitutions were unique to this transcript, and not found in any other previously described cytolytic actinoporin. Together, these findings reveal that early toxin gene expression in clownfish-hosting sea anemones is largely stable, yet subtly dynamic at the transcript level. This study provides the first comparative transcriptomic insights into the molecular processes shaping symbiosis establishment in clownfish-anemone mutualisms, offering a framework for understanding venom evolution in the context of co-evolutionary interactions.
Enzootic calcinosis caused by Nierembergia spp. (Solanaceae) poisoning causes important economic losses for sheep and cattle production in South America. This study aims to provide a comprehensive description of N. rivularis Miers, focusing on its morphological characteristics, biomass distribution, dry matter content, phenological cycle, floral biology, environmental growth preferences, and the presence of potentially toxic compounds. The results revealed that N. rivularis is a perennial, small-sized plant whose stems are modified into underground rhizomes. These subterranean structures feature nodes from which adventitious roots emerge, functioning as the primary mechanism for clonal asexual reproduction. Its white, pentamerous flowers display capitate trichomes in the corolla throat and a long, firm corolla tube that positions the corolla semi-parallel to the soil. Two insect species were observed interacting with flowers of N. rivularis, both during the spring season: Astylus quadrilineatus (Melyridae) and a small bee from the family Apidae, subfamily Apinae, tribe Tapinotaspidini. The plant exhibited a belowground biomass (rhizomes and roots) up to 15 times greater (dry weight based) than its aerial structures (leaves and flowers). The greater presence of N. rivularis in the fields was associated with high soil humidity, direct sunlight exposure, mixed soil texture, and low competition from rhizomatous species for underground space. Hydroxylated vitamin D derivatives were detected by HPLC in all structures of N. rivularis, suggesting this species' capacity to accumulate calcinogenic substances. Knowledge about the toxic compounds, morphology, biology, and phenology of N. rivularis will contribute towards the prevention and control of poisoning by this plant.
Historically, venom potencies have been assessed using measures of lethality, such as the median lethal dose (LD50). However, venoms may be selected primarily for their ability to rapidly incapacitate rather than cause mortality, meaning LD50 may not capture the efficacy of venoms in an ecological and evolutionary context. To capture this context, recent studies have adapted measures that assess venoms’ ability to rapidly incapacitate, such as the median paralysis dose (PD50). However, while PD50 values are expected to provide a more proximate assessment of ecological variation in venom potency, it is unknown whether historically available LD50 values are still useful proxies of ecologically relevant potency or whether they capture independent axes of venom variation. Here, we test the relationship between LD50 and PD50 in spider venoms by experimentally estimating LD50 and PD50 for 12 species and collating additional potency data for 46 species retrieved from the literature, producing a dataset of 55 species spanning 26 families when combined. We observed a linear isometric relationship between LD50 and PD50, showing these potency measures are both strongly correlated, with an increase in paralysis efficiency associated with a similar increase in lethality. Our results suggest that due to the correlation between functional aspects of venom potency, paralysis and lethality, historically available LD50 values may be used to compare general venom potencies in spiders, provided that they are based on the same prey model.
Within the field of rehabilitation and aesthetic medicine, botulinum neurotoxin (BoNT), particularly type A (BoNT-A), has gained significant popularity for its unique muscle-relaxing properties including muscular spasticity and reducing wrinkles. Nevertheless, its widespread use is accompanied by the inherent risk of poisoning. This report presents two distinct patterns of neurological adverse events observed across three patients involving BoNT-A. In the first pattern, Patients 1 and 2, who had cerebral infarction and cerebral hemorrhage, respectively, both developed seizures after BoNT-A injection in the context of multiple seizure risk factors, but with no definitive causal link between BoNT-A and seizures. In the second pattern, Patient 3, a healthy woman, developed severe generalized muscular weakness after receiving BoNT-A injection for cosmetic purposes. Based on a comprehensive review of the patients’ clinical manifestations, auxiliary examinations, and rehabilitation treatments, this report underscores the importance of prompt recognition, accurate diagnosis, and timely intervention to improve patient outcomes and prevent complications such as seizures.
Within the field of jellyfish first-aid treatments, we have identified a distinct lack of evidence-based clinical research, which is most notable among species considered non-lethal. One such species is the southern Australia cubomedusa, Carybdea rastonii Haacke, 1886, affectionately known as the 'jimble'. Little is understood about the symptoms of envenomation or the distribution of this species throughout its Australian range. Evidence infers that there is no effective first-aid treatment to alleviate pain from its sting, which may last up to 24 h. Variant spellings of the scientific species name and local common names complicate our understanding of first-aid research. Species misidentification and errant distributions can confound appropriate first-aid treatment. Here, we synthesise evidence of clinical symptoms, past and current first-aid treatments related to Carybdea rastonii envenoming. In addition, we provide a brief taxonomic overview of Carybdea Péron and Lesueur, 1809, highlighting the frequent misidentification of Carybdea species and define future research streams.
The puff adder (Bitis arietans) is a highly venomous viper responsible for many snakebite fatalities in Africa, yet there have been few geographically comprehensive analyses of its venom proteins, particularly of the proteases that play a key role in pathology of envenoming. To address this, we have isolated, identified and characterised the bioactivity of the venom metalloproteases of puff adders obtained from a range of localities. Prominent in all venoms was a PI snake venom metalloproteinase (SVMP), derived from a larger PII precursor. This protein existed as either non-glycosylated (21 kDa) or glycosylated, the latter containing either one (26 kDa) or two N-glycans (30 kDa). All the venoms we tested contained either one or the other form: none had both. The 21 kDa form proved to be highly bioactive, with alpha-, beta- and in some cases gamma-fibrinogenase activities and was very destructive towards laminin. Prothrombin and factor X were also extensively degraded by the 21 kDa SVMP, but in neither case did this result in generation of the respective active forms of these clotting factors. This protein was also shown to specifically and efficiently convert angiotensin I to the vasodilatory product, angiotensin 1-7. In contrast, the two-glycan forms were markedly less active against all of these substrates. The one-glycan form isolated from a Kenyan venom possessed activities that were intermediate between the non- and two-glycan forms. Using insulin B chain as a substrate, it was shown that these SVMPs cleave at the same peptide bonds as those observed for similar proteases found in other snake venoms, but the higher potency of the 21 kDa form was due to its ability to cleave peptide bonds C-terminal to glycine residues. The PIII SVMP content of the puff adder venoms was quite low, atypically for African vipers. In some Kenyan venoms, however, there was an abundant PIII SVMP with strong gelatinase activity. This protein possesses an unusual oligomeric structure, being a 140 kDa homodimer (c.f. PIII-c SVMP) but without the disulphide bonds that normally hold the monomers together in this class of SVMP. This diversity in venom metalloprotease activities is discussed with reference to the potential implications on the pathology of envenoming and the development of therapeutic interventions.
Snakebite envenoming remains a neglected tropical disease that disproportionately affects rural populations in the tropical regions, where access to timely and effective treatment is often limited. Conventional antivenoms, produced by immunizing animals with pooled venoms, have demonstrated clinical benefit but may show variable performance against the complex and geographically heterogeneous composition of snake venoms. Advances in proteomics, transcriptomics, and genomics have revealed substantial intra- and interspecies variation in venom composition with potential implications for antivenom design and evaluation. This review synthesizes current knowledge on the molecular, ecological, and evolutionary drivers of venom diversity and discusses how these insights may inform the development of more regionally informed and evidence-based therapeutic strategies. Particular attention is given to toxin-resolved antivenomics, monoclonal antibody–based approaches, recombinant platforms, and emerging computational tools for antigen prioritization. The potential role of rapid diagnostics and immunoinformatics in supporting clinical decision-making is also considered. Overall, the review highlights how population-level venom data and translational research may contribute to evidence-based improvements in antivenom design, while acknowledging the regulatory, economic, and implementation challenges involved.
Snake venoms are complex mixtures primarily composed of toxic proteins used during prey capture and defence. There is limited knowledge concerning the protein concentration of snake venom and the biases of different protein determination methods. Here, we assess the ability of the Qubit protein assay, bicinchoninic acid (BCA) assay, Bradford assay and NanoDrop spectrometry (A280 with a mass extinction coefficient of one) to accurately quantify protein concentrations of toxins isolated from venom, including three-finger toxins and phospholipase A2. The Bradford assays severely underestimated three-finger toxin concentrations and NanoDrop spectrometry overestimated phospholipase A2 concentrations, whilst the BCA assay was the most accurate. Venom from six major African venomous snake genera was also assessed: coral cobras (Aspidelaps spp.); mambas (Dendroaspis spp.); cobras (Naja spp.); bush vipers (Atheris sp.); adders (Bitis spp.); and saw-scaled vipers (Echis sp.). Protein concentration results were inconsistent between methods. Protein concentrations were found to be lowest for Bitis spp. venom and highest for Naja spp. venom and did not vary between species of the same genus. However, in general, Elapidae species had venoms with significantly higher protein concentrations than Viperidae species. Moreover, there was greater variability between Elapidae species. We also determined wet venom yields and used this to provide a tentative estimate of the total protein quantity that may be injected during a snake bite. We found snake weight and length influenced wet venom yield for the Atheris squamigera but not for Bitis arietans and Echis romani. Our results aim to improve our understanding of the physical properties of snake venom.
Cnidarians possess a cell-based venom system in the form of nematocytes or “stinging cells” that are found across various tissues. The scattered distribution of these venom-containing cells makes isolation difficult, particularly for proteomic studies. These challenges can be circumvented in laboratory systems with efficient culturing conditions and robust molecular resources for downstream validation, such as exists for Hydra and Nematostella. The colonial hydrozoan Hydractinia symbiolongicarpus is an established laboratory model and an emerging candidate for functional studies of the venom system. Here, we present a proteome derived from a fluorescence-activated cell sorted cell population of developing and mature nematocytes from an established Hydractinia transgenic line. We detected a total of 8,470 proteins, of which 2,232 could be statistically quantified across two different fluorescence-activated cell sorting gating strategies. We found that 165 proteins were enriched within a more lenient, low-cell bias strategy while 760 proteins were enriched using a more stringent gating strategy with greater predicted cell viability. We compared this dataset to a previously assembled nematocyst-enriched transcriptome, as well as two different single-cell RNA-sequencing datasets for Hydractinia, to validate the enrichment of protein candidates in the nematocyte lineage. Furthermore, we evaluated orthologous clusters shared between our Hydractinia proteome, a well-established nematocyst proteome from Hydra, and nematocyst-enriched proteomes from two other cnidarians. Through these comparisons, we revealed substantial shared clusters across these four cnidarian species as well as multiple hydrozoan-specific clusters. Overall, our proteomic analysis provides an integral, complementary resource to the established molecular and laboratory tools available in Hydractinia, advancing its utility as a functional venom systems model.
We evaluated a family of repurposed sPLA2 inhibitors as novel candidate snakebite envenoming therapeutics. Stereospecific (R)-7 AZD2716 and its racemic mixture were compared to varespladib in an in vitro sPLA2 assay against a sample of 26 venoms from medically important snake species from five continents. All compounds demonstrated potent nano-to picomolar IC50 values, comparable to the benchmark inhibitory profile of varespladib. Surprisingly, however, this in vitro efficacy did not translate to survival in an in vivo mouse model under GLP standard conditions at an independent third party laboratory. In animal rescue studies evaluating both oral and IV dosing against the same four high sPLA2 venoms, varespladib demonstrated more consistent survival duration versus the chirally separated AZD2716 enantiomer and racemate following single-dose intravenous or two-dose oral drug administration. Additionally, the stereospecific AZD2716 did not provide the same survival advantage as the racemic mixture and neither molecule resulted in the same survival advantage as varespladib in vivo (p < 0.05), despite similar in vitro potency. These findings highlight the importance of following in vitro inhibition assays with preclinical studies in drug candidate selection for lead compounds and advancement to clinical development.
Introduction:Vascular insufficiency is an uncommon but potentially limb-threatening complication of jellyfish envenomation, with limited documentation in Southeast Asia. This study characterizes its epidemiology, clinical course, and response to targeted vasodilator therapy in Malaysia. Methods:A retrospective cohort review was conducted for confirmed jellyfish-sting cases complicated by vascular insufficiency reported to the Remote Envenomation Consultancy Services (RECS) from 2017 to 2022. Demographic, geographic, clinical, and management data were extracted from RECS consultation logs. Serial Doppler ultrasound findings and treatment responses were analysed descriptively. Results:Among 105 jellyfish sting consultations, four (3.8 %) cases of vascular insufficiency were identified, all occurring in coastal Penang and affecting children aged 7-12 years. All primary stings involved the upper limbs; two had concurrent lower limb lesions. The onset of peripheral numbness and cyanosis occurred on day three post-sting. Doppler ultrasonography revealed subcutaneous oedema, reduced arterial calibre, and diminished flow velocities consistent with arterial vasospasm. All patients received intravenous iloprost (0.5-2 ng/kg/min) with gradual tapering, guided by clinical and Doppler parameters. Rapid improvement in perfusion was documented in all cases, with minimal adverse effects (vomiting, dyspnoea, haematuria). Hospitalization lasted 12-32 days. Three patients achieved full functional recovery; one had residual scarring and contracture. No deaths occurred. Conclusion:Delayed-onset arterial vasospasm can complicate paediatric jellyfish stings, particularly in the upper limb. Early recognition of evolving ischemic signs and timely initiation of iloprost with structured tapering may avert tissue loss. Broader drug availability and standardized treatment algorithms are needed to optimize outcomes in resource-limited coastal settings.
Cnidaria represent one of the most ancient venomous lineages with thousands of extant species and their toxins have long been known to signify a source of therapeutic potential. Despite this recognition, cnidarian toxin research has progressed relatively slowly when compared to other taxa. One of the major factors for this slow development pertains to the difficulties involved with obtaining samples, particularly from benthic species which are sessile, where dissected tissues have historically been required. Additionally, the instability of marine venoms has further hindered progression of cnidarian venom research. The research presented aimed to address these issues through the design and development of a novel, non-invasive, venom extraction device that works on a range of cnidarian species. The device functioned underwater at depths ranging from 50 mm down to 5 m whilst scuba diving and was able to successfully obtain venom samples from all 12 species tested. These species were from three taxonomic groups Actiniaria (sea anemones), Scleractinia (corals) and Scyphozoan (Jellyfish) with four species from each. These venom samples revealed the expected phospholipase A2 activity but also the four Scleractinia venoms demonstrated phospholipase A2 inhibitory properties. This is the first description of phospholipase A2 inhibitory activity in cnidarian venoms and further work is required for full characterisation.
Androctonus finitimus (Pocock, 1897; Scorpiones: Buthidae) is a highly venomous scorpion species that poses a substantial threat to humans and livestock, often resulting in severe envenomation incidents and even fatalities. Medicinal plants, rich in secondary metabolites, represent a valuable source of compounds with diverse pharmacological and therapeutic potential. Current study investigated the venom neutralization potential of Prosopis cineraria, Salvadora oleoides and Salvadora persica using Swiss albino mice as model. The lethal dose (LD99) of A. finitimus venom for mice was 1.5 μg/g. Methanolic extract of P. cineraria showed 100% venom neutralization, followed by S. persica (72%) and S. oleoides (50%). The values of liver function markers including alanine transaminase (ALT), aspartate transaminase (AST), and bilirubin; muscle damage markers including lactate dehydrogenase (LDH) and creatinine phosphokinase (CPK) and renal function markers including creatinine and urea were significantly higher in negative control group which did not receive any treatment after exposing with the venom as compared to positive control and plant extract’s treated groups. The major active compounds found in P. cineraria, S. persica and S. oleoides were palmitic acid, neophytadiene and octadecamethyl-cyclononasiloxane respectively. The current study provides some empirical basis for the traditional use of P. cineraria in treating scorpion envenomation and may have potential for development into anti-venom medicines.
Bothrops atrox is a terrestrial pit viper inhabiting the Amazon region. The venom of B. atrox acts almost immediately at the site of the bite, leading to significant tissue damage, but also affects different organs. The present study investigated the acute impact of intraperitoneally administered B. atrox venom on bone tissue integrity and calcium homeostasis in mice. Plasma, bone homogenate, and urine samples from adult male and female Swiss mice (30±2 g/mouse) were analyzed to assess calcium and phosphorus levels. Additionally, we examined bone oxidative stress parameters alongside histological and scanning electron microscopy (SEM) analysis. Our findings showed that B. atrox envenoming results in profound phosphocalcic homeostasis disturbances with hypercalcemia, hypophosphatemia, and decreased calcium and phosphorus bone content. We also observed increased reactive oxygen species and malondialdehyde, and consumption of antioxidants. Histological examination and SEM of bone tissue revealed thinning and discontinuity of trabecular bone and a significant reduction in intertrabecular links. In conclusion, B. atrox envenoming profoundly impacts bone metabolism and structural integrity in mice. The venom induces substantial alterations in calcium and phosphorus homeostasis, elevates oxidative stress, and disrupts the antioxidant defense system. Histological and SEM analyses reveal extensive damage to the trabecular bone architecture, reinforcing the harmful effects of the venom on skeletal health. These results underscore the need for further research to better understand the acute and long-term implications of B. atrox envenoming, particularly regarding its potential impact on human bone.
Type B fumonisins (FBs), including fumonisin B1 (FB1), fumonisin B2 (FB2) and fumonisin B3 (FB3), are common mycotoxins in cereal and food products. FBs contamination causes substantial social impacts and economic losses. Effective control of FBs contamination is essential for human and animal health. Laccase Lac-W has the unique property of degrading a variety of mycotoxins in the absence of mediators. Nevertheless, the degradation rates are low. In this study, a laccase mediator system (LMS), Lac-W-2, 2'-azino-bis (3-ethylbenzothiazoline-6-sulfonate) (Lac-W-ABTS), was constructed by screening different mediators, which can improve the degradation rate of FB1 (34.70 %) within 2 h. By optimizing the reaction conditions (static conditions, pH 7.0, 40 °C, 0.5 U/mL Lac-W, 5 mM ABTS), 1 μg/mL FB1 was effectively degraded within 24 h (88.25 %), and FB2 (93.16 %) and FB3 (78.24 %) were degraded efficiently. The degradation products of FB1, FB2 and FB3 failed to generate cell death of intestinal porcine epithelial cells. Additionally, two detoxification products (hydrolysed FB1 (HFB1) and tricarboxylic acid) of FB1 were identified by high resolution mass spectrometry. Finally, the mechanism by which ABTS acts as a more efficient electron acceptor and thus promotes Lac-W degradation of FB1 was explained using molecular docking. This work highlights an eco-friendly bio-enzyme method that degrade FB1, FB2 and FB3 simultaneously and efficiently using only one enzyme.
Masked mycotoxins are modified forms of mycotoxins that escape conventional detection, posing underexplored risks to food safety. Despite their potential public health risks, research on these compounds remains limited in Sub-Saharan Africa (SSA). This study systematically reviewed 22 publications, analyzing research trends, geographic focus, and knowledge gaps using network analysis to assess the evolution and structure of masked mycotoxin research in SSA. Studies began in 2013, grew slowly with one study per year from 2014 to 2017, and modestly increased to 2-4 studies annually between 2018 and 2024. Geographically, research efforts are concentrated in a few countries, particularly Nigeria (47.6 % of publications), with Ethiopia, South Africa, Kenya, and Namibia contributing sporadically. The findings reveal that only 13.6 % of the studies had masked, modified, emerging, or hidden mycotoxins as part of the primary focus of the study objectives, while the majority included them as ancillary findings. The most prevalent masked mycotoxins identified are derivatives of aflatoxins and fumonisins, which pose significant risks to food safety and public health. Emerging challenges include the limited detection capabilities and weak regulatory frameworks on masked mycotoxins, with many studies failing to capture the full extent of their impact. Notably, no systematic reviews were found to focus exclusively on masked mycotoxins, indicating a major research gap. The field remains fragmented and underdeveloped, with significant limitations in analytical capacity and geographic scope. Addressing these gaps requires enhanced regional collaboration, increased funding for targeted research, and the integration of masked mycotoxin monitoring into national food safety policies.
Background:Malabar Pit Viper (Craspedocephalus malabaricus), endemic to the Western Ghats of India, is an emerging concern in snakebite envenomation. Despite its increasing recognition as a medically significant species, the absence of a species-specific antivenom and limited epidemiological data hinder effective treatment protocols. This study examines the ecological, clinical, and therapeutic aspects of Malabar pit viper envenomation to bridge knowledge gaps and guide clinical management. Methodology/principal findings:A retrospective analysis was conducted at a tertiary care centre in Coastal Karnataka, encompassing 16 cases from May 2018 to March 2024. Identification was based on the following method.• killed or live specimen produced at the hospital.• photographic/videographic evidence captured of the culprit snake by the patient or witness.• photographic identification (using standard images of known venomous snakes in the region for patients to identify which snakes it is that they saw biting them).Seven out of sixteen cases were identified based on photographic identification and other circumstantial evidence like snake description, location and habitat where the patient was bitten. These cases were included on a presumed basis due to the lower quality of evidence available. The remaining nine were reliably confirmed with evidence provided. Clinical presentations included severe local envenomation (100 %), coagulopathy (50 %), and mild renal dysfunction (25 %). Local complications such as severe local effects and compartment syndrome necessitated interventions. A notable trend of prolonged prothrombin time derangement, persisting up to 72 h, was observed in patients with coagulopathy. Additionally, three cases of anaphylaxis were reported following Indian Polyvalent Anti Snake Venom (ASV) administration, underscoring the challenges in its use. Indian Polyvalent ASV demonstrated limited but observable cross-reactivity, improving coagulopathy in some cases. The study identified seasonal and occupational risk factors, with most incidents occurring during monsoon-related agricultural activities. Epidemiological mapping highlighted habitat overlaps between human populations and the species range. Conclusions/Significance:Malabar Pit Viper envenomation is characterized by distinct local and systemic syndromes, requiring targeted management strategies. While Indian Polyvalent ASV may offer interim relief in severe cases, a species-specific antivenom remains essential. This study emphasizes the importance of advancing research into venom composition, therapeutic cross-reactivity, and regional incidence to develop evidence-based treatment protocols and improve patient outcomes.
Over 100 lineages of animal have evolved venom for a wide variety of purposes. An estimated 2.5 million people are bitten by snakes and another 1.2 million are stung by scorpions with many envenomings resulting in death. However, survival is not the end point of the envenoming syndrome as chronic life altering conditions, such as amputations, disfigurement and neuropathies can occur. In this context, infections at the site of envenomation could play an important role as they can exacerbate mortality and the incidence and severity of life altering conditions.This review assesses the connection between envenoming and infections. It summarises and highlights the literature describing cases of envenoming-mediated infection by various taxa and the circumstances of these envenomings and the outcomes of infection. It could be deduced that the risk factors for envenoming-led infections are multifactorial. Factors enhancing the risk of infection include; 1. The delivery system, with larger devices leading to more substantial wounds, 2. Venom composition, with venoms containing cytotoxins more commonly implicated in infections, and 3. The environment, with aquatic microbiomes and venom system microbiomes as sources of the pathogen species. Infections are difficult to diagnose due to symptoms synonymous with those of the envenoming and it is recommended that medical practitioners consider the possibility of infection throughout all stages of medical treatment. There is a notable gap in our understanding of envenoming-led infections and further research will help to increase patient survival.
