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New antidote on-trial at Duke could be the first to work for most venomous snakes

Close up photo of a copperhead snake in the woods.
RooM RF/Getty Images
A copperhead snake, the most common venomous snake in North Carolina. A new antidote could counteract the venom from copperheads and many other kinds of snake.

A broad-acting antidote against snake venom — currently in clinical trials at Duke University and around the world — could make a lifesaving difference for snakebite victims.

The current treatment for a snakebite is effective, but it’s also difficult to administer and is specific to the species of snake. Researchers hope that the new antidote will be effective against many kinds of snakes, and could be given before patients reach a hospital.

If the drug is effective, it would have other advantages over standard antivenom, according to Charles Gerardo, chief of the division of emergency medicine at the Duke University School of Medicine, who is leading the clinical trial.

“It’s oral and easy to administer, and it will likely improve early access to care because of its simplicity,” he said.

New treatment likely to be useful, but not universal

Snakebite treatment has remained essentially the same for over a hundred years: injection through an IV with a mix of antibodies against snake venom. The antibodies, called “antivenom,” bind to the toxic molecules in the venom and prevent their harmful effects. Different species of snakes have venom containing different toxins, which means a given antivenom will only work against bites from specific kinds of snakes.

The antidote targets a large group of toxins that is found at high levels in most snake venoms. The exact effects of these toxins depends on the species of snake, but can range from causing tissue death at the bite site to paralyzing the muscles that allow the victim to breathe.

Since most snake venoms contain these toxins, the antidote could work against many species of snake. This means that snakebite victims wouldn’t need to know exactly what kind of snake bit them for health professionals to provide care.

Gerardo says because the antidote comes as a pill rather than in an IV, it could be taken right away, before the patient is able to get to a hospital. This could save lives, especially for victims in remote regions.

However, despite its potential usefulness, the antidote is unlikely to be truly universal.

Andreas Laustsen-Kiel, director of the Center for Antibody Technologies at the Technical University of Denmark, explains that snake venom is a complicated mix of multiple toxins, some of which won’t be affected by the drug. This means that snakebite patients should continue to receive standard antivenom in addition to the new antidote.

Still, the ability to take the antidote immediately would be a major advantage because venom toxins can act rapidly. Laustsen-Kiel explains, “In cases of snakebite, you are really in a race against time.” A new antidote could give patients a head start.

Sophia Friesen is a science writer and WUNC’s 2022 AAAS Mass Media Fellow. Before working with WUNC, they wrote for science news outlets including Massive Science, preLights, and the Berkeley Science Review, covering everything from wildfire mitigation to pterosaur flight abilities.
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