Comparison of the intrageneric neutralization scope of monospecific, bispecific/monogeneric and polyspecific/monogeneric antisera raised in horses immunized with sub-Saharan African snake venoms.

Background: Snakebite envenomation inflicts a high burden of mortality and morbidity in sub-Saharan Africa. Antivenoms are the mainstay in the therapy of envenomation, and there is an urgent need to develop antivenoms of broad neutralizing efficacy for this region. The venoms used as immunogens to manufacture snake antivenoms are normally selected considering their medical importance and availability. Additionally, their ability to induce antibody responses with high neutralizing capability should be considered, an issue that involves the immunization scheme and the animal species being immunized. Methodology/Principal findings: Using the lethality neutralization assay in mice, we compared the intrageneric neutralization scope of antisera generated by immunization of horses with monospecific, bispecific/monogeneric, and polyspecific/monogeneric immunogens formulated with venoms of Bitis spp., Echis spp., Dendroaspis spp., spitting Naja spp. or non-spitting Naja spp. It was found that the antisera raised by all the immunogens were able to neutralize the homologous venoms and, with a single exception, the heterologous congeneric venoms (considering spitting and non-spitting Naja separately). In general, the polyspecific antisera of Bitis spp, Echis spp, and Dendroaspis spp gave the best neutralization profile against venoms of these genera. For spitting Naja venoms, there were no significant differences in the neutralizing ability between monospecific, bispecific and polyspecific antisera. A similar result was obtained in the case of non-spitting Naja venoms, except that polyspecific antiserum was more effective against the venoms of N. melanoleuca and N. nivea as compared to the monospecific antiserum. Conclusions/Significance: The use of polyspecific immunogens is the best alternative to produce monogeneric antivenoms with wide neutralizing coverage against venoms of sub-Saharan African snakes of the Bitis, Echis, Naja (non-spitting) and Dendroaspis genera. On the other hand, a monospecific immunogen composed of venom of Naja nigricollis is suitable to produce a monogeneric antivenom with wide neutralizing coverage against venoms of spitting Naja spp. These findings can be used in the design of antivenoms of wide neutralizing scope for sub-Saharan Africa. Author summary: Parenteral administration of antivenoms is the core of the current treatment of snakebite envenomations, and there is an urgent need to produce antivenoms of wide neutralizing efficacy for sub-Saharan Africa. The active substance of antivenoms are antibodies (or antibody fragments) purified from plasma of horses or sheep immunized by the repeated injection of snake venoms. Generally, these antibodies can neutralize the venoms used as immunogens and other related venoms. Normally, the venoms used as immunogens are selected considering their medical importance and availability. To complement these criteria with information regarding the immunogenicity of venoms, we compared monospecific, bispecific/monogeneric, and polyspecific/monogeneric antisera towards venoms of Bitis spp., Echis spp., Dendroaspis spp., spitting Naja spp. or non-spitting Naja spp, regarding their intrageneric neutralization scope, evaluated by the lethality neutralization assay in mice. We found that the polyspecific antisera against venoms of Bitis spp, Echis spp, Dendroaspis spp, or non-spitting Naja gave the best neutralization profile. On the other hand, the monospecific, bispecific and polyspecific antisera towards venoms of spitting Naja venoms showed a similar performance. This information suggests that polyspecific immunogens could be the best alternative to produce antivenoms with the widest neutralizing coverage against sub-Saharan African snake venoms. [ABSTRACT FROM AUTHOR]