Standard Quality Characteristics and Efficacy of a New Third-Generation Antivenom Developed in Colombia Covering Micrurus spp. Venoms

In Colombia, Micrurus snakebites are classified as severe according to the national clinical care guidelines and must be treated with specific antivenoms. Unfortunately, these types of antivenoms are scarce in certain areas of the country and are currently reported as an unavailable vital medicine....

Full description

Autores:
Santiago Tabares Vélez
Lina María Preciado
Leidy Johana Vargas Muñoz
Carlos Alberto Madrid Bracamonte
Angelica Zuluaga
Jeisson Gómez Robles
Camila Renjifo-Ibañez
Sebastián Estrada-Gómez
Tipo de recurso:
Article of journal
Fecha de publicación:
2024
Institución:
Universidad Cooperativa de Colombia
Repositorio:
Repositorio UCC
Idioma:
eng
OAI Identifier:
oai:repository.ucc.edu.co:20.500.12494/55465
Acceso en línea:
https://hdl.handle.net/20.500.12494/55465
Palabra clave:
antivenom
quality control
coral snake
preclinical
freeze-dried
Rights
openAccess
License
http://creativecommons.org/licenses/by-nc-nd/4.0/
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dc.title.eng.fl_str_mv Standard Quality Characteristics and Efficacy of a New Third-Generation Antivenom Developed in Colombia Covering Micrurus spp. Venoms
title Standard Quality Characteristics and Efficacy of a New Third-Generation Antivenom Developed in Colombia Covering Micrurus spp. Venoms
spellingShingle Standard Quality Characteristics and Efficacy of a New Third-Generation Antivenom Developed in Colombia Covering Micrurus spp. Venoms
antivenom
quality control
coral snake
preclinical
freeze-dried
title_short Standard Quality Characteristics and Efficacy of a New Third-Generation Antivenom Developed in Colombia Covering Micrurus spp. Venoms
title_full Standard Quality Characteristics and Efficacy of a New Third-Generation Antivenom Developed in Colombia Covering Micrurus spp. Venoms
title_fullStr Standard Quality Characteristics and Efficacy of a New Third-Generation Antivenom Developed in Colombia Covering Micrurus spp. Venoms
title_full_unstemmed Standard Quality Characteristics and Efficacy of a New Third-Generation Antivenom Developed in Colombia Covering Micrurus spp. Venoms
title_sort Standard Quality Characteristics and Efficacy of a New Third-Generation Antivenom Developed in Colombia Covering Micrurus spp. Venoms
dc.creator.fl_str_mv Santiago Tabares Vélez
Lina María Preciado
Leidy Johana Vargas Muñoz
Carlos Alberto Madrid Bracamonte
Angelica Zuluaga
Jeisson Gómez Robles
Camila Renjifo-Ibañez
Sebastián Estrada-Gómez
dc.contributor.author.none.fl_str_mv Santiago Tabares Vélez
Lina María Preciado
Leidy Johana Vargas Muñoz
Carlos Alberto Madrid Bracamonte
Angelica Zuluaga
Jeisson Gómez Robles
Camila Renjifo-Ibañez
Sebastián Estrada-Gómez
dc.contributor.corporatename.none.fl_str_mv Sebastián Estrada-Gómez
Leidy Johana Vargas Muñoz
dc.contributor.researchgroup.none.fl_str_mv Infettare
dc.subject.proposal.none.fl_str_mv antivenom
quality control
coral snake
preclinical
freeze-dried
topic antivenom
quality control
coral snake
preclinical
freeze-dried
description In Colombia, Micrurus snakebites are classified as severe according to the national clinical care guidelines and must be treated with specific antivenoms. Unfortunately, these types of antivenoms are scarce in certain areas of the country and are currently reported as an unavailable vital medicine. To address this issue, La Universidad de Antioquia, through its spin-off Tech Life Saving, is leading a project to develop third-generation polyvalent freeze-dried antivenom. The goal is to ensure access to this therapy, especially in rural and dispersed areas. This project aims to evaluate the physicochemical and preclinical parameters (standard quality characteristics) of a lab-scale anti-elapid antivenom batch. The antivenom is challenged against the venoms of several Micrurus species, including M. mipartitus, M. dumerilii, M. ancoralis, M. dissoleucus, M. lemniscatus, M. medemi, M. spixii, M. surinamensis, and M. isozonus, following the standard quality characteristics set by theWorld Health Organization (WHO). The antivenom demonstrates an appearance consistent with standards, 100% solubility within 4 min and 25 s, an extractable volume of 10.39 mL, a pH of 6.04, an albumin concentration of 0.377 mg/mL (equivalent to 1.22% of total protein), and a protein concentration of 30.97 mg/mL. Importantly, it maintains full integrity of its F(ab′)2 fragments and exhibits purity over 98.5%. Furthermore, in mice toxicity evaluations, doses up to 15 mg/mouse show no toxic effects. The antivenom also demonstrates a significant recognition pattern against Micrurus venoms rich in phospholipase A2 (PLA2) content, as observed in M. dumerilii, M. dissoleucus, and M. isozonus. The effective dose 50 (ED50) indicates that a single vial (10 mL) can neutralize 2.33 mg of M. mipartitus venom and 3.99 mg of M. dumerilii venom. This new anti-elapid third-generation polyvalent and freeze-dried antivenom meets the physicochemical parameters set by the WHO and the regulators in Colombia. It demonstrates significant efficacy in neutralizing the venom of the most epidemiologically important Micrurus species in Colombia. Additionally, it recognizes seven other species of Micrurus venom with a higher affinity for venoms exhibiting PLA2 toxins. Fulfilling these parameters represents the first step toward proposing a new pharmacological alternative for treating snakebites in Colombia, particularly in dispersed rural areas, given that this antivenom is formulated as a freeze-dried product.
publishDate 2024
dc.date.accessioned.none.fl_str_mv 2024-04-19T22:15:26Z
dc.date.available.none.fl_str_mv 2024-04-19T22:15:26Z
dc.date.issued.none.fl_str_mv 2024-04-09
dc.type.none.fl_str_mv Artículo
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dc.identifier.citation.none.fl_str_mv Tabares Vélez, S.; Preciado, L.M.; Vargas Muñoz, L.J.; Madrid Bracamonte, C.A.; Zuluaga, A.; Gómez Robles, J.; Renjifo-Ibañez, C.; Estrada-Gómez, S. Standard Quality Characteristics and Efficacy of a New Third-Generation Antivenom Developed in Colombia Covering Micrurus spp. Venoms. Toxins 2024, 16, 183. https://doi.org/10.3390/toxins16040183
dc.identifier.issn.none.fl_str_mv 2072-6651
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/20.500.12494/55465
dc.identifier.doi.none.fl_str_mv doi.org/10.3390/ toxins16040183
dc.identifier.eissn.none.fl_str_mv 2072-6651
identifier_str_mv Tabares Vélez, S.; Preciado, L.M.; Vargas Muñoz, L.J.; Madrid Bracamonte, C.A.; Zuluaga, A.; Gómez Robles, J.; Renjifo-Ibañez, C.; Estrada-Gómez, S. Standard Quality Characteristics and Efficacy of a New Third-Generation Antivenom Developed in Colombia Covering Micrurus spp. Venoms. Toxins 2024, 16, 183. https://doi.org/10.3390/toxins16040183
2072-6651
doi.org/10.3390/ toxins16040183
url https://hdl.handle.net/20.500.12494/55465
dc.language.iso.none.fl_str_mv eng
language eng
dc.relation.citationendpage.none.fl_str_mv 21
dc.relation.citationstartpage.none.fl_str_mv 1
dc.relation.citationvolume.none.fl_str_mv 16
dc.relation.ispartofjournal.none.fl_str_mv Toxins
dc.relation.references.none.fl_str_mv Lynch, J.; Angarita, T.; Ruiz, F. Programa Nacional Para La Conservación De Las Serpientes Presentes En Colombia; Ministerio de Ambiente y Desarrollo Sostenible: Bogotá, Colombia, 2014; ISBN 9789588901183.
Uetz, P.; Freed, P.; Hošek, J. The Reptile Database. Choice Rev. Online 2012, 49, 49–6294. [CrossRef]
Instituto Nacional de Salud. Accidente Ofídico Periodo Epidemiológico 2022. Available online: https://www.ins.gov.co/ buscador-eventos/Informesdeevento/ACCIDENTEOFIDICOPEXIII2022.pdf (accessed on 18 April 2023).
Lomonte, B.; Rey-Suárez, P.; Fernández, J.; Sasa, M.; Pla, D.; Vargas, N.; Bénard-Valle, M.; Sanz, L.; Corrêa-Netto, C.; Núñez, V.; et al. Venoms of Micrurus Coral Snakes: Evolutionary Trends in Compositional Patterns Emerging from Proteomic Analyses. Toxicon 2016, 122, 7–25. [CrossRef]
Rey-Suárez, P.; Núñez, V.; Gutiérrez, J.M.; Lomonte, B. Proteomic and Biological Characterization of the Venom of the Redtail Coral Snake, Micrurus Mipartitus (Elapidae), from Colombia and Costa Rica. J. Proteom. 2011, 75, 655–667. [CrossRef]
Rey-Suárez, P.; Núñez, V.; Fernández, J.; Lomonte, B. Integrative Characterization of the Venom of the Coral Snake Micrurus Dumerilii (Elapidae) from Colombia: Proteome, Toxicity, and Cross-Neutralization by Antivenom. J. Proteom. 2016, 136, 262–273. [CrossRef] [PubMed]
Naturalista Comisión Nacional Para El Conocimiento y Uso de La Biodiversidad. Available online: https://colombia.inaturalist. org/ (accessed on 7 May 2023).
Campbell, J.; Lamar,W.; Brodie, E. The Venomous Reptiles of the Western Hemisphere; Comstock, Cornell University Press: Ithaca, NY, USA, 2004.
Pardal, P.P.d.O.; Pardal, J.S.d.O.; Gadelha, M.A.d.C.; Rodrigues, L.d.S.; Feitosa, D.T.; Prudente, A.L.d.C.; Fan, H.W. Envenenamento Por Coral Do Gênero Micrurus Na Amazônia Brasileira: Relato de Dois Casos. Rev. Inst. Med. Trop. Sao Paulo 2010, 52, 333–337. [CrossRef]
Cañas, C.A.; Castro-Herrera, F.; Castaño-Valencia, S. Envenomation by the Red-Tailed Coral Snake (Micrurus mipartitus) in Colombia. J. Venom. Anim. Toxins Incl. Trop. Dis. 2017, 23, 1–4.
Lewis, R.L.; Gutmann, L. Snake Venoms and the Neuromuscular Junction. Semin Neurol. 2004, 24, 175–179.
Estrada-Gómez, S.; Vargas-Muñoz, L.J.; Higuita-Gutiérrez, L.F. Epidemiology of Snake Bites Linked with the Antivenoms Production in Colombia 2008–2020: Produced Vials Do Not Meet the Needs. Drug Healthc. Patient. Saf. 2022, 14, 171–184.
Temprano, G.; Aprea, P.; Christian Dokmetjian, J. La Producción Pública de Antivenenos En La Región de Las Américas Como Factor Clave En Su Accesibilidad. Rev. Panam. De Salud Pública 2017, 41, 1. [
Mendes, G.F.; Stuginski, D.R.; Loibel, S.M.C.; De Morais-Zani, K.; Da Rocha, M.M.T.; Fernandes, W.; Sant’anna, S.S.; Grego, K.F. Factors That Can Influence the Survival Rates of Coral Snakes (Micrurus coralnus) for Antivenom Production. J. Anim. Sci. 2019, 97, 972–980. [
INVIMA Medicamentos Vitales No Disponibles. Available online: https://www.invima.gov.co/medicamentos-vitales-nodisponibles (accessed on 13 November 2021).
Chippaux, J.P.; Goyffon, M. Venoms, Antivenoms and Immunotherapy. Toxicon 1998, 36, 823–846.
Sarmiento, K.; Rodríguez, A.; Quevedo-Buitrago, W.; Torres, I.; Ríos, C.; Ruíz, L.; Salazar, J.; Hidalgo-Martínez, P.; Diez, H. Comparación de La Eficacia, La Seguridad y La Farmacocinética de Los Antivenenos Antiofídicos: Revisión de Literatura. Univ. Médica 2019, 61, 30–51.
Vázquez, H.; Olvera, F.; Alagón, A.; Sevcik, C. Production of Anti-Horse Antibodies Induced by IgG, F(Ab’)2 and Fab Applied Repeatedly to Rabbits. Effect on Antivenom Pharmacokinetics. Toxicon 2013, 76, 362–369.
World Health Organization. Annex 5: Guidelines for the production, control and regulation of snake antivenom immunoglobulins. In WHO Expert Committee on Biological Standardization; World Health Organization: Geneva, Switzerland, 2017; pp. 197–388. Available online: http://www.jstor.org/stable/resrep44225.16 (accessed on 1 May 2023).
Sanz, L.; de Freitas-Lima, L.N.; Quesada-Bernat, S.; Graça-de-Souza, V.K.; Soares, A.M.; Calderón, L.d.A.; Calvete, J.J.; Caldeira, C.A.S. Comparative Venomics of Brazilian Coral Snakes: Micrurus Frontalis, Micrurus Spixii Spixii, and Micrurus Surinamensis. Toxicon 2019, 166, 39–45
Sanz, L.; Quesada-Bernat, S.; Ramos, T.; Casais-e-Silva, L.L.; Corrêa-Netto, C.; Silva-Haad, J.J.; Sasa, M.; Lomonte, B.; Calvete, J.J. New Insights into the Phylogeographic Distribution of the 3FTx/PLA 2 Venom Dichotomy across Genus Micrurus in South America. J. Proteom. 2019, 200, 90–101.
Otero, R.; Osorio, R.G.; Valderrama, R.; Giraldo, C.A. Efectos Farmacologicos y Enzimaticos de Los Venenos de Serpientes de Antioquia y Choco (Colombia). Toxicon 1992, 30, 611–620.
Istvan Lazar GelAnalyzer. Available online: http://www.gelanalyzer.com/index.html (accessed on 1 May 2023).
Diehl, L.; Morse, M. A Comparison of Selected Organ Weights and Clinical Pathology Parameters in Male and Female CD-1 and CByB6F1 Hybrid Mice 12–14 Weeks in Age; Charles River: Spencerville, OH, USA, 2015.
Rey-Suárez, P.; Floriano, R.S.; Rostelato-Ferreira, S.; Saldarriaga-Córdoba, M.; Núñez, V.; Rodrigues-Simioni, L.; Lomonte, B. Mipartoxin-I, a Novel Three-Finger Toxin, Is the Major Neurotoxic Component in the Venom of the Redtail Coral Snake Micrurus Mipartitus (Elapidae). Toxicon 2012, 60, 851–863.
Rodríguez-Vargas, A.; Franco-Vásquez, A.M.; Bolívar-Barbosa, J.A.; Vega, N.; Reyes-Montaño, E.; Arreguín-Espinosa, R.; Carbajal- Saucedo, A.; Angarita-Sierra, T.; Ruiz-Gómez, F. Unveiling the Venom Composition of the Colombian Coral Snakes Micrurus Helleri, M. Medemi, and M. Sangilensis. Toxins 2023, 15, 622. [
Gutiérrez, J.M.; León, G.; Lomonte, B.; Angulo, Y. Antivenoms for Snakebite Envenomings. Inflamm. Allergy Drug Targets 2011, 10, 369–380. [
Castillo-Beltrán, M.C.; Hurtado-Gómez, J.P.; Corredor-Espinel, V.; Ruiz-Gómez, F.J. A Polyvalent Coral Snake Antivenom with Broad Neutralization Capacity. PLoS Negl. Trop Dis. 2018, 13, e0007250.
Rawat, S.; Laing, G.; Smith, D.C.; Theakston, D.; Landon, J. A New Antivenom to Treat Eastern Coral Snake (Micrurus Fulvius Fulvius) Envenoming. Toxicon 1994, 32, 185–190. [CrossRef] [PubMed
Solano, S.; Segura, Á.; León, G.; Gutiérrez, J.M.; Burnouf, T. Low PH Formulation of Whole IgG Antivenom: Impact on Quality, Safety, Neutralizing Potency and Viral Inactivation. Biologicals 2012, 40, 129–133. [
Cádiz, A.; Esther Castellano, M.; Hernández, J.; Castillo, J.; Mustelier, P.; Teresa Ramírez, A. Influencia Del PH Sobre La Estabilidad de Preparados de Inmunoglobulinas Intravenosas Para Uso Humano Durante El Almacenamiento. Vaccimonitor 2000, 9, 21–25.
Zurbano, B.N.; Tavarone, E.; Viacava, B.G.; Dokmetjian, J.C.; Cascone, O.; Fingermann, M. Critical Aspects on Traditional Antivenom Production Processes and Their Optimization by Factorial Analysis. Biologicals 2020, 68, 65–73.
Gutiérrez, J.M. Envenenamientos Por Mordeduras de Serpientes En América Latina y El Caribe: Una Visión Integral de Carácter Regional. Bol. Malariol. Salud Ambient. 2011, 51, 1–16.
Serna-Trejos, J.S.; Erazo-Zamora, A.M.; Ibarguen-Gómez, W.T.; Vergara-Portocarrero, M.L. Escenario Epidemiológico Del Accidente Ofídico En Colombia, 2023. Rev. Exp. En Med. Del Hosp. Reg. Lambayeque 2023, 9, 124–125. [
Albus, U. Guide for the Care and Use of Laboratory Animals (8th Edn). Lab. Anim. 2012, 46, 267–268.
He, F. Laemmli-SDS-PAGE. Bio. Protoc. 2011, 1, e80.
Zheng, K.; Wu, L.; He, Z.; Yang, B.; Yang, Y. Measurement of the Total Protein in Serum by Biuret Method with Uncertainty Evaluation. Measurement 2017, 112, 16–21
Doumas, B.T.; Bayse, D.D.; Carter, R.J.; Peters, T.; Schaffer, R. A Candidate Reference Method for Determination of Total Protein in Serum. I. Development and Validation. Clin. Chem. 1981, 27, 1642–1650
Doumas, B.T.; Ard Watson, W.; Biggs, H.G. Albumin Standards and the Measurement of Serum Albumin with Bromcresol Green. Clin. Chim. Acta 1971, 31, 87–96.
Ouchterlony, O. Antigen-Antibody Reactions in Gels. Acta Pathol. Microbiol. Scand. 1949, 26, 507–515.
Laemmli, U.K. Cleavage of Structural Proteins during the Assembly of the Head of Bacteriophage T4. Nature 1970, 227, 680–685.
Otero-Patiño, R.; Segura, Á.; Herrera, M.; Angulo, Y.; León, G.; Gutiérrez, J.M.; Barona, J.; Estrada, S.; Pereañez, A.; Quintana, J.C.; et al. Comparative Study of the Efficacy and Safety of Two Polyvalent, Caprylic Acid Fractionated [IgG and F(Ab’)2] Antivenoms, in Bothrops Asper Bites InColombia. Toxicon 2012, 59, 344–355. [CrossRef
Weil, C.S. Tables for Convenient Calculation of Median-Effective Dose (LD 50 or ED 50 ) and Instructions in Their Use. Biometrics 1952, 8, 249.
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spelling Santiago Tabares VélezLina María PreciadoLeidy Johana Vargas MuñozCarlos Alberto Madrid BracamonteAngelica ZuluagaJeisson Gómez RoblesCamila Renjifo-IbañezSebastián Estrada-GómezSebastián Estrada-GómezLeidy Johana Vargas MuñozInfettare2024-04-19T22:15:26Z2024-04-19T22:15:26Z2024-04-09Tabares Vélez, S.; Preciado, L.M.; Vargas Muñoz, L.J.; Madrid Bracamonte, C.A.; Zuluaga, A.; Gómez Robles, J.; Renjifo-Ibañez, C.; Estrada-Gómez, S. Standard Quality Characteristics and Efficacy of a New Third-Generation Antivenom Developed in Colombia Covering Micrurus spp. Venoms. Toxins 2024, 16, 183. https://doi.org/10.3390/toxins160401832072-6651https://hdl.handle.net/20.500.12494/55465doi.org/10.3390/ toxins160401832072-6651In Colombia, Micrurus snakebites are classified as severe according to the national clinical care guidelines and must be treated with specific antivenoms. Unfortunately, these types of antivenoms are scarce in certain areas of the country and are currently reported as an unavailable vital medicine. To address this issue, La Universidad de Antioquia, through its spin-off Tech Life Saving, is leading a project to develop third-generation polyvalent freeze-dried antivenom. The goal is to ensure access to this therapy, especially in rural and dispersed areas. This project aims to evaluate the physicochemical and preclinical parameters (standard quality characteristics) of a lab-scale anti-elapid antivenom batch. The antivenom is challenged against the venoms of several Micrurus species, including M. mipartitus, M. dumerilii, M. ancoralis, M. dissoleucus, M. lemniscatus, M. medemi, M. spixii, M. surinamensis, and M. isozonus, following the standard quality characteristics set by theWorld Health Organization (WHO). The antivenom demonstrates an appearance consistent with standards, 100% solubility within 4 min and 25 s, an extractable volume of 10.39 mL, a pH of 6.04, an albumin concentration of 0.377 mg/mL (equivalent to 1.22% of total protein), and a protein concentration of 30.97 mg/mL. Importantly, it maintains full integrity of its F(ab′)2 fragments and exhibits purity over 98.5%. Furthermore, in mice toxicity evaluations, doses up to 15 mg/mouse show no toxic effects. The antivenom also demonstrates a significant recognition pattern against Micrurus venoms rich in phospholipase A2 (PLA2) content, as observed in M. dumerilii, M. dissoleucus, and M. isozonus. The effective dose 50 (ED50) indicates that a single vial (10 mL) can neutralize 2.33 mg of M. mipartitus venom and 3.99 mg of M. dumerilii venom. This new anti-elapid third-generation polyvalent and freeze-dried antivenom meets the physicochemical parameters set by the WHO and the regulators in Colombia. It demonstrates significant efficacy in neutralizing the venom of the most epidemiologically important Micrurus species in Colombia. Additionally, it recognizes seven other species of Micrurus venom with a higher affinity for venoms exhibiting PLA2 toxins. Fulfilling these parameters represents the first step toward proposing a new pharmacological alternative for treating snakebites in Colombia, particularly in dispersed rural areas, given that this antivenom is formulated as a freeze-dried product.application/pdfenghttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://purl.org/coar/access_right/c_abf2https://www.mdpi.com/2072-6651/16/4/183Standard Quality Characteristics and Efficacy of a New Third-Generation Antivenom Developed in Colombia Covering Micrurus spp. VenomsArtículohttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1http://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTinfo:eu-repo/semantics/publishedVersion21116ToxinsLynch, J.; Angarita, T.; Ruiz, F. Programa Nacional Para La Conservación De Las Serpientes Presentes En Colombia; Ministerio de Ambiente y Desarrollo Sostenible: Bogotá, Colombia, 2014; ISBN 9789588901183.Uetz, P.; Freed, P.; Hošek, J. The Reptile Database. Choice Rev. Online 2012, 49, 49–6294. [CrossRef]Instituto Nacional de Salud. Accidente Ofídico Periodo Epidemiológico 2022. Available online: https://www.ins.gov.co/ buscador-eventos/Informesdeevento/ACCIDENTEOFIDICOPEXIII2022.pdf (accessed on 18 April 2023).Lomonte, B.; Rey-Suárez, P.; Fernández, J.; Sasa, M.; Pla, D.; Vargas, N.; Bénard-Valle, M.; Sanz, L.; Corrêa-Netto, C.; Núñez, V.; et al. Venoms of Micrurus Coral Snakes: Evolutionary Trends in Compositional Patterns Emerging from Proteomic Analyses. Toxicon 2016, 122, 7–25. [CrossRef]Rey-Suárez, P.; Núñez, V.; Gutiérrez, J.M.; Lomonte, B. Proteomic and Biological Characterization of the Venom of the Redtail Coral Snake, Micrurus Mipartitus (Elapidae), from Colombia and Costa Rica. J. Proteom. 2011, 75, 655–667. [CrossRef]Rey-Suárez, P.; Núñez, V.; Fernández, J.; Lomonte, B. Integrative Characterization of the Venom of the Coral Snake Micrurus Dumerilii (Elapidae) from Colombia: Proteome, Toxicity, and Cross-Neutralization by Antivenom. J. Proteom. 2016, 136, 262–273. [CrossRef] [PubMed]Naturalista Comisión Nacional Para El Conocimiento y Uso de La Biodiversidad. Available online: https://colombia.inaturalist. org/ (accessed on 7 May 2023).Campbell, J.; Lamar,W.; Brodie, E. The Venomous Reptiles of the Western Hemisphere; Comstock, Cornell University Press: Ithaca, NY, USA, 2004.Pardal, P.P.d.O.; Pardal, J.S.d.O.; Gadelha, M.A.d.C.; Rodrigues, L.d.S.; Feitosa, D.T.; Prudente, A.L.d.C.; Fan, H.W. Envenenamento Por Coral Do Gênero Micrurus Na Amazônia Brasileira: Relato de Dois Casos. Rev. Inst. Med. Trop. Sao Paulo 2010, 52, 333–337. [CrossRef]Cañas, C.A.; Castro-Herrera, F.; Castaño-Valencia, S. Envenomation by the Red-Tailed Coral Snake (Micrurus mipartitus) in Colombia. J. Venom. Anim. Toxins Incl. Trop. Dis. 2017, 23, 1–4.Lewis, R.L.; Gutmann, L. Snake Venoms and the Neuromuscular Junction. Semin Neurol. 2004, 24, 175–179.Estrada-Gómez, S.; Vargas-Muñoz, L.J.; Higuita-Gutiérrez, L.F. Epidemiology of Snake Bites Linked with the Antivenoms Production in Colombia 2008–2020: Produced Vials Do Not Meet the Needs. Drug Healthc. Patient. Saf. 2022, 14, 171–184.Temprano, G.; Aprea, P.; Christian Dokmetjian, J. La Producción Pública de Antivenenos En La Región de Las Américas Como Factor Clave En Su Accesibilidad. Rev. Panam. De Salud Pública 2017, 41, 1. [Mendes, G.F.; Stuginski, D.R.; Loibel, S.M.C.; De Morais-Zani, K.; Da Rocha, M.M.T.; Fernandes, W.; Sant’anna, S.S.; Grego, K.F. Factors That Can Influence the Survival Rates of Coral Snakes (Micrurus coralnus) for Antivenom Production. J. Anim. Sci. 2019, 97, 972–980. [INVIMA Medicamentos Vitales No Disponibles. Available online: https://www.invima.gov.co/medicamentos-vitales-nodisponibles (accessed on 13 November 2021).Chippaux, J.P.; Goyffon, M. Venoms, Antivenoms and Immunotherapy. Toxicon 1998, 36, 823–846.Sarmiento, K.; Rodríguez, A.; Quevedo-Buitrago, W.; Torres, I.; Ríos, C.; Ruíz, L.; Salazar, J.; Hidalgo-Martínez, P.; Diez, H. Comparación de La Eficacia, La Seguridad y La Farmacocinética de Los Antivenenos Antiofídicos: Revisión de Literatura. Univ. Médica 2019, 61, 30–51.Vázquez, H.; Olvera, F.; Alagón, A.; Sevcik, C. Production of Anti-Horse Antibodies Induced by IgG, F(Ab’)2 and Fab Applied Repeatedly to Rabbits. Effect on Antivenom Pharmacokinetics. Toxicon 2013, 76, 362–369.World Health Organization. Annex 5: Guidelines for the production, control and regulation of snake antivenom immunoglobulins. In WHO Expert Committee on Biological Standardization; World Health Organization: Geneva, Switzerland, 2017; pp. 197–388. Available online: http://www.jstor.org/stable/resrep44225.16 (accessed on 1 May 2023).Sanz, L.; de Freitas-Lima, L.N.; Quesada-Bernat, S.; Graça-de-Souza, V.K.; Soares, A.M.; Calderón, L.d.A.; Calvete, J.J.; Caldeira, C.A.S. Comparative Venomics of Brazilian Coral Snakes: Micrurus Frontalis, Micrurus Spixii Spixii, and Micrurus Surinamensis. Toxicon 2019, 166, 39–45Sanz, L.; Quesada-Bernat, S.; Ramos, T.; Casais-e-Silva, L.L.; Corrêa-Netto, C.; Silva-Haad, J.J.; Sasa, M.; Lomonte, B.; Calvete, J.J. New Insights into the Phylogeographic Distribution of the 3FTx/PLA 2 Venom Dichotomy across Genus Micrurus in South America. J. Proteom. 2019, 200, 90–101.Otero, R.; Osorio, R.G.; Valderrama, R.; Giraldo, C.A. Efectos Farmacologicos y Enzimaticos de Los Venenos de Serpientes de Antioquia y Choco (Colombia). Toxicon 1992, 30, 611–620.Istvan Lazar GelAnalyzer. Available online: http://www.gelanalyzer.com/index.html (accessed on 1 May 2023).Diehl, L.; Morse, M. A Comparison of Selected Organ Weights and Clinical Pathology Parameters in Male and Female CD-1 and CByB6F1 Hybrid Mice 12–14 Weeks in Age; Charles River: Spencerville, OH, USA, 2015.Rey-Suárez, P.; Floriano, R.S.; Rostelato-Ferreira, S.; Saldarriaga-Córdoba, M.; Núñez, V.; Rodrigues-Simioni, L.; Lomonte, B. Mipartoxin-I, a Novel Three-Finger Toxin, Is the Major Neurotoxic Component in the Venom of the Redtail Coral Snake Micrurus Mipartitus (Elapidae). Toxicon 2012, 60, 851–863.Rodríguez-Vargas, A.; Franco-Vásquez, A.M.; Bolívar-Barbosa, J.A.; Vega, N.; Reyes-Montaño, E.; Arreguín-Espinosa, R.; Carbajal- Saucedo, A.; Angarita-Sierra, T.; Ruiz-Gómez, F. Unveiling the Venom Composition of the Colombian Coral Snakes Micrurus Helleri, M. Medemi, and M. Sangilensis. Toxins 2023, 15, 622. [Gutiérrez, J.M.; León, G.; Lomonte, B.; Angulo, Y. Antivenoms for Snakebite Envenomings. Inflamm. Allergy Drug Targets 2011, 10, 369–380. [Castillo-Beltrán, M.C.; Hurtado-Gómez, J.P.; Corredor-Espinel, V.; Ruiz-Gómez, F.J. A Polyvalent Coral Snake Antivenom with Broad Neutralization Capacity. PLoS Negl. Trop Dis. 2018, 13, e0007250.Rawat, S.; Laing, G.; Smith, D.C.; Theakston, D.; Landon, J. A New Antivenom to Treat Eastern Coral Snake (Micrurus Fulvius Fulvius) Envenoming. Toxicon 1994, 32, 185–190. [CrossRef] [PubMedSolano, S.; Segura, Á.; León, G.; Gutiérrez, J.M.; Burnouf, T. Low PH Formulation of Whole IgG Antivenom: Impact on Quality, Safety, Neutralizing Potency and Viral Inactivation. Biologicals 2012, 40, 129–133. [Cádiz, A.; Esther Castellano, M.; Hernández, J.; Castillo, J.; Mustelier, P.; Teresa Ramírez, A. Influencia Del PH Sobre La Estabilidad de Preparados de Inmunoglobulinas Intravenosas Para Uso Humano Durante El Almacenamiento. Vaccimonitor 2000, 9, 21–25.Zurbano, B.N.; Tavarone, E.; Viacava, B.G.; Dokmetjian, J.C.; Cascone, O.; Fingermann, M. Critical Aspects on Traditional Antivenom Production Processes and Their Optimization by Factorial Analysis. Biologicals 2020, 68, 65–73.Gutiérrez, J.M. Envenenamientos Por Mordeduras de Serpientes En América Latina y El Caribe: Una Visión Integral de Carácter Regional. Bol. Malariol. Salud Ambient. 2011, 51, 1–16.Serna-Trejos, J.S.; Erazo-Zamora, A.M.; Ibarguen-Gómez, W.T.; Vergara-Portocarrero, M.L. Escenario Epidemiológico Del Accidente Ofídico En Colombia, 2023. Rev. Exp. En Med. Del Hosp. Reg. Lambayeque 2023, 9, 124–125. [Albus, U. Guide for the Care and Use of Laboratory Animals (8th Edn). Lab. Anim. 2012, 46, 267–268.He, F. Laemmli-SDS-PAGE. Bio. Protoc. 2011, 1, e80.Zheng, K.; Wu, L.; He, Z.; Yang, B.; Yang, Y. Measurement of the Total Protein in Serum by Biuret Method with Uncertainty Evaluation. Measurement 2017, 112, 16–21Doumas, B.T.; Bayse, D.D.; Carter, R.J.; Peters, T.; Schaffer, R. A Candidate Reference Method for Determination of Total Protein in Serum. I. Development and Validation. Clin. Chem. 1981, 27, 1642–1650Doumas, B.T.; Ard Watson, W.; Biggs, H.G. Albumin Standards and the Measurement of Serum Albumin with Bromcresol Green. Clin. Chim. Acta 1971, 31, 87–96.Ouchterlony, O. Antigen-Antibody Reactions in Gels. Acta Pathol. Microbiol. Scand. 1949, 26, 507–515.Laemmli, U.K. Cleavage of Structural Proteins during the Assembly of the Head of Bacteriophage T4. Nature 1970, 227, 680–685.Otero-Patiño, R.; Segura, Á.; Herrera, M.; Angulo, Y.; León, G.; Gutiérrez, J.M.; Barona, J.; Estrada, S.; Pereañez, A.; Quintana, J.C.; et al. Comparative Study of the Efficacy and Safety of Two Polyvalent, Caprylic Acid Fractionated [IgG and F(Ab’)2] Antivenoms, in Bothrops Asper Bites InColombia. Toxicon 2012, 59, 344–355. [CrossRefWeil, C.S. Tables for Convenient Calculation of Median-Effective Dose (LD 50 or ED 50 ) and Instructions in Their Use. 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