Cobra venom could potentially be treated with a blood thinner
August 2, 2024 10:48 AM   Subscribe

 
And the great news is, if you accidentally OD on heparin, a simple cobra bite will fix you right up!
posted by mittens at 11:27 AM on August 2 [5 favorites]


Anti-venom injections require refrigeration; I knew that heparin doesn't need that, which was already promising, but since heparin has "small molecules", "if you put them in a DMSO patch and apply that topically, they can absorb straight through the skin." (!)

If successful, the treatment can prevent deaths and local tissue necrosis from some venomous snakebites. Fewer deaths, and fewer life-altering complications for snakebite survivors (like nerve and muscle damage and destruction, debridement, limb loss ["People could travel hours or even days to reach the anti-venom and by then there is already significant local tissue damage, and this results in amputation or loss of entire limbs, not just the fingers"], systemic infection, cerebral stroke...) would be extraordinary.

Thank you, chariot pulled by cassowaries.
posted by Iris Gambol at 11:34 AM on August 2 [3 favorites]


Will they rename it “herperin?”
posted by GenjiandProust at 11:57 AM on August 2 [6 favorites]


"Najarin" might be more apt.
posted by senor biggles at 1:29 PM on August 2


"The method we have used to discover the heparin, it's using CRISPR (clustered regularly interspaced short palindromic repeats) gene editing and it's a little bit complicated, but essentially we look at what genes the venom is actually attacking on human cells.

And knowing that is half the battle.
posted by Avelwood at 1:37 PM on August 2 [1 favorite]


Cobra venom kills by collapsing blood vessels, organ-on-a-chip shows (Live Science, June 4, 2024) "A new 3D model of a human blood vessel made in the lab [MIMETAS' OrganoReady® Blood Vessel HUVEC] may help accelerate the development of new antivenoms, researchers say." [Related Eureka Alert; Research paper.]

The team used exposed the new chip to venom milked from four species of snakes: Indian cobras (Naja naja), West African carpet vipers (Echis ocellatus), many-banded kraits (Bungarus multicinctus) and Mozambique spitting cobras (Naja mossambica). The snakes belong to the most venomous families of snakes — the vipers and elapids. The researchers used specialized imaging techniques to peer inside the chips as venom coursed through them. They discovered that some of these venoms can directly injure the membranes of endothelial cells, while others dislodge the cells from their extracellular matrices, prompting blood vessels to collapse.

[^ "organ-on-a-chip" tech, whaT the wHat]

Despite the existence of hundreds of venoms, nearly all snake venoms fall into one of three categories, depending on how they affect us: neurotoxins, cytotoxins or myotoxins. Neurotoxins are common to the Elapidae family of snakes, which include cobras, mambas, coral snakes, and copperheads. They work on the nervous system by disrupting the electrical impulses that our nerves and muscles use to function. (McGill's Office for Science and Society ["Separating Sense from Nonsense"], Nov. 11, 2022.)

Nearly 20 years ago, a Stanford snake venom study showed that certain cells may eliminate venom: Mast cells. "Given that tendency to overreact when stimulated by allergens, it seemed plausible that introducing venom into the body would trigger a similar response. But [Dr. Stephen] Galli and Martin Metz, MD, a postdoctoral scholar in pathology and first author of the study, have shown that when mast cells respond to selected venoms, they unleash proteins that break down some of the venoms' most toxic components."

Two years earlier, Galli, Metz, and a team of researchers showed that "mast cells reduced the mortality rate of mice suffering from bacterial peritonitis, a severe bacterial infection in the abdominal cavity that can also be fatal to humans. They found that mast cells released proteins that broke down a molecule called endothelin-1, one of the major toxins produced by the body during bacterial peritonitis or sepsis. In perusing the scientific literature, Metz noticed that endothelin-1 bore a striking similarity to sarafotoxin 6b, the most toxic component in the venom of the burrowing asp."

In the FPP, it's cobras, thus neurotoxins; "Professor Bryan Fry, venom expert at the University of Queensland, told ABC NewsRadio that the breakthrough could 'absolutely' work on other types of snake venom and not just cobra bites."

A better understanding of how system-wide shutdown happens (venoms can damage endothelial cells, the workhorse linings of blood cells; venoms can collapse blood cells outright; venoms "can increase blood pressure, decrease blood pressure, prevent bleeding or create it"); knowing how to create anti-venom traditionally [an expensive, time-consuming process - the shortage has gone on decades]; studying mast cell deployment of proteins against venom; it's now possible to trace venom [a neurotoxin, cytotoxin or myotoxin] targeting specific genes, and at least one already-existing medication "could revolutionise treatment for cobra bites" during an extended worldwide shortage of antivenoms — possibly as a topical application?

folks I am excited for future snake-bite victims, and mildly optimistic about scientific advancements.
posted by Iris Gambol at 6:34 PM on August 2 [3 favorites]


So I've been on warfarin for over a decade, and switched to heparin injectables for any kind of surgery and during my pregnancy etc. All of this is SUCH good news - the thought of heparin available as a patch rather than injectables - the needles were a daily dread and led to extensive bruising and just a hassle to store and dispose.

Heparin is pretty shelf-stable and this would be so great to have wider availability - not just for snake bites! But anyone on blood thinners who needs surgery has to switch to heparin or the equivalent because otherwise you will bleed out during surgery. Wider availability and PLEASE lower costs - at the time I took it for nearly a year, it was like printer-ink cost per ounce because it is an intensive process starting from I think pig or cow mucus to get the stuff, versus cheap warfarin or even the slightly more expensive patented versions (mine was cow, I guess because of the haram stuff).

Now I'm seeing there are trials of synthetic versions coming up - the trick is to get something cost effective and shelf stable, although I do wonder if the advances in cold-chain from covid are making even that an obstacle.

Sincerely truly exciting. I can't plan travel anywhere distant from a major hospital center, and I can't even ride a bicycle now because the risk of an accident on blood thinners that might require surgery is too high. I've experienced that once and had to go literally septic in the ward waiting for my levels to lower enough and the surgery was still pretty dicey with I think 17 blood units needed.

Cassowary, this is such amazing medical news - improvements like this to make heparin more available and more usable will have a ripple effect for so many more people. I am going to keep an eye on this - maybe in a few years I'll be able to go somewhere rural again! And for people living far away from cities, to be able to get help on-route or locally, huge!
posted by dorothyisunderwood at 10:54 PM on August 2 [1 favorite]


This was fascinating, thank you!
posted by tiny frying pan at 4:51 AM on August 3


The only anti-venom that I trust is a mongoose.
posted by SnowRottie at 4:20 PM on August 3


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