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Neutralization of the Venom of 2 North American Rattlesnake Venoms by a Hyperimmune Equine Plasma Product in Mice

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Neutralization of the Venom of 2 North American Rattlesnake Venoms by a Hyperimmune Equine Plasma Product in Mice Central Journal of Pharmacology & Clinical Toxicology Bringing Excellence in Open Access Research Article *Corresponding author Lyndi Gilliam, Department of Clinical Sciences, Oklahoma State University, USA, Tel: 4057446656; Email: Neutralization of the Venom of Submitted: 26 April 2017 2 North American Rattlesnake Accepted: 16 May 2017 Published: 19 May 2017 ISSN: 2333-7079 Venoms by a Hyperimmune Copyright © 2017 Gilliam et al. Equine Plasma product in Mice OPEN ACCESS 1 1 2 Lyndi L. Gilliam *, Darla K. Moser , Jerry W. Ritchey , Mark E. Keywords Payton3, and Jordan Cassidy1 • Antivenom 1Department of Veterinary Clinical Sciences, Oklahoma State University, USA • Equine 2Department of Veterinary Pathobiology, Oklahoma State University, USA • Rattlesnake 3Department of Statistics, Oklahoma State University, USA • Venom Abstract Antivenom treatment of domestic animals is becoming more common following introduction of more veterinary products. The aim of this study was to investigate the ability of a new hyperimmune equine origin antivenina to neutralize the effects of two North American rattlesnake venoms. LD50s were established for two rattlesnake venoms [Western Diamondback rattlesnake (Crotalus atrox) and Mojave rattlesnake (Crotalus scutulatus)] using a murine model and standard methods. An ED50 was established for the product for both venoms using these LD50s. Venom (5x the LD50) and hyperimmune plasma (5 varying doses) were combined and incubated for 30 minutes and administered intraperitoneally. Sickness scores and time to death were recorded during the study period and compared amongst groups in the ED50 studies. The LD50 for the Western Diamondback rattlesnake was 5.567ug/g and Mojave rattlesnake was 0.122ug/g. The ED50 for the Western Diamondback rattlesnake was 16.4mls/kg and the Mojave rattlesnake was 17.3mls/kg. Envenomated mice treated with higher doses of hyperimmune plasma had significantly lower sickness scores (p < 0.05) and lived longer (p < 0.05). The equine hyperimmune plasma product tested in this study was successful at neutralizing lethality up to 48 hours and reducing morbidity when tested against 5 times the LD50 of both venoms in this mouse model. INTRODUCTION Rattlesnake envenomation is not uncommon in domestic is the head, followed by the limbs. In either species, secondary coagulopathies can be severe and life threatening. The mortality in domestic animals can be quite variable. Some of the variability animals and is often clinically significant. Clinical signs in these may be due to the broad range of treatments that are administered animals range from mild tissue swelling to severe coagulopathies, in veterinary practice. Although antivenom has long been the extensive tissue swelling, tissue necrosis and death. The severity treatment of choice for pit viper envenomation in humans [1], its of clinical signs can depend on many factors such as the amount use in veterinary medicine is not as well established. In human of venom injected, the species of snake, time of year, age of the medicine, antivenom has been shown to reduce not only mortality snake and other environmental factors as well as the health of the but also morbidity [2]. In contrast to people, some literature patient envenomated. Rattlesnake venoms are a complex mixture suggests that antivenom may not be beneficial following pit viper of proteins that work together to destroy tissue in an effort to rattlesnake (Crotalus scutulatus) costenvenomations of treatment in oftenveterinary limits patients, its use in and veterinary increases patients both the and cost a digest their prey. Some rattlesnake venoms, such as the Mojave of treatment and the length of hospitalization [3]. This increased , also contain neurotoxins to assist in immobilizing prey. Bites from these snakes can be much cost effective alternative is needed. more rapidly fatal and require immediate intervention. There are three products licensed for use in treating In the horse, the most common bite locations are the envenomation in veterinary patients in addition to the product muzzle or distal limbs. Limb envenomations in horses can lead tested in this study. The productb that has been used the longest to secondary complications such as lameness and subsequent in veterinary medicineCrotalus is an adamanteus, equine derived Crotalus lyophilized atrox, Crotalus serum supportive-limb laminitis. These complications may result in a polyvalent whole IgG product . Venoms used in the production prolonged recovery and even loss of use in some cases. Horses are terrificus, and Bothrops atrox of this product are c obligate nasal breathers therefore bites to the muzzle resulting . A newer productBothrops on the veterinaryalternatus in extensive tissue swelling that occludes the nasal passages market is an equine derived polyvalent F(ab)2 product . Venoms are life threatening. In the dog the most common bite location used in the production of this product are Cite this article: Gilliam LL, Moser DK, Ritchey JW, Payton ME, Cassidy J (2017) Neutralization of the Venom of 2 North American Rattlesnake Venoms by a Hyperimmune Equine Plasma product in Mice. J Pharmacol Clin Toxicol 5(3):1077. Gilliam et al. (2017) Email: Central Bringing Excellence in Open Access or Bothrop sdirorus, Lachesis muta, Crotalusduris susterrificus making serial dilutions. Stock solution was only subject to one or Crotalus simus. Additionally there is a hyperimmune freeze/thaw cycle. All serial dilutions were used immediately and equine plasma productd that can be used to treat rattlesnake were not frozen. envenomation in the horse. This product is produced using Crotalus atrox, Crotalus scutulatus scutulatus and Crotalus viridis Hyperimmune plasma viridis (Table 1). The producta is a hyperimmune equine plasma. The snake Although there are marked similarities in venom composition venoms used in the production of this product were Crotalus across species of rattlesnakes, there are also important atrox (Western Diamondback rattlesnake), Crotalus adamanteus (Eastern Diamondback rattlesnake), Crotalus viridis viridis a) RTLRTM, Mg Biologics, Ames IA (Prairie rattlesnake), and Crotalus scutulatus scutulatus (Mojave a b) Antivenin™, Boehringer-Ingelheim, St. Joseph, MO rattlesnake). The plasma sete was used to aseptically remove 5ml aliquots that were then c) VenomVet™, MT Venom, LLC, Canoga Park, CA frozen at -20°C until use. Plasmawas received was allowed in 100ml to thawbags. at A roomfilter d) Antigen Select Equine HI Plasma (options Western temperature prior to use. All plasma was frozen a minimum of Diamondback, Prairie, and/or Mojave rattlesnakes), Lake 24 hours prior to use and was only subject to two freeze/thaw Immunogenics, Ontario, NY cycles. differences and not all antivenoms neutralize all venoms e) Blood Set, Hospira, Lake Forest, IL equally. For example, a much higher dose of antivenin crotalidae Lethal dose (LD ) polyvalent was required to neutralize Crotalus helleri, a 50 f rattlesnake species similar to Crotalus virdis viridis Equal numbers of 18-20g, male and female mice of the ICR (CD-1) strain were used in this study. Mice were group housed Although there are marked similarities in venom composition by sex 5 per cage in individually ventilated cagesg on 1/8 inch across species of rattlesnakes, there are also important differences corn cob beddingh in a room dedicated to mouse colonies. Mice and not all antivenoms neutralize all venoms equally. For were fed a commercially available, standard dieti free choice and example, a much higher dose of antivenin crotalidae polyvalent given access to ad libitum water. A 12 hr light: dark cycle was was required to neutralize Crotalus helleri, a rattlesnake species maintained with no twilight. Mice were given a minimum 3 day similar to Crotalus virdis viridis [4]. Recent work utilizing acclimation period prior to entering the study. At the end of the proteomics, antivenomics and venomics has shown that there acclimation period mice were randomly assigned to a treatment may be venom composition differences that make a patient more group and marked using non-toxic colored markers. or less likely to respond to a given antivenom treatment [5,6], indicating all antivenoms may not be created equally. For humane reasons in compliance with the Institutional Animal Care and Use Committee’s request, analgesia was The present study evaluated the ability of an equine origin administered to all mice (control and treatment groups) a polyvalent plasma antivenin product produced using Crotalus throughout the study. The analgesia protocol for all mice was; atrox, Crotalus adamanteus, Crotalus viridis viridis, and Crotalus buprenorphinej (0.05 mg/kg subcutaneously) and meloxicamk scutulatus scutulatus to neutralize Crotalus atrox and Crotalus (5 mg/kg subcutaneously) 12 hours prior to receiving each scutulatus scutulatus venoms including the ability to decrease treatment and every 12 hours after until they died or were morbidity using an LD /ED murine model. Although alternative 50 50 euthanized. All mice still surviving at 48 hours after treatment methods are being sought, the LD50/ED50 murine model remains were euthanized using a CO2 chamber. Our hypotheses were that this equine hyperimmune plasma Each lyophilized venom [Western Diamondback Rattlesnake productthe mosta wouldstandard effectively method neutralize for assessing both antivenom venoms characterized efficacy [1]. (Crotalus atrox) and Mojave Rattlesnake (Crotalus scutulatus)], by a dose-dependent increase
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