Introduction

The ‘Big Four’ venomous snakes – Daboia russelii, Naja naja, Bungarus caeruleus, and Echis carinatus – are primarily responsible for the majority of snake envenomation in India. Several other lesser-known venomous snake species also inflict severe envenomation in the country.

Areas covered

A comprehensive analysis of the venom proteome composition of the ‘Big Four’ and other medically important venomous snakes of India and the effect of regional variation in venom composition on immunorecognition and/or neutralization by commercial antivenom was undertaken by searching the literature (from 1985 to date) available in large public databases. Further, mass spectrometric identification of poorly immunogenic toxins of snake venom (against which commercial polyvalent antivenom contains a significantly lower proportion of antibodies) and its impact on antivenom therapy against snakebite are discussed. The application of mass spectrometry to identify protein (toxin) complexes as well as drug prototypes from Indian snake venoms and the clinical importance of such studies are also highlighted.

Expert opinion

Further detailed clinical and proteomic research is warranted to better understand the effects of regional snake venom composition on the clinical manifestation of envenomation and antivenom therapy and to improve the production of antibodies against poorly immunogenic venom components.

中文翻译：

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揭示印度蛇毒液蛋白质组组成的质谱分析：开辟临床研究的新途径。

简介

“四大”毒蛇——Daboia russelii、Naja naja、Bungarus caeruleus和Echis carinatus——是印度大部分蛇毒中毒的主要原因。其他几种鲜为人知的毒蛇也在该国造成严重的毒液中毒。

覆盖区域

通过检索文献（从 1985 年到日期）在大型公共数据库中可用。此外，还讨论了对蛇毒免疫原性较差的毒素（针对这种商业多价抗蛇毒血清含有显着较低比例的抗体）的质谱鉴定及其对抗蛇咬伤的抗蛇毒血清疗法的影响。还强调了质谱法在印度蛇毒中鉴定蛋白质（毒素）复合物和药物原型的应用以及此类研究的临床重要性。

专家意见

需要进一步详细的临床和蛋白质组学研究，以更好地了解区域蛇毒成分对毒液和抗蛇毒治疗的临床表现的影响，并提高针对免疫原性较差的毒液成分的抗体的产生。