{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:10:06Z","timestamp":1792840206133,"version":"4.5.0"},"reference-count":52,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Australian Research Council Discovery Project DP190100304"},{"name":"Ophirex, Inc., a Public Benefit Corporation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>The African viperid snake genera Atheris, Cerastes, and Proatheris are closely related, similar in size, but occupy extremely divergent ecological niches (arboreal in tropical rainforests, fossorial in deserts, and swamp-dwelling, respectively). Their venoms have not previously been subjected to comparative analyses for their action upon the coagulation of blood, most notably with significant data deficiencies from Atheris and Proatheris. In contrast, the closely related genus Echis is well-documented as capable of producing potent procoagulant effects. In light of this, we set out to compare the coagulotoxic actions of Atheris ceratophora, A. chlorechis, A. desaixi, A. nitschei, A. squamigera, C. cerastes, C. cerastes\u00a0gasperettii, C. vipera, and Proatheris superciliaris and explore potential pharmacological interventions to reestablish normal blood coagulation. All venoms displayed extremely potent procoagulant effects, over twice as fast as the most potent Echis reported to date. Although Cerastes is used in the immunising mixture of two different regionally available antivenoms (Inoserp-MENA with C. cerastes, C. cerastes\u00a0gasperettii, C. vipera and Saudi Arabian polyvalent with C. cerastes), none of the other species in this study are included in the immunising mixture of any antivenom. Notably, all the Cerastes species were only neutralised by the Inoserp-MENA antivenom. C. cerastes venom was not neutralised well by the Saudi Arabian antivenom, with the low levels of recognition for any of the Cerastes venoms suggesting a strong regional variation in the venom of this species, as the C. cerastes venom tested was of African (Tunisian) origin versus Saudi locality used in that antivenom\u2019s production. The other antivenoms (Micropharm EchiTAbG, ICP EchiTAb-Plus-ICP, Inosan Inoserp Pan-Africa, Premium Serums PANAF Sub-Sahara Africa, South African Vaccine Producers Echis, South African Vaccine Producers Polyvalent) all displayed trivial-to-no ability to neutralise the procoagulant toxicity of any of the Atheris, Cerastes, or Proatheris venoms. Comparative testing of the enzyme inhibitors DMPS, marimastat, and prinomastat, revealed a very potent neutralising capacity of marimastat, with prinomastat showing lower but still significant potency at the same molar concentration, while a 5\u00d7 molar concentration of DMPS had no apparent effect on procoagulant venom effects normalized by the other inhibitors. These results and methods contribute to the body of knowledge of potential clinical effects and data necessary for evidence-based advancement of clinical management strategies.<\/jats:p>","DOI":"10.3390\/toxins14120836","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T03:03:41Z","timestamp":1669863821000},"page":"836","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Extreme Procoagulant Potency in Human Plasma of Venoms from the African Viperid Genera Atheris, Cerastes, and Proatheris and the Relative Efficacy of Antivenoms and Synthetic Enzyme-Inhibitors"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4427-1542","authenticated-orcid":false,"given":"Abhinandan","family":"Chowdhury","sequence":"first","affiliation":[{"name":"Venom Evolution Lab, School of Biological Science, University of Queensland, St. Lucia, QLD 4072, Australia"},{"name":"Department of Biochemistry & Microbiology, North South University, Dhaka 1229, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4480-9891","authenticated-orcid":false,"given":"Matthew R.","family":"Lewin","sequence":"additional","affiliation":[{"name":"Ophirex, Inc., Corte Madera, CA 94925, USA"},{"name":"California Academy of Sciences, San Francisco, CA 94118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5977-7338","authenticated-orcid":false,"given":"Rebecca","family":"Carter","sequence":"additional","affiliation":[{"name":"Ophirex, Inc., Corte Madera, CA 94925, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul","family":"Soria","sequence":"additional","affiliation":[{"name":"Inosan Biopharma, 28108 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt","family":"Aldridge","sequence":"additional","affiliation":[{"name":"MicroPharm Limited, Newcastle Emlyn SA38 9BY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6661-1283","authenticated-orcid":false,"given":"Bryan G.","family":"Fry","sequence":"additional","affiliation":[{"name":"Venom Evolution Lab, School of Biological Science, University of Queensland, St. Lucia, QLD 4072, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1371\/journal.pmed.0050218","article-title":"The Global Burden of Snakebite: A Literature Analysis and Modelling Based on Regional Estimates of Envenoming and Deaths","volume":"5","author":"Kasturiratne","year":"2008","journal-title":"PLoS Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Harrison, R.A., Hargreaves, A., Wagstaff, S.C., Faragher, B., and Lalloo, D.G. 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