{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T17:53:25Z","timestamp":1773942805647,"version":"3.50.1"},"reference-count":20,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2016,4,28]],"date-time":"2016-04-28T00:00:00Z","timestamp":1461801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1061041"],"award-info":[{"award-number":["1061041"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1055176"],"award-info":[{"award-number":["1055176"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Venom detection is crucial for confirmation of envenomation and snake type in snake-bite patients. Enzyme immunoassay (EIA) is used to detect venom, but antivenom in samples prevents venom detection. We aimed to detect snake venom in post-antivenom samples after dissociating venom-antivenom complexes with glycine-HCl (pH 2.2) and heating for 30 min at 950 \u00b0C. Serum samples underwent dissociation treatment and then Russell\u2019s viper venom or Australian elapid venom measured by EIA. In confirmed Russell\u2019s viper bites with venom detected pre-antivenom (positive controls), no venom was detected in untreated post-antivenom samples, but was after dissociation treatment. In 104 non-envenomed patients (negative controls), no venom was detected after dissociation treatment. In suspected Russell\u2019s viper bites, ten patients with no pre-antivenom samples had venom detected in post-antivenom samples after dissociation treatment. In 20 patients with no venom detected pre-antivenom, 13 had venom detected post-antivenom after dissociation treatment. In another 85 suspected Russell\u2019s viper bites with no venom detected pre-antivenom, 50 had venom detected after dissociation treatment. Dissociation treatment was also successful for Australian snake envenomation including taipan, mulga, tiger snake and brown snake. Snake venom can be detected by EIA in post-antivenom samples after dissociation treatment allowing confirmation of diagnosis of envenomation post-antivenom.<\/jats:p>","DOI":"10.3390\/toxins8050130","type":"journal-article","created":{"date-parts":[[2016,4,28]],"date-time":"2016-04-28T10:25:55Z","timestamp":1461839155000},"page":"130","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Detection of Snake Venom in Post-Antivenom Samples by Dissociation Treatment Followed by Enzyme Immunoassay"],"prefix":"10.3390","volume":"8","author":[{"given":"Kalana","family":"Maduwage","sequence":"first","affiliation":[{"name":"Clinical Toxicology Research Group, University of Newcastle, Newcastle 2298, Australia"},{"name":"South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka"},{"name":"Department of Biochemistry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"O\u2019Leary","sequence":"additional","affiliation":[{"name":"Clinical Toxicology Research Group, University of Newcastle, Newcastle 2298, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9968-3707","authenticated-orcid":false,"given":"Anjana","family":"Silva","sequence":"additional","affiliation":[{"name":"Monash Venom Group, Monash University, Melbourne 3168, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1519-7419","authenticated-orcid":false,"given":"Geoffrey","family":"Isbister","sequence":"additional","affiliation":[{"name":"Clinical Toxicology Research Group, University of Newcastle, Newcastle 2298, Australia"},{"name":"South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2016,4,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kasturiratne, A., Wickremasinghe, A.R., de Silva, N., Gunawardena, N.K., Pathmeswaran, A., Premaratna, R., Savioli, L., Lallo, D.G., and de Silva, H.J. (2008). The global burden of snakebite: A literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Med., 5.","DOI":"10.1371\/journal.pmed.0050218"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"593","DOI":"10.4269\/ajtmh.1992.47.593","article-title":"Use of enzyme immunoassays to compare the effect and assess the dosage regimens of three Brazilian Bothrops antivenoms. The Butantan Institute Antivenom Study Group (BIASG)","volume":"47","author":"Theakston","year":"1992","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Isbister, G.K., Shahmy, S., Mohamed, F., Abeysinghe, C., Karunathilake, H., and Ariaratnam, A. (2012). A randomised controlled trial of two infusion rates to decrease reactions to antivenom. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0038739"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1111\/jth.12218","article-title":"A randomized controlled trial of fresh frozen plasma for treating venom-induced consumption coagulopathy in cases of Australian snakebite (ASP-18)","volume":"11","author":"Isbister","year":"2013","journal-title":"J. Thromb. Haemost."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Maduwage, K., O\u2019Leary, M.A., Scorgie, F.E., Shahmy, S., Mohamed, F., Abeysinghe, C., Karunathilake, H., Lincz, L.F., Gnanathasan, C.A., and Isbister, G.K. (2014). Detection of venom after antivenom is not associated with persistent coagulopathy in a prospective cohort of Russell\u2019s Viper (Daboia russelii) envenomings. PLoS Negl. Trop. Dis., 8.","DOI":"10.1371\/journal.pntd.0003304"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1093\/jaoac\/89.5.1360","article-title":"Quantitation of Indian krait (Bungarus caeruleus) venom in human specimens of forensic origin by indirect competitive inhibition enzyme-linked immunosorbent assay","volume":"89","author":"Brunda","year":"2006","journal-title":"J. AOAC Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1016\/j.toxicon.2010.03.003","article-title":"Development of a sensitive enzyme immunoassay for measuring taipan venom in serum","volume":"55","author":"Kulawickrama","year":"2010","journal-title":"Toxicon"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.toxicon.2013.11.001","article-title":"Detection of venom-antivenom (VAV) immunocomplexes in vitro as a measure of antivenom efficacy","volume":"77","author":"Isbister","year":"2014","journal-title":"Toxicon"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.toxicon.2014.11.221","article-title":"Detection of venom after antivenom administration is largely due to bound venom","volume":"93","author":"Maduwage","year":"2015","journal-title":"Toxicon"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Silva, A., Maduwage, K., Sedgwick, M., Pilapitiya, S., Weerawansa, P., Dahanayaka, N.J., Buckley, N.A., Siribaddana, S., and Isbister, G.K. (2016). Neurotoxicity in Russell\u2019s viper (Daboia russelii) envenoming in Sri Lanka: A clinical and neurophysiological study. Clin. Toxicol. (Phila).","DOI":"10.3109\/15563650.2016.1143556"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1128\/CVI.00409-08","article-title":"Improved detection of Histoplasma antigenemia following dissociation of immune complexes","volume":"16","author":"Swartzentruber","year":"2009","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1128\/CVI.00227-09","article-title":"Detection of Coccidioides antigenemia following dissociation of immune complexes","volume":"16","author":"Durkin","year":"2009","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/S0022-1759(98)00107-0","article-title":"A simple and robust method for the complete dissociation of HIV-1 p24 and other antigens from immune complexes in serum and plasma samples","volume":"217","author":"Steindl","year":"1998","journal-title":"J. Immunol. Method"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/S0753-3322(97)89279-7","article-title":"Antigen\/antibody content of circulating immune complexes in HIV-infected patients","volume":"50","author":"Stanojevic","year":"1996","journal-title":"Biomed. Pharmacother."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.jim.2005.06.014","article-title":"An acid dissociation bridging ELISA for detection of antibodies directed against therapeutic proteins in the presence of antigen","volume":"304","author":"Patton","year":"2005","journal-title":"J. Immunol. Method."},{"key":"ref_16","first-page":"513","article-title":"Comparison of an amplified enzyme-linked immunosorbent assay with procedures based on molecular biology for assessing human immunodeficiency virus type 1 viral load","volume":"5","author":"Goldschmidt","year":"1998","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1111\/j.1471-4159.2008.05477.x","article-title":"Antigen-antibody dissociation in Alzheimer disease: A novel approach to diagnosis","volume":"106","author":"Gustaw","year":"2008","journal-title":"J. Neurochem."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Isbister, G.K., Maduwage, K., Saiao, A., Buckley, N.A., Jayamanne, S.F., Seyed, S., Mohamed, F., Chathuranga, U., Mendes, A., and Abeysinghe, C. (2015). Population pharmacokinetics of an indian f(ab\u2032)2 snake antivenom in patients with Russell\u2019s Viper (Daboia russelii) bites. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003873"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"183","DOI":"10.5694\/j.1326-5377.2009.tb02736.x","article-title":"Envenoming by the rough-scaled snake (Tropidechis carinatus): A series of confirmed cases","volume":"191","author":"Gan","year":"2009","journal-title":"Med. J. Aust."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Allen, G.E., Brown, S.G., Buckley, N.A., O\u2019Leary, M.A., Page, C.B., Currie, B.J., White, J., and Isbister, G.K. (2012). Clinical effects and antivenom dosing in Brown snake (Pseudonaja spp.) Envenoming-Australian Snakebite Project (ASP-14). PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0053188"}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/8\/5\/130\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:22:59Z","timestamp":1760210579000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/8\/5\/130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,4,28]]},"references-count":20,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2016,5]]}},"alternative-id":["toxins8050130"],"URL":"https:\/\/doi.org\/10.3390\/toxins8050130","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,4,28]]}}}