{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:10:03Z","timestamp":1792840203208,"version":"4.5.0"},"reference-count":64,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2016,8,25]],"date-time":"2016-08-25T00:00:00Z","timestamp":1472083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Snakebite remains a neglected medical problem of the developing world with up to 125,000 deaths each year despite more than a century of calls to improve snakebite prevention and care. An estimated 75% of fatalities from snakebite occur outside the hospital setting. Because phospholipase A2 (PLA2) activity is an important component of venom toxicity, we sought candidate PLA2 inhibitors by directly testing drugs. Surprisingly, varespladib and its orally bioavailable prodrug, methyl-varespladib showed high-level secretory PLA2 (sPLA2) inhibition at nanomolar and picomolar concentrations against 28 medically important snake venoms from six continents. In vivo proof-of-concept studies with varespladib had striking survival benefit against lethal doses of Micrurus fulvius and Vipera berus venom, and suppressed venom-induced sPLA2 activity in rats challenged with 100% lethal doses of M. fulvius venom. Rapid development and deployment of a broad-spectrum PLA2 inhibitor alone or in combination with other small molecule inhibitors of snake toxins (e.g., metalloproteases) could fill the critical therapeutic gap spanning pre-referral and hospital setting. Lower barriers for clinical testing of safety tested, repurposed small molecule therapeutics are a potentially economical and effective path forward to fill the pre-referral gap in the setting of snakebite.<\/jats:p>","DOI":"10.3390\/toxins8090248","type":"journal-article","created":{"date-parts":[[2016,8,25]],"date-time":"2016-08-25T10:11:44Z","timestamp":1472119904000},"page":"248","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":216,"title":["Varespladib (LY315920) Appears to Be a Potent, Broad-Spectrum, Inhibitor of Snake Venom Phospholipase A2 and a Possible Pre-Referral Treatment for Envenomation"],"prefix":"10.3390","volume":"8","author":[{"given":"Matthew","family":"Lewin","sequence":"first","affiliation":[{"name":"Research and Development, Ophirex, Inc., Corte Madera, CA 94925, USA"},{"name":"Center for Exploration and Travel Health, California Academy of Sciences, San Francisco, CA 94118, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Samuel","sequence":"additional","affiliation":[{"name":"General Medicine, Queen Elizabeth Hospital, King\u2019s Lynn, Norfolk PE30 4ET, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janie","family":"Merkel","sequence":"additional","affiliation":[{"name":"Yale Center for Molecular Discovery, Yale University, West Haven, CT 06516, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Bickler","sequence":"additional","affiliation":[{"name":"Anesthesia and Perioperative Care, University of California, San Francisco, CA 94143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2016,8,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Mohapatra, B., Warrell, D.A., Suraweera, W., Bhatia, P., Dhingra, N., Jotkar, R.M., Rodriguez, P.S., Mishra, K., Whitaker, R., and Jha, P. (2011). Snakebite mortality in India: A nationally representative mortality survey. PLoS Negl. Trop. Dis., 5.","DOI":"10.1371\/journal.pntd.0001018"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2174\/1381612822666160623073438","article-title":"From Fangs to Pharmacology: The Future of Snakebite Envenoming Therapy","volume":"22","author":"Laustsen","year":"2016","journal-title":"Curr. Pharm. Des."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"234","DOI":"10.4269\/ajtmh.2004.71.234","article-title":"Impact of snake bites and determinants of fatal outcomes in southeastern Nepal","volume":"71","author":"Sharma","year":"2004","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"9205","DOI":"10.1073\/pnas.1405484111","article-title":"Medically important differences in snake venom composition are dictated by distinct postgenomic mechanisms","volume":"111","author":"Casewell","year":"2014","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.toxicon.2011.11.005","article-title":"Venom of Bothrops asper from Mexico and Costa Rica: Intraspecific variation and cross-neutralization by antivenoms","volume":"59","author":"Segura","year":"2012","journal-title":"Toxicon"},{"key":"ref_6","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\u2019)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_7","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jprot.2014.11.011","article-title":"Venomics and antivenomics of Bothrops erythromelas from five geographic populations within the Caatinga ecoregion of northeastern Brazil","volume":"114","author":"Jorge","year":"2015","journal-title":"J. Proteom."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Alirol, E., Lechevalier, P., Zamatto, F., Chappuis, F., Alcoba, G., and Potet, J. (2015). Antivenoms for Snakebite Envenoming: What Is in the Research Pipeline?. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003896"},{"key":"ref_9","first-page":"503","article-title":"Neostigmine in the treatment of Elapidae bites","volume":"20","author":"Banerjee","year":"1972","journal-title":"J. Assoc. Phys. India"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1056\/NEJM198612043152303","article-title":"Positive response to edrophonium in patients with neurotoxic envenoming by cobras (Naja naja philippinensis). A placebo-controlled study","volume":"315","author":"Watt","year":"1986","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"522","DOI":"10.5694\/j.1326-5377.1988.tb99464.x","article-title":"Resolution of neurotoxicity with anticholinesterase therapy in death-adder envenomation","volume":"148","author":"Currie","year":"1988","journal-title":"Med. J. Aust."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/0035-9203(90)90297-R","article-title":"Envenoming by the common krait (Bungarus caeruleus) and Sri Lankan cobra (Naja naja naja): Efficacy and complications of therapy with Haffkine antivenom","volume":"84","author":"Theakston","year":"1990","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Ranawaka, U.K., Lalloo, D.G., and de Silva, H.J. (2013). Neurotoxicity in snakebite-the limits of our knowledge. PLoS Negl. Trop. Dis., 7.","DOI":"10.1371\/journal.pntd.0002302"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Vaiyapuri, S., Harrison, R.A., Bicknell, A.B., Gibbins, J.M., and Hutchinson, G. (2010). Purification and functional characterisation of rhinocerase, a novel serine protease from the venom of Bitis gabonica rhinoceros. PLoS ONE, 5.","DOI":"10.1371\/journal.pone.0009687"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Vaiyapuri, S., Wagstaff, S.C., Harrison, R.A., Gibbins, J.M., and Hutchinson, E.G. (2011). Evolutionary analysis of novel serine proteases in the venom gland transcriptome of Bitis gabonica rhinoceros. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0021532"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"763","DOI":"10.6026\/97320630008563","article-title":"Sequence and phylogenetic analysis of viper venom serine proteases","volume":"8","author":"Vaiyapuri","year":"2012","journal-title":"Bioinformation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.toxicon.2006.11.020","article-title":"Neutralization of the haemorrhagic activities of viperine snake venoms and venom metalloproteinases using synthetic peptide inhibitors and chelators","volume":"49","author":"Howes","year":"2007","journal-title":"Toxicon"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1080\/07391102.2014.963146","article-title":"Identification of potent inhibitors against snake venom metalloproteinase (SVMP) using molecular docking and molecular dynamics studies","volume":"33","author":"Chinnasamy","year":"2015","journal-title":"J. Biomol. Struct. Dyn."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.toxicon.2014.11.224","article-title":"Inhibitory potential of three zinc chelating agents against the proteolytic, hemorrhagic, and myotoxic activities of Echis carinatus venom","volume":"93","author":"Urs","year":"2015","journal-title":"Toxicon"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.toxicon.2004.01.016","article-title":"Effect of the metalloproteinase inhibitor batimastat in the systemic toxicity induced by Bothrops asper snake venom: Understanding the role of metalloproteinases in envenomation","volume":"43","author":"Rucavado","year":"2004","journal-title":"Toxicon"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jprot.2010.12.002","article-title":"High resolution analysis of snake venom metalloproteinase (SVMP) peptide bond cleavage specificity using proteome based peptide libraries and mass spectrometry","volume":"74","author":"Escalante","year":"2011","journal-title":"J. Proteom."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Fernandes, C.A., Cardoso, F.F., Cavalcante, W.G., Soares, A.M., Dal-Pai, M., Gallacci, M., and Fontes, M.R. (2015). Structural Basis for the Inhibition of a Phospholipase A2-Like Toxin by Caffeic and Aristolochic Acids. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0133370"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1016\/0041-0101(95)00100-X","article-title":"The effects of two phospholipase A2 inhibitors on the neuromuscular blocking activities of homologous phospholipases A2 from the venom of Pseudechis australis, the Australian king brown snake","volume":"33","author":"Fatehi","year":"1995","journal-title":"Toxicon"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"743","DOI":"10.2174\/156802607780487614","article-title":"Snake venom phospholipase A2 inhibitors: Medicinal chemistry and therapeutic potential","volume":"7","author":"Marcussi","year":"2007","journal-title":"Curr. Top. Med. Chem."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"787","DOI":"10.2174\/156802607780487678","article-title":"Chemistry and structural evaluation of different phospholipase A2 inhibitors in arachidonic acid pathway mediated inflammation and snake venom toxicity","volume":"7","author":"Ponnappa","year":"2007","journal-title":"Curr. Top. Med. Chem."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1002\/jmr.2492","article-title":"Virtual analysis of structurally diverse synthetic analogs as inhibitors of snake venom secretory phospholipase A2","volume":"29","author":"Sivaramakrishnan","year":"2016","journal-title":"J. Mol. Recognit."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1055\/s-0030-1254053","article-title":"Snakebite doesn\u2019t cause disseminated intravascular coagulation: Coagulopathy and thrombotic microangiopathy in snake envenoming","volume":"36","author":"Isbister","year":"2010","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2128","DOI":"10.1016\/j.jprot.2012.01.006","article-title":"Comparative proteomic analysis of the venom of the taipan snake, Oxyuranus scutellatus, from Papua New Guinea and Australia: Role of neurotoxic and procoagulant effects in venom toxicity","volume":"75","author":"Herrera","year":"2012","journal-title":"J. Proteom."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.toxicon.2012.11.001","article-title":"Effect of Australian elapid venoms on blood coagulation: Australian Snakebite Project (ASP-17)","volume":"61","author":"Gulati","year":"2013","journal-title":"Toxicon"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.thromres.2013.09.004","article-title":"Point-of-care derived INR does not reliably detect significant coagulopathy following Australian snakebite","volume":"132","author":"Correlje","year":"2013","journal-title":"Thromb. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/0035-9203(89)90301-5","article-title":"Comparison of Tensilon\u00ae and antivenom for the treatment of cobra-bite paralysis","volume":"83","author":"Watt","year":"1989","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"6130","DOI":"10.1021\/cr200085w","article-title":"Phospholipase A2 enzymes: Physical structure, biological function, disease implication, chemical inhibition, and therapeutic intervention","volume":"111","author":"Dennis","year":"2011","journal-title":"Chem. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.toxicon.2014.07.010","article-title":"Intravascular hemolysis induced by the venom of the Eastern coral snake, Micrurus fulvius, in a mouse model: Identification of directly hemolytic phospholipases A2","volume":"90","author":"Lomonte","year":"2014","journal-title":"Toxicon"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.jprot.2016.02.006","article-title":"Integrative characterization of the venom of the coral snake Micrurus dumerilii (Elapidae) from Colombia: Proteome, toxicity, and cross-neutralization by antivenom","volume":"136","author":"Nunez","year":"2016","journal-title":"J. Proteom."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Vergara, I., Castillo, E.Y., Romero-Pi\u00f1a, M.E., Torres-Viquez, I., Paniagua, D., Boyer, L.V., Alag\u00f3n, A., and Medina, L.A. (2016). Biodistribution and Lymphatic Tracking of the Main Neurotoxin of Micrurus fulvius Venom by Molecular Imaging. Toxins, 8.","DOI":"10.3390\/toxins8040085"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1136\/emj.13.5.346","article-title":"Incidence, pathology, and treatment of adder (Vipera berus L.) bites in man","volume":"13","author":"Reading","year":"1996","journal-title":"J. Accid. Emerg. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1024\/0301-1526\/a000029","article-title":"Proximal lower limb vein thrombosis following Vipera berus hand bite","volume":"39","author":"Gary","year":"2010","journal-title":"VASA Z. Gefasskrankh."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Lervik, J.B., Lilliehook, I., and Frendin, J.H. (2010). Clinical and biochemical changes in 53 Swedish dogs bitten by the European adder\u2014Vipera berus. Acta Vet. Scand., 52.","DOI":"10.1186\/1751-0147-52-26"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.neuro.2010.11.007","article-title":"First clinical experiences about the neurotoxic envenomings inflicted by lowland populations of the Balkan adder, Vipera berus bosniensis","volume":"32","author":"Malina","year":"2011","journal-title":"Neurotoxicology"},{"key":"ref_40","unstructured":"Honge, B.L., Hedegaard, S.K., Cederstrom, S., and Nielsen, H. (2015). Hospital Contacts after Bite by the European Adder (Vipera berus). Dan. Med. J., 61, Available online: http:\/\/www.danmedj.dk\/portal\/pls\/portal\/!PORTAL.wwpob_page.show?_docname=10693350.PDF."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1177\/0394632015572566","article-title":"Snake (Vipera berus) bite: The cause of severe anaphylactic shock and hepatocellular injury","volume":"28","author":"Palgan","year":"2015","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1136\/vr.162.20.652","article-title":"Effects of bites by the European adder (Vipera berus) in seven Swedish horses","volume":"162","author":"Anlen","year":"2008","journal-title":"Vet. Rec."},{"key":"ref_43","unstructured":"Lewin, M.R. (2016). Envenomation Therapies and Related Pharmaceutical Compositions, Systems and Kits: USPTO: PCT\/US2015\/061834, Ophirex, Inc."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Katkar, G.D., Sundaram, M.S., NaveenKumar, S.K., Swethakumar, B., Sharma, R.D., Paul, M., Vishalakshi, G.J., Devaraja, S., Girish, K.S., and Kemparaju, K. (2016). NETosis and lack of DNase activity are key factors in Echis carinatus venom-induced tissue destruction. Nat. Commun., 7.","DOI":"10.1038\/ncomms11361"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"(2011). Varespladib. Am. J. Cardiovasc. Drugs, 11, 137\u2013143.","DOI":"10.2165\/11533650-000000000-00000"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1097\/01.CCM.0000053648.42884.89","article-title":"Efficacy and safety of LY315920Na\/S-5920, a selective inhibitor of 14-kDa group IIA secretory phospholipase A2, in patients with suspected sepsis and organ failure","volume":"31","author":"Abraham","year":"2003","journal-title":"Crit. Care Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1097\/01.CCM.0000171540.54520.69","article-title":"LY315920NA\/S-5920, a selective inhibitor of group IIA secretory phospholipase A2, fails to improve clinical outcome for patients with severe sepsis","volume":"33","author":"Zeiher","year":"2005","journal-title":"Crit. Care Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s10557-011-6344-2","article-title":"Anti-inflammatory effects of varespladib methyl in diabetic patients with acute coronary syndrome","volume":"25","author":"Rosenson","year":"2011","journal-title":"Cardiovasc. Drugs Ther."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1001\/jama.2013.282836","article-title":"Varespladib and cardiovascular events in patients with an acute coronary syndrome: The VISTA-16 randomized clinical trial","volume":"311","author":"Nicholls","year":"2014","journal-title":"JAMA"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Hamza, M., Lamorde, M., Dalhat, M.M., Habib, Z.G., and Kuznik, A. (2016). Cost-Effectiveness of Antivenoms for Snakebite Envenoming in 16 Countries in West Africa. PLoS Negl. Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004568"},{"key":"ref_51","unstructured":"Herzel, B. (2015). Snakebite in Southern India: A Threshold Cost-Effectiveness Analysis. [Master\u2019s Thesis, University of California San Francisco]."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1146\/annurev.genom.9.081307.164356","article-title":"The toxicogenomic multiverse: Convergent recruitment of proteins into animal venoms","volume":"10","author":"Fry","year":"2009","journal-title":"Annu. Rev. Genom. Hum. Genet."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1042\/bj3060167","article-title":"Phospholipase A2 from plasma of patients with septic shock is associated with high-density lipoproteins and C3 anaphylatoxin: Some implications for its functional role","volume":"306 Pt 1","author":"Gijon","year":"1995","journal-title":"Biochem. J."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/0305-0491(92)90029-Q","article-title":"The biological properties of venoms of some American coral snakes (Genus micrurus)","volume":"101","author":"Tan","year":"1992","journal-title":"Comp. Biochem. Physiol. B Comp. Biochem."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1590\/S0036-46652006000300005","article-title":"Bites by coral snakes (Micrurus spp.) in Campinas, State of Sao Paulo, Southeastern Brazil","volume":"48","author":"Bucaretchi","year":"2006","journal-title":"Rev. Inst. Med. Trop. Sao Paulo"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Tanaka, G.D., Furtado Mde, F., Portaro, F.C., Sant\u2019Anna, O.A., and Tambourgi, D.V. (2010). Diversity of Micrurus snake species related to their venom toxic effects and the prospective of antivenom neutralization. PLoS Negl. Trop. Dis., 4.","DOI":"10.1371\/journal.pntd.0000622"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Tanaka, G.D., Pidde-Queiroz, G., de Fatima, D.F.M., van den Berg, C., and Tambourgi, D.V. (2012). Micrurus snake venoms activate human complement system and generate anaphylatoxins. BMC Immunol., 13.","DOI":"10.1186\/1471-2172-13-4"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1016\/S0041-0101(97)00031-7","article-title":"Toxins isolated from the venom of the Brazilian coral snake (Micrurus frontalis frontalis) include hemorrhagic type phospholipases A2 and postsynaptic neurotoxins","volume":"35","author":"Francis","year":"1997","journal-title":"Toxicon"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S0041-0101(02)00213-1","article-title":"Purification and characterization of an anticoagulant phospholipase A(2) from Indian monocled cobra (Naja kaouthia) venom","volume":"41","author":"Doley","year":"2003","journal-title":"Toxicon"},{"key":"ref_60","first-page":"31","article-title":"Biochemical and biological characterization of Naja kaouthia venom from North-East India and its neutralization by polyvalent antivenom","volume":"4","author":"Das","year":"2013","journal-title":"J. Venom Res."},{"key":"ref_61","first-page":"38","article-title":"New approaches & technologies of venomics to meet the challenge of human envenoming by snakebites in India","volume":"138","author":"Warrell","year":"2013","journal-title":"Indian J. Med. Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.toxicon.2015.09.027","article-title":"Evaluation of the preclinical efficacy of four antivenoms, distributed in sub-Saharan Africa, to neutralize the venom of the carpet viper, Echis ocellatus, from Mali, Cameroon, and Nigeria","volume":"106","author":"Sanchez","year":"2015","journal-title":"Toxicon"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.toxicon.2016.06.022","article-title":"Preclinical evaluation of three polyspecific antivenoms against the venom of Echis ocellatus: Neutralization of toxic activities and antivenomics","volume":"119","author":"Calvete","year":"2016","journal-title":"Toxicon"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Maduwage, K., Buckley, N.A., de Silva, H.J., Lalloo, D.G., and Isbister, G.K. (2015). Snake antivenom for snake venom induced consumption coagulopathy. Cochrane Database Syste. Rev., 6.","DOI":"10.1002\/14651858.CD011428.pub2"}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/8\/9\/248\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:29:11Z","timestamp":1760210951000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/8\/9\/248"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8,25]]},"references-count":64,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2016,9]]}},"alternative-id":["toxins8090248"],"URL":"https:\/\/doi.org\/10.3390\/toxins8090248","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8,25]]}}}