Role of toxin-specific antibody fragments in the treatment of acute poisoning.
Poisoning treatment in early years was not quite effective and in some cases used to be a highly toxic. Over the last 25 years, more effective and potentially less toxic therapies have been developed. The antidotes currently produced are specific and are employed in a variety of biochemical strategies, such as preventing production of toxic metabolites, exerting direct antagonistic effects against the poison, or binding to the poison to make it ineffective or enhance its elimination. Antibody therapy is also currently available to manage toxicity caused by certain venoms, cardiac glycosides, clostridial toxin, and colchicines [1]. Although the number of antidotes that are specific for certain drugs or poisons is limited, when used in the correct setting, they can be life saving. .
Specific antibody fragments may be the future in treating acute poisoning caused by venoms. In 1894 Calmette prepared the first antivenom based on earlier studies relating to the treatment of diphtheria and tetanus [2]. More than a century has gone by, but this is still the only specific treatment for envenoming. Almost all antivenom producers worldwide are trying to isolate and concentrate on the improvement of antivenom antibodies and their enzymatically derived fragments, which were originally developed by Pope in 1938. A few alternatives have been stated to produce fragments or Fab antivenoms, which improve their purity, neutralizing (venoms) potency, and safety. Majority of producers have introduced an enzymatic digestion step in their antivenom purification procedures to split the Fc portion of the IgG molecule that is thought to be responsible for allergic side effects. Improvements in the production of antibody fragments (purity and efficacy) have resulted in the increased concentration of toxin-specific fragments, with no side effects when used intravenously and a high neutralising ability.