Oral Presentation: 20 minutes 11th Asia-Pacific Congress of the International Society on Toxinology 2021

The efficacy of chemically diverse small-molecule inhibitors against anticoagulant African spitting cobra (Naja species) venoms. (#11)

Abhinandan ACH Chowdhury 1 , Matthew R. MRL Lewin 2 , Christina CNZ Zdenek 1 , Rebecca RC Carter 3 , Bryan BGF Fry 1
  1. Venom Evolution Lab, University of Queensland School, Brisbane, QLD, Australia
  2. Ophirex, Inc., Corte Madera, California, USA
  3. California Academy of Sciences, San Francisco, California, USA

African spitting cobras are unique amongst cobras in their potent anticoagulant venom activity via the strong inhibition of Factor Xa exerted by phospholipase A2 (PLA2) toxins. This clinically relevant pathophysiological action contributes to the lethality of this species due to escaping neutralisation by available antivenom. However, previous work demonstrated varespladib was able to neutralize this toxic action but only a single high concentration of varespladib was tested. The present work builds upon this previous work by testing the efficacy of varespladib at a lower concentration level against the African spitting cobra species Naja ashei, N. katiensis, N. mossambica, N. nigricincta, N. nigricollis, N. nubiae, and N. pallida. In addition, building on a previous study that suggested an unexpected cross-reactivity of the metalloprotease inhibitor prinomastat with PLA2, we also showed that prinomastat (and to a lesser extent, marimastat) inhibited the FXa-inhibiting PLA2 toxins. Due to logistical (cold-chain requirement) and efficacy (cross-reactivity across snake species) limitations of traditional antivenoms, particularly in developing countries where snakebite is most common, these small molecule inhibitors (SMIs) hold great promise as primary, field-based treatments for snakebite.