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

Development of a lateral flow assay for stratification of venom from Brazilian snake genera (#32)

Cecilie Knudsen 1 2 , Aleksander M. Haack 1 , Jonas A. Jürgensen 1 , Rasmus U. W. Friis 1 , Søren H. Dam 1 , Andreas H. Laustsen 1
  1. Bioengineering, Technical University of Denmark, Kgs. Lyngby, Hovedstadsområdet, Danmark
  2. BioPorto Diagnostics, Hellerup, Hovedstadsområdet, Denmark

Snakebite envenoming is a Neglected Tropical Disease, which annually destroys millions of lives, causing significant morbidity and mortality. Nobody knows the exact extent of this disease, as epidemiological data is notoriously difficult to come by, and a large dark figure of unreported snakebites is suspected to exist. Snakebite envenoming is typically diagnosed via a syndromic approach and treated with either monovalent antivenom (if the snake species is known) or polyvalent antivenom (if it is not). In this work, we discuss design considerations of snakebite diagnostics, including the pros and cons of various technological platforms and sample matrices. Furthermore, we describe our own efforts to develop such a diagnostic in the form of a lateral flow assay-based diagnostic tool capable of measuring the presence of snake venom toxins in two different sample matrices. We have raised more than a hundred monoclonal antibodies against venoms from Brazillian snakes, and thoroughly evaluated their binding profiles on representative venoms. The most promising antibodies were selected and modified for use in a lateral flow assay. The assay conditions were optimised to minimise background signal, and preliminary limits of detection were established in mock-up wound swab samples and human serum spiked with venom, respectively. Once optimised and evaluated with real patient samples, we envisage the diagnostic tool to be able to support clinicians in diagnosing snakebites, warning them to expect an envenoming before clinical manifestations become apparent and aiding them in choosing the most appropriate course of treatment (e.g. antivenom). Through use in epidemiological studies, such a tool might also guide antivenom developers in evaluating which snake venoms to include in future antivenoms and decision makers in deciding where to deploy antivenoms within a healthcare system.