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A randomized blinded clinical trial of two antivenoms, prepared by caprylic acid or ammonium sulphate fractionation of IgG, in Bothrops and Porthidium snake bites in Colombia: correlation between safety and biochemical characteristics of antivenoms

Artículo científico
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151_1999_Toxicon_Otero_trial_IgG antivenoms.pdf (152.3Kb)
Date
1999-06
Author
Otero Patiño, Rafael
Gutiérrez, José María
Rojas Céspedes, Gustavo
Núñez Rangel, Vitelbina
Díaz, Abel
Miranda, E.
Uribe, A. F.
Silva, Juan F.
Ospina, J. G.
Medina, Y.
Toro, María Fabiola
García, Martha E.
León Montero, Guillermo
García, M.
Lizano González, Sergio
De La Torre, J.
Márquez, J.
Mena, Y.
González, N.
Arenas, L. C.
Puzón, A.
Blanco, N.
Sierra, A.
Espinal, M. E.
Arboleda, Margarita
Jiménez, J. C.
Ramírez, P.
Díaz, M.
Guzmán, M. C.
Barros, J.
Henao, S.
Ramírez, A.
Macea, U.
Lozano, R.
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Abstract
A randomized blinded clinical trial was performed in 53 patients bitten by Bothrops sp. and Porthidium sp. in Antioquia and Chocó, Colombia, in order to compare the efficacy and safety of two antivenoms made of whole IgG obtained by either ammonium sulphate (monovalent anti-B. atrox) or caprylic acid (polyvalent) fractionation. Additionally, antivenoms were compared by electrophoretic and chromatographic analyses and anticomplementary activity in vitro. With a protocol of 2, 4 and 6 antivenom vials for the treatment of mild, moderate and severe envenomings, respectively, both antivenoms were equally efficient to neutralize the most relevant signs of envenoming and to clear serum venom levels in patients from the first hour and later on. Three patients with severe envenoming and initially treated with less than six vials on admission had persistent or recurrent venom antigenemia within 12-48 h. Monovalent antivenom fractionated by ammonium sulphate precipitation had higher amounts of protein aggregates and nonimmunoglobulin proteins than polyvalent antivenom fractionated by caprylic acid precipitation. Both antivenoms presented anticomplementary activity in vitro, being higher in the monovalent product. In agreement, monovalent antivenom induced a significantly higher incidence of early antivenom reactions (52%) than polyvalent antivenom (25%).
URI
http://hdl.handle.net/10669/29452
External link to the item
10.1016/S0041-0101(98)00220-7
http://www.sciencedirect.com/science/article/pii/S0041010198002207
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  • Repositorios universitarios

  • Repositorio del SIBDI-UCR
  • Biblioteca Digital del CIICLA
  • Repositorio Documental Rafael Obregón Loría (CIHAC)
  • Biblioteca Digital Carlos Melendez (CIHAC)
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  • Buscador regional de LA Referencia
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  • Scientific Electronic Library Online (SciELO)
  • Directory of Open Access Journals (DOAJ)
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  • facebook.com/repositoriokerwa
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Contact Us | Send Feedback
Repositorio Institucional de la Universidad de Costa Rica. Algunos derechos reservados. Este repositorio funciona con DSpace.
Universidad de Costa Rica