Antivenomics and venom phenotyping: A marriage of convenience to address the performance and range of clinical use of antivenoms

Toxins from the same protein family present in venoms from snakes belonging to different genera often share antigenic determinants. A practical consequence of this circumstance is that it might be possible to formulate on an immunologically sound basis a mixture of venoms for generating antivenoms against a wide range of species. A deep insight into the inter- and intraspecific variation of the antigenic constituents of venoms from snakes of different geographic origin represents the key for designing novel polyvalent pan-generic antivenoms. This review illustrates how proteomic protocols ('venomics' and 'anti-venomics') can aid in assessing the crossreactivity of antivenoms against homologous and heterologous venoms, establishing thus the range of clinical application. Recent work showing how the knowledge of evolutionary trends along with venom phenotyping may have an impact in designing a mixture of venoms for immunization aimed to produce a pan-American anti-crotalic antivenom is discussed. (C) 2009 Elsevier Ltd. All rights reserved.