ArticlePLoS neglected tropical diseases2020
Pathogenesis of local necrosis induced by Naja atra venom: Assessment of the neutralization ability of Taiwanese freeze-dried neurotoxic antivenom in animal models.
Article in PLoS neglected tropical diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Multidimensional toxicity of snake venom causes multi-organ damage and treatment challenges: a narrative review.Frontiers in pharmacology · 2026Pooled it
- Snakebite Envenoming a Challenging Diagnosis for the Forensic Pathologist: A Systematic Review.Toxins · 2020Pooled it
- Clinical study of anti-snake venom blockade in the treatment of local tissue necrosis caused by Chinese cobra (Naja atra) bites.PLoS neglected tropical diseases · 2022Trial
- Why does local edema persist? Immunological mismatch between phospholipase A2 potency and antivenom affinity in Protobothrops mucrosquamatus envenomation.PLoS neglected tropical diseases · 2026Article
- Cardiotoxin from Naja atra Activates the NLRP3/Caspase-1/GSDMD Pyroptosis Pathway to Induce Skin Tissue Injury.PLoS neglected tropical diseases · 2026Article
- Lactic acid drives NLRP3 inflammasome activation and caspase-1-like cytokine cleavage via intracellular acidification.Cell death & disease · 2026Article
- Targeting cobra venom cytotoxin: a linear 40-mer ssDNA aptamer-based antivenom confers neutralisation potentials against cobra venom-induced cytotoxicity.Archives of toxicology · 2026Article
- Enhancing Deinagkistrodon acutus antivenom potency through acutolysin A-targeted antibody supplementation.PLoS neglected tropical diseases · 2025Article
- Retrospective analysis of clinical and epidemiological characteristics of Chinese cobra bites in a South China emergency department.Scientific reports · 2025Article
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- Free Skin Anterolateral Thigh Flap and Vacuum-Assisted Closure Therapy for Reconstruction of Snakebite-Induced Complex Hand Defects.Therapeutics and clinical risk management · 2025Article
- Review
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- Phage display-derived alpaca nanobodies as potential therapeutics forApplied and environmental microbiology · 2024Article
- Dermonecrosis caused by a spitting cobra snakebite results from toxin potentiation and is prevented by the repurposed drug varespladib.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Repurposed drugs and their combinations prevent morbidity-inducing dermonecrosis caused by diverse cytotoxic snake venoms.Nature communications · 2023Article
- Unveiling the functional epitopes of cobra venom cytotoxin by immunoinformatics and epitope-omic analyses.Scientific reports · 2023Article
- Application of Sonographic Assessments of the Rate of Proximal Progression to MonitorTropical medicine and infectious disease · 2023Article
- Clinical predictors of early surgical intervention in patients with venomous snakebites.European journal of medical research · 2023Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Naja atra envenomation is one of the most significant clinical snakebite concerns in Taiwan. Taiwanese freeze-dried neurotoxic antivenom (FNAV) is currently used clinically for the treatment of cobra snakebite, and has been shown to limit the mortality of cobra envenomation to less than 1%. However, more than half of victims (60%) require surgery because of local tissue necrosis, a major problem in patients with cobra envenomation. Although the importance of evaluating the neutralizing effect of FNAV on this pathology is recognized, whether FNAV is able to prevent the local necrosis extension induced by N. atra venom has not been investigated in detail. Cytotoxins (CTXs) are considered as the major components of N. atra venom that cause necrosis. In the current study, we isolated CTXs from whole cobra venom and used both whole venom and purified CTXs to develop animal models for assessing the neutralization potential of FNAV against venom necrotizing activity. Local necrotic lesions were successfully produced in mice using CTXs in place of whole N. atra venom. FNAV was able to rescue mice from a subcutaneously injected lethal dose of cobra venom; however, it was unable to prevent CTX-induced dermo-necrosis. Furthermore, using the minimal necrosis dose (MND) of CTXs and venom proteome data, we found a dose of whole N. atra venom suitable for FNAV and developed a workable protocol for inducing local necrosis in rodent models that successfully imitated the clinical circumstance of cobra envenoming. This information provides a more comprehensive understanding of the pathophysiology of N. atra envenomation, and serves as a guide for improving current antivenom strategies and advancing clinical snakebite management in Taiwan.
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