Toxinology of Snake Venoms: The Malaysian Context

Abstract

Venomous snakes native in Malaysia include the elapids (cobras, king cobra, kraits, coral snakes, sea snakes) and crotalids (Malayan pit viper, Asian lance-headed pit vipers). The elapid venoms are typically neurotoxic, while the crotalid venoms are usually hemorrhagic, coagulopathic, and necrotizing. Among the elapids, cobra and king cobra venoms produce pain and tissue-necrotizing effect, whereas sea snake venoms can cause rhabdomyolysis and acute kidney injury. Venom compositions greatly vary from species to species, resulting in differences in the clinical presentation of envenomation by different species and the varied effectiveness of antivenoms on different venoms. In Malaysia, research activities on snakes have been carried out since the 1960s; through these years venoms have been subjected to multifaceted characterizations where knowledge on toxin variants and compositions, envenoming pathophysiology, venom pharmacokinetics-pharmacodynamics, as well as antivenom neutralization had been greatly advanced. The knowledge is indispensable for improving clinical protocol on snakebite assessment and to guide on the appropriate type of antivenoms to stock in local hospitals for clinical use. This is especially important for Malaysia, where antivenoms are supplied by manufacturers from overseas without a clear standardization for the selection of antivenom source. Until today, there are research gaps and repertoires for scientists to further explore. These include proteomic profiling of venoms and venom gland transcriptomics for local species, antivenomics, antivenom formulation optimization, and so on.