Diagnostic use of snake venom components in the coagulation laboratory

Abstract

For almost every factor involved in haemostasis there exists a snake venom protein that can mimic, activate or deactivate it. Many of these compounds are insensitive to the physiological and therapeutically used coagulation inhibitors and, because of their unique features, are applied as molecular tools for diagnosis of haemostatic disorders. Different snake venom proteins are nowadays widely used in the coagulation laboratory and have facilitated extensively the routine assays of haemostatic parameters and understanding of basic biological mechanisms involved in the clotting and fibrinolysis processes. Some of these routine applications have been adopted as the preferred option of the diagnostic tests. The following parameters can be tested by means of snake venom components: antithrombin III, fibrinogen, its breakdown products and its dysfunctions, prothrombin and dysprothrombinaemias, blood clotting factors V, VII and X, lupus anticoagulants, protein C and its pathway, as well as activated protein C resistance, von Willebrand factor (vWF) and related syndromes. Further, immediately acting anticoagulants, such as heparins and direct thrombin inhibitors, which are among the most frequently applied drugs, can be monitored by an assay using snake venom enzyme. Ongoing research leads to isolation and characterization of new snake venom components, which are potential tools for future applications in the field of haemostasis, in diagnostic as well as in therapeutic approaches.