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King Cobra and snakebite envenomation: On the natural history, human-snake relationship and medical importance of Ophiophagus hannah

King Cobra (Ophiophagus hannah) has a significant place in many cultures, and is a medically important venomous snake in the world. Envenomation by this snake is highly lethal, manifested mainly by neurotoxicity and local tissue damage. King Cobra may be part of a larger species complex, and is wide...

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Main Authors:	Tan, Choo Hock, Bourges, Aymeric, Tan, Kae Yi
Format:	Article
Published:	Cevap-Sao Paulo State Univ-Unesp 2022
Subjects:	RS Pharmacy and materia medica RV Botanic, Thomsonian, and eclectic medicine SF Animal culture
Online Access:	http://eprints.um.edu.my/33502/
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spelling	my.um.eprints.335022022-08-03T03:22:51Z http://eprints.um.edu.my/33502/ King Cobra and snakebite envenomation: On the natural history, human-snake relationship and medical importance of Ophiophagus hannah Tan, Choo Hock Bourges, Aymeric Tan, Kae Yi RS Pharmacy and materia medica RV Botanic, Thomsonian, and eclectic medicine SF Animal culture King Cobra (Ophiophagus hannah) has a significant place in many cultures, and is a medically important venomous snake in the world. Envenomation by this snake is highly lethal, manifested mainly by neurotoxicity and local tissue damage. King Cobra may be part of a larger species complex, and is widely distributed across Southeast Asia, southern China, northern and eastern regions as well as the Western Ghats of India, indicating potential geographical variation in venom composition. There is, however, only one species-specific King Cobra antivenom available worldwide that is produced in Thailand, using venom from the snake of Thai origin. Issues relating to the management of King Cobra envenomation (e.g., variation in the composition and toxicity of the venom, limited availability and efficacy of antivenom), and challenges faced in the research of venom (in particular proteomics), are rarely addressed. This article reviews the natural history and sociocultural importance of King Cobra, cases of snakebite envenomation caused by this species, current practice of management (preclinical and clinical), and major toxinological studies of the venom with a focus on venom proteomics, toxicity and neutralization. Unfortunately, epidemiological data of King Cobra bite is scarce, and venom proteomes reported in various studies revealed marked discrepancies in details. Challenges, such as inconsistency in snake venom sampling, varying methodology of proteomic analysis, lack of mechanistic and antivenomic studies, and controversy surrounding antivenom use in treating King Cobra envenomation are herein discussed. Future directions are proposed, including the effort to establish a standard, comprehensive Pan-Asian proteomic database of King Cobra venom, from which the venom variation can be determined. Research should be undertaken to characterize the toxin antigenicity, and to develop an antivenom with improved efficacy and wider geographical utility. The endeavors are aligned with the WHO's roadmap that aims to reduce the disease burden of snakebite by 50% before 2030. Cevap-Sao Paulo State Univ-Unesp 2022-01-05 Article PeerReviewed Tan, Choo Hock and Bourges, Aymeric and Tan, Kae Yi (2022) King Cobra and snakebite envenomation: On the natural history, human-snake relationship and medical importance of Ophiophagus hannah. Journal of Venomous Animals and Toxins including Tropical Diseases, 27. ISSN 1678-9199, DOI https://doi.org/10.1590/1678-9199-JVATITD-2021-0051 <https://doi.org/10.1590/1678-9199-JVATITD-2021-0051>. 10.1590/1678-9199-JVATITD-2021-0051
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	RS Pharmacy and materia medica RV Botanic, Thomsonian, and eclectic medicine SF Animal culture
spellingShingle	RS Pharmacy and materia medica RV Botanic, Thomsonian, and eclectic medicine SF Animal culture Tan, Choo Hock Bourges, Aymeric Tan, Kae Yi King Cobra and snakebite envenomation: On the natural history, human-snake relationship and medical importance of Ophiophagus hannah
description	King Cobra (Ophiophagus hannah) has a significant place in many cultures, and is a medically important venomous snake in the world. Envenomation by this snake is highly lethal, manifested mainly by neurotoxicity and local tissue damage. King Cobra may be part of a larger species complex, and is widely distributed across Southeast Asia, southern China, northern and eastern regions as well as the Western Ghats of India, indicating potential geographical variation in venom composition. There is, however, only one species-specific King Cobra antivenom available worldwide that is produced in Thailand, using venom from the snake of Thai origin. Issues relating to the management of King Cobra envenomation (e.g., variation in the composition and toxicity of the venom, limited availability and efficacy of antivenom), and challenges faced in the research of venom (in particular proteomics), are rarely addressed. This article reviews the natural history and sociocultural importance of King Cobra, cases of snakebite envenomation caused by this species, current practice of management (preclinical and clinical), and major toxinological studies of the venom with a focus on venom proteomics, toxicity and neutralization. Unfortunately, epidemiological data of King Cobra bite is scarce, and venom proteomes reported in various studies revealed marked discrepancies in details. Challenges, such as inconsistency in snake venom sampling, varying methodology of proteomic analysis, lack of mechanistic and antivenomic studies, and controversy surrounding antivenom use in treating King Cobra envenomation are herein discussed. Future directions are proposed, including the effort to establish a standard, comprehensive Pan-Asian proteomic database of King Cobra venom, from which the venom variation can be determined. Research should be undertaken to characterize the toxin antigenicity, and to develop an antivenom with improved efficacy and wider geographical utility. The endeavors are aligned with the WHO's roadmap that aims to reduce the disease burden of snakebite by 50% before 2030.
format	Article
author	Tan, Choo Hock Bourges, Aymeric Tan, Kae Yi
author_facet	Tan, Choo Hock Bourges, Aymeric Tan, Kae Yi
author_sort	Tan, Choo Hock
title	King Cobra and snakebite envenomation: On the natural history, human-snake relationship and medical importance of Ophiophagus hannah
title_short	King Cobra and snakebite envenomation: On the natural history, human-snake relationship and medical importance of Ophiophagus hannah
title_full	King Cobra and snakebite envenomation: On the natural history, human-snake relationship and medical importance of Ophiophagus hannah
title_fullStr	King Cobra and snakebite envenomation: On the natural history, human-snake relationship and medical importance of Ophiophagus hannah
title_full_unstemmed	King Cobra and snakebite envenomation: On the natural history, human-snake relationship and medical importance of Ophiophagus hannah
title_sort	king cobra and snakebite envenomation: on the natural history, human-snake relationship and medical importance of ophiophagus hannah
publisher	Cevap-Sao Paulo State Univ-Unesp
publishDate	2022
url	http://eprints.um.edu.my/33502/
_version_	1740826036897054720
score	13.211869

King Cobra and snakebite envenomation: On the natural history, human-snake relationship and medical importance of Ophiophagus hannah

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