Toxicon : official journal of the International Society on Toxinology
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In the four decades since toxinologists in Australia and elsewhere started to investigate the active constituents of venomous cone snails, a wealth of information has emerged on the various classes of peptides and proteins that make their venoms such potent bioactive cocktails. This article provides an overview of the current state of knowledge of these venom constituents, several of which are of interest as potential human therapeutics as a consequence of their high potency and exquisite target specificity. With the promise of as many as 50,000 venom components across the entire Conus genus, many more interesting peptides can be anticipated.
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The seas and oceans around Australia harbour numerous venomous jellyfish. Chironex fleckeri, the box jellyfish, is the most lethal causing rapid cardiorespiratory depression and although its venom has been characterised, its toxins remain to be identified. A moderately effective antivenom exists which is also partially effective against another chirodropid, Chiropsalmus sp. ⋯ The venom contains a sodium channel modulator. Two species of Physalia are present and although one is potentially lethal, has not caused death in Australian waters. Other significant genera of jellyfish include Tamoya, Pelagia, Cyanea, Aurelia and Chyrosaora.
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Despite the wealth of anecdotes and case reports there are fundamental questions of management of snakebite in Australia that remain unresolved or for which the current evidence is limited. The efficacy in the field, potential limitations and possibility of improvements in pressure immobilisation first aid need objective studies in humans. Optimal bandage sizes, stretch and pressure for different sized limbs need further evaluation, as does the use of pressure pads. ⋯ Confirmation of clinical efficacy and dosing recommendations for use of tiger snake (Notechis) antivenom in envenoming from Australian copperhead (Austrelaps spp.), broad headed (Hoplocephalus spp.) and rough-scaled snakes (Tropidechis carinatus) also require formal study in patients. Other examples of clinical relevance of cross-specificity of current and future monospecific antivenoms and whether there are geographical variations in antivenom responses within species will require elucidation. Prospective multicentre collaborative studies with predefined data collection and serial venom level assays are proposed as the way forward in Australia to help resolve therapeutic uncertainties and to establish a firmer evidence base for best-practice treatment guidelines for Australasian elapid snakebite.
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Biography Historical Article
Struan Sutherland--Doyen of envenomation in Australia.
Struan Sutherland (1936-2002) was the doyen of medical research in the field of envenomation and the ultimate authority on the medical management of envenomated victims in Australia for almost 3 decades. In 1981 as Head of Immunology Research of Commonwealth Serum Laboratories (CSL), he produced an antivenom against the Sydney Funnel-web Spider (Atrax robustus)-an accomplishment that had defied numerous previous attempts. Struan also invented the pressure-immobilisation technique of first-aid for snake bite. ⋯ Struan served the medical fraternity and the public selflessly. He was always available to doctors, or to anybody, to give advice at any hour of the day or night, on management of envenomated victims. Members of the Australian Venom Research Unit, which he founded in 1994 at The University of Melbourne, now continue this 24-h advisory service.
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Biography Historical Article
The pioneers of venom production for Australian antivenoms.
Before the introduction of the first Australian antivenom was the era of the self-styled 'snakemen' and their diverse snakebite remedies. Many received multiple bites from highly dangerous snakes, some of which were deliberately taken to either prove a certain treatment or liven up their show. ⋯ Collecting venoms in the development and early production of antivenoms was carried out by a number of professional herpetologists often with little or no reward and in some instances at the ultimate cost of their lives. This paper reviews the most important of those late nineteenth and twentieth century snakemen and their contributions to venom research, antivenom production and current toxinological knowledge.