The Venom Proteome and Immunorecognition Profile of Clinically Important Echis carinatus sochureki from Northwestern India Underscores the Need for Regionally Specific Antivenoms

Akhilesh Kumar PH; Alka Sahu; Maya Gopalakrishnan; Avni Blotra; Vishal Rout; Sourish Rajagopalan Kuttalam; Shibi Muralidar; Anita Malhotra; Karthikeyan Vasudevan

doi:10.3390/toxins18010054

The Venom Proteome and Immunorecognition Profile of Clinically Important Echis carinatus sochureki from Northwestern India Underscores the Need for Regionally Specific Antivenoms

Akhilesh Kumar PH
, Alka Sahu
, Maya Gopalakrishnan
, Avni Blotra
, Vishal Rout
, Sourish Rajagopalan Kuttalam
, Shibi Muralidar
, Anita Malhotra
, Karthikeyan Vasudevan

School of Environmental & Natural Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

The saw-scaled viper Echis carinatus, one of the “Big Four” causes of snakebites in India,
is found from Sri Lanka to eastern Iraq. To investigate clinical reports regarding the
limited efficacy of Indian polyvalent antivenom (IPAV) against envenomation in Echis
carinatus sochureki (ECS) in northwestern India, we obtained 22 snakes from three locations
in Rajasthan and identified 148–174 toxin isoforms belonging to 21–25 toxin families in their
venom using a bottom-up proteomics approach. All samples showed a high abundance
of snake venom metalloproteinases (SVMPs), particularly SVMP class III. Other major
components were phospholipases A2, L-amino-acid oxidases, snake venom serine proteases
and snaclecs (C-type lectins). Variation in venom composition among locations in Rajasthan,
compared to E. c. carinatus (ECC) from southern India, was primarily due to differences
in the relative abundance of these toxin families. Recognition of all venom components
by IPAV was poor at lower antivenom concentrations. Notably, SVMP classes II and III
were poorly recognized at all venom-to-antivenom ratios in all ECS venoms, and a plasma
clotting assay revealed poor neutralization of procoagulant activity. This collaborative
study highlights the need for the development of regional antivenoms to effectively treat
snakebites in northwestern India.

Original language	English
Article number	54
Pages (from-to)	1-18
Number of pages	18
Journal	Toxins
Volume	18
Issue number	1
DOIs	https://doi.org/10.3390/toxins18010054
Publication status	Published - 21 Jan 2026

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10.3390/toxins18010054Licence: CC BY

toxins-18-00054Final published version, 2.12 MBLicence: CC BY

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Kumar PH, A., Sahu, A., Gopalakrishnan, M., Blotra, A., Rout, V., Kuttalam, S. R., Muralidar, S., Malhotra, A., & Vasudevan, K. (2026). The Venom Proteome and Immunorecognition Profile of Clinically Important Echis carinatus sochureki from Northwestern India Underscores the Need for Regionally Specific Antivenoms. Toxins, 18(1), 1-18. Article 54. https://doi.org/10.3390/toxins18010054

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title = "The Venom Proteome and Immunorecognition Profile of Clinically Important Echis carinatus sochureki from Northwestern India Underscores the Need for Regionally Specific Antivenoms",

abstract = "The saw-scaled viper Echis carinatus, one of the “Big Four” causes of snakebites in India, is found from Sri Lanka to eastern Iraq. To investigate clinical reports regarding the limited efficacy of Indian polyvalent antivenom (IPAV) against envenomation in Echis carinatus sochureki (ECS) in northwestern India, we obtained 22 snakes from three locations in Rajasthan and identified 148–174 toxin isoforms belonging to 21–25 toxin families in their venom using a bottom-up proteomics approach. All samples showed a high abundance of snake venom metalloproteinases (SVMPs), particularly SVMP class III. Other major components were phospholipases A2, L-amino-acid oxidases, snake venom serine proteases and snaclecs (C-type lectins). Variation in venom composition among locations in Rajasthan, compared to E. c. carinatus (ECC) from southern India, was primarily due to differences in the relative abundance of these toxin families. Recognition of all venom components by IPAV was poor at lower antivenom concentrations. Notably, SVMP classes II and III were poorly recognized at all venom-to-antivenom ratios in all ECS venoms, and a plasma clotting assay revealed poor neutralization of procoagulant activity. This collaborative study highlights the need for the development of regional antivenoms to effectively treat snakebites in northwestern India.",

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Kumar PH, A, Sahu, A, Gopalakrishnan, M, Blotra, A, Rout, V, Kuttalam, SR, Muralidar, S, Malhotra, A & Vasudevan, K 2026, 'The Venom Proteome and Immunorecognition Profile of Clinically Important Echis carinatus sochureki from Northwestern India Underscores the Need for Regionally Specific Antivenoms', Toxins, vol. 18, no. 1, 54, pp. 1-18. https://doi.org/10.3390/toxins18010054

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T1 - The Venom Proteome and Immunorecognition Profile of Clinically Important Echis carinatus sochureki from Northwestern India Underscores the Need for Regionally Specific Antivenoms

AU - Kumar PH, Akhilesh

AU - Sahu, Alka

AU - Gopalakrishnan, Maya

AU - Blotra, Avni

AU - Rout, Vishal

AU - Kuttalam, Sourish Rajagopalan

AU - Muralidar, Shibi

AU - Malhotra, Anita

AU - Vasudevan, Karthikeyan

PY - 2026/1/21

Y1 - 2026/1/21

N2 - The saw-scaled viper Echis carinatus, one of the “Big Four” causes of snakebites in India, is found from Sri Lanka to eastern Iraq. To investigate clinical reports regarding the limited efficacy of Indian polyvalent antivenom (IPAV) against envenomation in Echis carinatus sochureki (ECS) in northwestern India, we obtained 22 snakes from three locations in Rajasthan and identified 148–174 toxin isoforms belonging to 21–25 toxin families in their venom using a bottom-up proteomics approach. All samples showed a high abundance of snake venom metalloproteinases (SVMPs), particularly SVMP class III. Other major components were phospholipases A2, L-amino-acid oxidases, snake venom serine proteases and snaclecs (C-type lectins). Variation in venom composition among locations in Rajasthan, compared to E. c. carinatus (ECC) from southern India, was primarily due to differences in the relative abundance of these toxin families. Recognition of all venom components by IPAV was poor at lower antivenom concentrations. Notably, SVMP classes II and III were poorly recognized at all venom-to-antivenom ratios in all ECS venoms, and a plasma clotting assay revealed poor neutralization of procoagulant activity. This collaborative study highlights the need for the development of regional antivenoms to effectively treat snakebites in northwestern India.

AB - The saw-scaled viper Echis carinatus, one of the “Big Four” causes of snakebites in India, is found from Sri Lanka to eastern Iraq. To investigate clinical reports regarding the limited efficacy of Indian polyvalent antivenom (IPAV) against envenomation in Echis carinatus sochureki (ECS) in northwestern India, we obtained 22 snakes from three locations in Rajasthan and identified 148–174 toxin isoforms belonging to 21–25 toxin families in their venom using a bottom-up proteomics approach. All samples showed a high abundance of snake venom metalloproteinases (SVMPs), particularly SVMP class III. Other major components were phospholipases A2, L-amino-acid oxidases, snake venom serine proteases and snaclecs (C-type lectins). Variation in venom composition among locations in Rajasthan, compared to E. c. carinatus (ECC) from southern India, was primarily due to differences in the relative abundance of these toxin families. Recognition of all venom components by IPAV was poor at lower antivenom concentrations. Notably, SVMP classes II and III were poorly recognized at all venom-to-antivenom ratios in all ECS venoms, and a plasma clotting assay revealed poor neutralization of procoagulant activity. This collaborative study highlights the need for the development of regional antivenoms to effectively treat snakebites in northwestern India.

U2 - 10.3390/toxins18010054

DO - 10.3390/toxins18010054

M3 - Article

SN - 2072-6651

VL - 18

SP - 1

EP - 18

JO - Toxins

JF - Toxins

IS - 1

M1 - 54

ER -

The Venom Proteome and Immunorecognition Profile of Clinically Important Echis carinatus sochureki from Northwestern India Underscores the Need for Regionally Specific Antivenoms

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