Will protein design tools solve the snake antivenom shortage? | Hacker News Reader

Will protein design tools solve the snake antivenom shortage?

owlposting.com

63 pointssebg28 comments

Or one man with more than 200 bites and more than 700 injections of venom he prepared from some of the world's deadliest snakes[0].

[0] https://www.bbc.com/news/articles/cr5d0l7el36o

A man called "Ram Chandra" used to come to my school in the 80-90's and educate us on the danger of snakes (he has since passed away).

There is a little talk of it here https://www.mackayandwhitsundaylife.com/article/remembering-...

I had seen him get bitten by a bunch of different snakes during his time demonstrating dangerous animals to my school on different occasions, he was always very kind and educational.

I believe he had was also involved in milking snakes and making antivenom, but the specifics evade me.

I believe he went to many different schools educating the small townships of the Australian outback (Imagine more than 20 less than 30) and always had time to answer my stupid questions as a child.

This part of my local culture will be missed.

It doesn't mention if he died from snake bites... Sounds like an interesting guy!

“Milking snakes…” tempted to put that on gpt and see what that looks like.

I just got off the phone from my parents, they seem to believe it was complications from continuous snake bites.

https://www.youtube.com/watch?v=5xCoaycbbus

He's definitely a machine.

Anyone else find it hilarious that snake bites follow the logic of "expose yourself to just a little deadly poison to gain immunity"?

Why? It's immunologically sensible : let the immune system train antibodies on a non lethal amount of novel protein antigen, like traditional vaccines, and (i bet to your point) in stark contrast with "homeopathy" in some definitions.

Homeopathy is way more extreme, for what it's worth. The idea is to keep diluting the thing until it's basically chemically absent, with only the "nature" or the juju or whatever it is.

Relevant Mitchell & Webb comedy sketch, title translated for Americans as "Homepathic ER".

https://www.youtube.com/watch?v=DqWieBlI1bA

Their venom is protein based so what can they do?

I mention this in the article :)

I recently watched this YouTube documentary about a Borneo tribe, barely clinging onto their traditional ways/knowledge (displaced by the logging industry) who used a plant as a supposedly universal snake bite remedy ... I wonder if there was ever a scientific study of how effective it actually is?

https://www.youtube.com/watch?v=TiQBTesZUJQ

There's no such thing as a universal snake bite remedy, because venoms are largely all different. One might cause asphyxiation by affecting your nervous system. One might kill muscle tissue. Another might be a glorified digestive aid. The compounds are all vastly different and have very different ways of affecting the body.

It might be the case that such a plant happened to be somewhat effective in treating venoms from some snakes in a particular area, but the ability to be universally effective is simply impossible.

The shortage is already rather artificial. A snakebite treatment that costs $150k in the USA is just a few hundred dollars in Mexico.

How is that possible?

Is your second sentence supposed to be evidence of your first?

I'm no fan of a system that prices things differently based on how much the dying person (or their insurance) is likely to be able to pay, but in such a system you've got prices dictated by demand... can you really reason your way from prices back to notions of authentic supply?

You have to deregulate the supply. Right now you have to be specifically approved to manufacture a drug. This causes monopolies / oligopolies even in non-patented medications. It should be changed to a system where any company who wants can manufacture any drug as long as it meets purity and dosage accuracy standards.

>You have to deregulate the supply.

We already had that.

It was a disaster.

For centuries. No. Millennia.

Until enough people died to make regulation palatable.

Going back to that would be like going back to bloodletting to balance the four humors.

"Oh but baby we've changed" --some random private equity sociopath

"We've got computers now man that changes things, we'll build an ai-enabled pharma tech stack on the blockchain" --some techbro

>For centuries. No. Millennia.

We might have had other, confounding factors during that time period. And while he did mention "deregulation", he also indicated that he only wanted partial deregulation... that there would still be some demand for purity/dosage.

When people talk about deregulation, there is this idea that regulations already exist. If you're talking about periods from anitquity where no regulations existed at all, this isn't comparable to a period of deregulation where presumably everyone knows what the regulations were trying to accomplish and agree on those and other basic scientific principles. We also had no FAA 10,000 years ago, and no one died in plane crashes then, right? That proves how awesome regulation is in the same way your example proves how awful it is. How can these two arguments reach entirely difference conclusions, do you think?

>"Oh but baby we've changed" --some random private equity sociopath

Or, just possibly, people come to realize over time that their initial knee-jerk reactions went too far, and cause measurable harm that they want to reduce. Unfettered capitalism does get a few things right... it can go from supply shortages to excess quickly. Let it work.

Yes, how could I forget all those people who died from correctly dosed and uncontaminated medications.

Thalidomide was both correctly dosed and uncontaminated.

Thank god a strong and burdensome FDA existed in the United States, back when men were free and America was great.

I see, I had assumed that the same party was supplying both sides of the border.

Does it actually cost $150k, or is that just the sticker price? What does United Healthcare pay for a dose? That’s the actual price.

Fake price tags are a huge issue in health care policy.

There's two kinds of shortage here: the availability in principle of an antivenom for a specific snake venom and the availability in practice of a dose of antivenom to treat a specific snake bite.

Rich people paying whatever it takes to avoid dying provide a captive market for the first case (at least as far as snakes that rich people often get bitten by are concerned), and protein design tools also aim at this kind of shortage.

But as the article points out, most people getting bitten by snakes are affected by the second kind of shortage, because they're too poor to afford several hundred dollars. To address this, the newly-designed antivenom also needs to be cheap enough to manufacture that people actually buy it in large enough volumes that it justifies the initial R&D investment for the manufacturer.

It is a bit more complicated than that [0]. Most of those costs are not attributable to the antivenom but to other overheads that are part of the process, including litigation costs. The FDA fees per vial alone are a few hundred dollars, even higher than the clinical trial costs.

[0] https://www.amjmed.com/article/S0002-9343(15)00781-0/fulltex...

Recent Derek Lowe article on antivenom: https://www.science.org/content/blog-post/whole-lotta-snakin...

I live in an area with tons of rattlesnakes and deal with at least 6-10 per year on my property. They generally just want to be left alone which I usually oblige unless they are near the house or shop. I heard an old timer say that the majority of snake bite victims in our area are young males and the most common pre-bite words are "hold my beer, watch this."

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