Snake venom treatment causes concern

What does the email say?

The content of the email is a testimonial from a woman in Scotland who received their drug known as Alpha-Immunokine Peptide in 2004. Its active ingredient is a protein extracted from cobra venom.

Later versions of this email include a copy of a presentation on the drug development. The information in this presentation is not supported by any accompanying data. The presentation is brief about the production and safety testing of this treatment; and conflicting and inaccurate about the suggested scientific rationale for its beneficial effects.

How does Alpha Immunokine Peptide work?

There is no clear scientific explanation about how this treatment may work in MND. One suggested mechanism of action for the drug is a protective effect on the myelin sheath that insulates nerves and is damaged in Multiple Sclerosis; such damage is not a feature of MND.

Another is that the drug acts on a specific protein on the surface of neurones, altering neuronal communication. In MND it is the structure of the neurones that is damaged rather than poor communication. (A possible analogy is that Esperanza claim that the drug works by improving the mobile phone signal on a certain network. This is not helpful as in MND the mobile phone itself is broken and a different phone network is used).

Who might benefit from this treatment?

Esperanza suggest that the treatment may benefit people with "Lyme positive ALS/ MND”, this is not a clinically recognised diagnosis.

ALS is the clinical name for the most common form of MND. Lyme disease is a bacterial infection transmitted to humans from tick bites, it does not cause MND. It can very rarely cause some of the signs and symptoms seen in MND. Lyme disease is diagnosed from blood tests followed by lumbar puncture. It can be treated with a two to four week course of antibiotics.

Have there been any clinical trials?

Two research papers have been published on the therapeutic uses of snake venom. In 1980 Riviera and colleagues investigated the effect of snake venom extract in 64 people with MND. They concluded that the "study did not demonstrate any benefit from administration from modified snake venom to patients with ALS".

More recently a study by Mundy and colleagues was conducted to investigate the reported dramatic effects of Alpha Immunokine Peptide in the treatment of a rare, genetic condition that has similar symptoms as Multiple Sclerosis. No improvement was seen in the eight patients followed. No side effects of the treatment were seen in this small number of patients. This study did not look at how the drug worked on a cellular level.