Editing Redback spider (section)

===Antivenom===
[[File:F ab2 pFc.png|thumb|An [[antibody]] digested by [[pepsin]] yields two fragments: a [[F(ab')2|F(ab')<sub>2</sub>]] fragment and a pFc' fragment. Redback spider [[antivenom]] contains purified F(ab')<sub>2</sub> derived from [[IgG]] in hyperimmune horse [[Plasma (blood)|plasma]].<ref name=cmg2007>{{cite web|url=http://www0.health.nsw.gov.au/archive/policies/gl/2007/pdf/GL2007_006.pdf |title=Snakebite & Spiderbite Clinical Management Guidelines 2007 – NSW |publisher=Department of Health, NSW |page=47 |date=17 May 2007 |access-date=10 November 2013}}</ref><!--ref for last sentence only-->]]
{{Further|Antivenom}}
Redback antivenom was developed by [[CSL Limited|Commonwealth Serum Laboratories]], then a government body involved with discovering antivenoms for many venomous Australian creatures. Production involves the milking of venom from redbacks and repeatedly inoculating horses with non-lethal doses. The horse [[immune system]]s makes polyclonal [[antibody|antibodies]].<ref>{{cite web|url=http://www.powerhousemuseum.com/australia_innovates/?behaviour=view_article&Section_id=1030&article_id=10026|title=CSL antivenoms|author=ATSE project team|year=2001|work=Australia Innovates|publisher=Powerhouse Museum|access-date=9 October 2013|location=Haymarket, New South Wales|archive-date=7 August 2016|archive-url=https://web.archive.org/web/20160807152107/http://www.powerhousemuseum.com/australia_innovates/?behaviour=view_article&Section_id=1030&article_id=10026|url-status=live}}</ref> [[Blood plasma]], containing the antibodies, is extracted by [[plasmapheresis]].<ref>{{cite web|url=http://www.aomevents.com/media/files/AIMS%20NZIMLS%20SPC/Prowse.pdf |title=Antivenom Improvements |first=Claire |last=Prowse |publisher=aomevents.com |archive-url=https://web.archive.org/web/20131110170051/http://www.aomevents.com/media/files/AIMS%20NZIMLS%20SPC/Prowse.pdf|archive-date=10 November 2013 |access-date=10 November 2013}}</ref> The plasma is treated with [[pepsin]], and the active [[F(ab')2|F(ab')<sub>2</sub>]] fragments are separated and purified.<ref>{{cite book|url=https://books.google.com/books?id=BfdighlyGiwC&q=antivenom+redback+spider+pepsin&pg=PA262 |title=Medical Toxicology |author= Seifert, Stephen A |editor=Dart, Richard C|publisher=Lippincott Williams & Wilkins |edition=3rd |page=262 |year=2004|isbn=978-0-7817-2845-4}}</ref> Each vial contains 500 units of redback antivenom in approximately 1.5 ml,<ref name=ACCCN2011>{{cite book|author1=Elliott, Doug |author2=Aitken, Leanne |author3=Chaboyer, Wendy |title=ACCCN's Critical Care Nursing|publisher=Elsevier Australia|location=Chatswood, New South Wales|year=2011|edition=2nd|page=607|isbn=978-0-7295-4068-1|url=https://books.google.com/books?id=8Yg1lsItNdYC&q=redback+spider+ampoule&pg=PA607}}</ref> which is enough to inactivate 5&nbsp;mg of redback spider venom in a test tube.{{sfn|White|2013|p=312}} The antivenom has been safely administered to women in various stages of pregnancy.<ref name=ACCCN2011/> Redback antivenom has been widely used in Australia since 1956, although evidence from [[Scientific control|controlled]] studies for its [[effectiveness]] has been lacking. Recent trials show antivenom has a low response rate little better than placebo, and any effect is less than might be achieved with optimal use of standard analgesics.<ref name=":2" /><ref name=":3" /><ref name=":1" /> Further studies are needed to confirm or refute its effectiveness.<ref name="lancet" /> It appears clinically active against [[arachnidism]] caused by ''Steatoda'' spiders;<ref name="Nicholson2003" /><ref>{{cite journal|last=South|first=Mike|author2=Wirth, Peter|author3=Winkel, Ken D.|title=Redback Spider Antivenom used to Treat Envenomation by a Juvenile ''Steatoda'' Spider|journal=Medical Journal of Australia|date=December 1998|volume=169|issue=11|page=642|url=https://www.mja.com.au/journal/1998/169/11/redback-spider-antivenom-used-treat-envenomation-juvenile-steatoda-spider|pmid=9887917|type=Case report, letter|doi=10.5694/j.1326-5377.1998.tb123445.x|s2cid=33602865|access-date=5 September 2013|archive-date=21 September 2013|archive-url=https://web.archive.org/web/20130921060117/https://www.mja.com.au/journal/1998/169/11/redback-spider-antivenom-used-treat-envenomation-juvenile-steatoda-spider|url-status=live|url-access=subscription}}</ref><ref>{{cite journal|last=Graudins|first=Andis|author2=Gunja, Narendra |author3=Broady, Kevin W. |author4= Nicholson, Graham M. |title=Clinical and ''in vitro'' Evidence for the Efficacy of Australian Red-back Spider (''Latrodectus hasselti'') Antivenom in the Treatment of Envenomation by a Cupboard Spider (''Steatoda grossa'')|journal=Toxicon|date=June 2002|volume=40|issue=6|pages=767–75|doi=10.1016/S0041-0101(01)00280-X|pmid=12175614|bibcode=2002Txcn...40..767G |type=Case report}}</ref><ref>{{cite journal|last1=Atakuziev|first1=Bakhadir U.|last2=Wright|first2=Christine E.|last3=Graudins|first3=Andis|last4=Nicholson|first4=Graham M.|last5=Winkel|first5=Kenneth D.|title=Efficacy of Australian red-back spider (Latrodectus hasselti) antivenom in the treatment of clinical envenomation by the cupboard spider Steatoda capensis (Theridiidae)|journal=Toxicon|volume=86|pages=68–78|doi=10.1016/j.toxicon.2014.04.011|pmid=24853919|year=2014|bibcode=2014Txcn...86...68A }}</ref> however, as these cases are often mild and the evidence of its effectiveness is limited, this treatment is not recommended.<ref name="lancet" /> Similarly, the antivenom has been reported as effective with bites of ''L. katipo'', and ''L. tredecimguttatus''.<ref name="Nicholson2003">{{cite journal|last=Nicholson|first=Graham M.|author2=Graudins, Andis|title=Antivenoms for the Treatment of Spider Envenomation|journal=Toxin Reviews|date=1 January 2003|volume=22|issue=1|pages=35–59|doi=10.1081/TXR-120019019|hdl=10453/4596|s2cid=84894614|hdl-access=free}}</ref> Animal studies also support its use against envenomation from other widow spiders, having successfully been tested against venom from ''L. mactans'', ''[[Latrodectus hesperus|L. hesperus]]'', and ''[[Latrodectus tredecimguttatus|L. tredecimguttatus]]'' ([[Synonym (taxonomy)|synonym]] ''L.&nbsp;lugubris'').<ref name="Nicholson2003" /><ref>{{cite journal|last=Graudins|first=Andis|author2=Padula, Matthew |author3=Broady, Kevin |author4= Nicholson, Graham M. |title=Red-back Spider (''Latrodectus hasselti'') Antivenom Prevents the Toxicity of Widow Spider Venoms|journal=Annals of Emergency Medicine|date=February 2001|volume=37|issue=2|pages=154–60|doi=10.1067/mem.2001.113033|pmid=11174232}}</ref><ref>{{cite journal|last1=Daly |first1=Frank |last2=Hill |first2=Robert E. |last3=Bogdan |first3=Gregory M. |last4=Dart |first4=Richard C.|title=Neutralization of ''Latrodectus mactans'' and ''L. hesperus'' Venom by Redback Spider (''L. hasseltii'') antivenom|journal=Clinical Toxicology|date=1 January 2001|volume=39|issue=2|pages=119–23|doi=10.1081/CLT-100103826|pmid=11407496|last5=Dart|first5=Richard C.|s2cid=22286370 |type=Comparative study}}</ref>