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Venoms, poisons, stings
Bio

Venoms, poisons, stings

Computation drug discovery for long-tail of diseases

Concept

Commoditization of drug discovery will lead to a long-tail of conditions being addressed with computational drug discovery.

Longer Description

People’s ultimate demise can come from a lot of different things (stings, bites, poisonings). This is tragic in its own right, but especially when we have the tools to make medicines for many different indications. Given drug discovery is commoditizing, trials can be run in foreign countries, the long tail of diseases starts to look interesting. While none of these toxin treatments are venture scale on their own, combining them together could lead to a ‘100 drugs’ platform.

What got us started on this was the man that used his immune system primed with 200 snake bites to serve as a starting point for broad-spectrum anti-venom drugs. The resultant anti-venom cocktail combined small-molecule venom inhibitor that protected mice from a wide range of cobra, mamba, krait, and taipan venoms. To find antivenoms though, we don’t necessarily need someone that’s been bitten, we can use the common protein design tools and traditional techniques (like phage and yeast display) to come up with venom neutralizing biologics. What’s more is that these methods might have cost parity with the horse serum products. [Antivenom small molecules are also an option.]

Taking a step back, there’s a lot of other poisonous creatures we could have a better treatments for. When looking at animal bites and deaths per year it’s clear snakes have the highest clear use-case. There are >2M snake bites per year and >60k deaths per year. When digging further though I found other places where new antivenoms are needed:

  • Scorpions have over 1.2M stings and >3,000 deaths per year but there seems to be less innovation happening here. Looking at the mixture of snake and scorpion venoms, scorpion venoms are easier to express and structurally target due to size, stability, and lower number of them (4 vs. 6).
  • Organophosphates are insecticides used in crop production in developing countries. This is a main source of suicide but many poisonings are accidental with 300k deaths per year. Again enzymes to break down the toxins or optimizing current ones (oximes) with better BBB penetration.
  • Amatoxin is from death cap mushrooms, with consumption resulting in 10,000 illnesses and 100 deaths per year. It’s suggested that indocyanine green can be repurposed but might be room for more specific treatments. Amatoxins stall RNA polymerase II, blocking mRNA synthesis and causing cell death, especially in the liver and kidneys. Molecular cages can be used to trap the toxin (like Sugammadex for anesthetic reversal) or directed evolution to make enzymes break down the toxin.
  • Pufferfish (fugu), blue-ringed octopus, some frogs, newts, and marine snails all produce tetrodotoxin (TTX). No clinically approved antidote and is very small making it hard for normal antibodies to bind to. Nanobodies and aptamers, molecular cages could be used.

Comparable companies

  • Centivax - snake antivenom

Related Reading

  • https://www.ncbi.nlm.nih.gov/books/NBK499860/
  • https://www.cell.com/action/showPdf?pii=S0092-8674%2825%2900402-7
  • https://www.nature.com/articles/s41586-024-08393-x
  • https://www.frontiersin.org/journals/bioengineering-and-biotechnology/articles/10.3389/fbioe.2020.00703/full
  • https://www.cuimc.columbia.edu/news/scientists-develop-new-antivenom-counter-many-snakebites#:~:text=Antivenom%20is%20typically%20made%20by,would%20cause%20fewer%20side%20effects
  • https://www.mountsinai.org/health-library/injury/snake-bites
  • https://pmc.ncbi.nlm.nih.gov/articles/PMC10150966/#:~:text=Scorpionism is a public health problem%2C with,[1].%20Several%20states%20report%20much%20higher%20levels.

*Picture is the “Death of Socrates” by Jacques-Louis David. He died by drinking Hemlock poison after being imprisoned.

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