Clinical management should shift from a single-organ treatment approach to a systemic intervention strategy for snakebite envenomation

Snakebite envenomation has become a global public health challenge due to the widespread distribution of venomous snakes. Snake venom, a complex mixture containing various bioactive components, exhibits distinct characteristics across different families. The core toxic components of snake venom are mainly Three-Finger Toxins (3FTxs), phospholipase A2(PLA2), and proteases, which together form the material basis of the venom’s multidimensional toxicity. Through synergistic effects, they activate common pathological pathways, enabling targeted disruption of multiple human organs., leading to acute injury and even multi-organ failure. Beyond the acute effects, some survivors may experience long-term sequelae such as chronic kidney disease or permanent musculoskeletal damage. Existing research suggests that snake venom may have modulatory effects on the immune system, however, the relevant evidence primarily comes from in vitro experiments or animal models, and its clinical significance requires further validation. In clinical management, treatment for snake envenomation involves immediate wound care, prompt medical attention, and rapid diagnosis to identify the snake species for the timely administration of specific antivenom, and a multidisciplinary collaborative treatment model. Moreover, adjunctive drug therapy is often necessary. Nevertheless, traditional antivenoms still face challenges in addressing local tissue damage and ensuring accessibility in resource-limited regions. This narrative review focuses on three major toxin families of snake venom toxins, analyzing their molecular characteristics and synergistic mechanisms to elucidate how these toxins induce systemic damage affecting the cardiovascular, neurological, and renal systems. It thereby reveals that multi-organ injury caused by snake venom is not an isolated event but rather a systemic process driven by the interplay and synergy of multiple common pathological pathways. This systematic analysis suggests that clinical management should shift from a single-organ treatment approach to a systemic intervention strategy.