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Denatured naja naja atra venom is the heat-treated form of the venom from the Chinese cobra, Naja naja atra. The drug comprises a mixture of denatured proteins, with main active ingredients including **cardiotoxin**, **neurotoxin** (such as cobrotoxin and cobratoxin), and **cytotoxins**, among others[1][4][5]. Heat treatment increases the proportion of low molecular weight peptides, potentially enhancing therapeutic effects and reducing toxicity[1][4]. This drug demonstrates **anti-inflammatory** and **antinociceptive** (pain-relieving) activity, with reported efficacy in animal models of **rheumatoid arthritis** and other inflammatory conditions[1][2][3][6]. Mechanistically, it reduces levels of pro-inflammatory cytokines (TNF-α, IL-1β, IL-17), increases anti-inflammatory cytokine IL-10, and inhibits activation of **nuclear factor kappa B (NF-κB)**, a transcription factor driving inflammation[2]. Individual venom peptides act through blocking nerve transmission by binding to the alpha subunit of the **nicotinic acetylcholine receptor**, and by modulating immune response via complement depletion (cobra venom factor)[1][2]. Additional analgesic effects are mediated partly via **cholinergic** and **opioidergic** pathways[2]. Denatured NNAV is orally bioavailable, with reduced toxicity compared to native venom, and has shown promise in preclinical studies for inflammatory diseases.
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