The biology and toxinology of blunt-nosed vipers

Blunt-nosed vipers (genus Macrovipera) are among the venomous snakes of highest medical relevance in the Palearctic region. Extensive research has been conducted on their venoms, covering toxin composition, biochemistry, function, pathology and biodiscovery. However, these studies are widely dispersed across the scientific literature, almost exclusively focus on biochemistry and drug discovery aspects, and largely neglect the zoological and systematic context of these snakes. Here, we provide a comprehensive, transdisciplinary compilation of what is known about the biology, taxonomy and toxinology of blunt-nosed vipers. After contextualising the three generally recognised Macrovipera species (Macrovipera lebetina, Macrovipera razii and Macrovipera schweizeri) within their zoological and taxonomic framework, we compile the venom proteomes available in the literature and identify general compositional patterns across the genus. We then report on the known biological activities of Macrovipera venoms and discuss their clinical and pharmacological potential. Furthermore, we detail the mainly haemorrhagic, coagulopathic and cytotoxic pathophysiological effects of blunt-nosed viper envenoming, and provide recommendations for the clinical management of Macrovipera bites. Finally, we propose future research directions, advocating for expanded research on these venoms to enhance our understanding and drive further innovation in both therapeutic applications and the treatment of bites inflicted by these remarkable snakes.