PLA2G2D and subacute bacterial endocarditis: This signal is biologically plausible because SBE is a time-dependent disease for which early treatment is essential to optimise outcomes.26 27 Because sPLA2s are relatively small and highly active toxins that diffuse rapidly to produce systemic effects, early treatment may be particularly important when using an sPLA2 inhibitor.8 17 It is encouraging to see consistent benefits for recovery across the major snake types included in the study.