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Gheshlaghi F, Akafzadeh Savari M, Nasiri R, Wong A, Feizi A, Reza Maracy M, Dorooshi G, Meamar R, Eizadi-Mood N. Efficacy of fresh frozen plasma transfusion in comparison with conventional regimen in organophosphate poisoning treatment: a meta-analysis study. Crit Rev Toxicol 2020; 50:677-684. [PMID: 33064048 DOI: 10.1080/10408444.2020.1823313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To evaluating the efficacy of fresh frozen plasma (FFP) in comparison with conventional regimen in the treatment of organophosphate (OP) poisoning. METHODS PubMed, ScopeMed, Cochrane, Scopus, and Google Scholar databases were searched. The search strategy used the following key words "organophosphate" and "poisoning or toxicity", "(atropine and oxime)", "fresh frozen plasma", "clinical trial", "outcome". The treatment with atropine or/and oxime was considered conventional therapy. The length of hospitalization, the length of ICU admission, need for mechanical ventilation and its duration, clinical recovery point, choline esterase level, mortality rate, and intermediate syndrome (IMS) occurrence were the key outcomes of interest. Databases were searched during the period of 2003-2019. Five studies were included in the analysis. RESULTS Pooling of data showed that the relative risk (RR) of mortality in OP poisoning for five included trials comparing FFP-treated group with conventional regimen therapy was [0.563 (95% CI (0.252, 1.255)]. The summary of RR for IMS in two studies was [RR: 1.34, 95% CI (0.655, 2.742)]. In addition, there was a non-significant mean difference (MD) in hospital stay [MD: -0.106, 95% CI (-0.434, 0.223)] in three included trials. A significant MD was observed in the length of ICU admission in two trials between FFP-treated group compared to the conventional treatment group [MD: -2.672, 95% CI (-4.189, -1.154)], but after random effects meta-analysis, the changes were not significant [MD: -2.015, 95% CI (-6.308, 2.277)]. The summary of fixed-effect meta-analysis for choline esterase level in three trails was [MD: -0.117, 95% CI (-0.468, 0.234)]. The RR of ventilation requirement for two included trials in the FFP-treated group comparing to the conventional regimen therapy was [0.84, 95% CI (0.691, 1.022)] while for ventilation duration in two studies was [MD: -0.183, 95% CI (-0.567, 0.201)]. CONCLUSION The addition of FFP to conventional therapy did not improve the outcomes of mortality, IMS, hospital length of stay, cholinesterase levels, need or duration of mechanical ventilation, and only the length of ICU stay could affect in the treated group.
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Affiliation(s)
- Farzad Gheshlaghi
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahsa Akafzadeh Savari
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rozita Nasiri
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Anselm Wong
- Victorian Poisons Information Centre, Austin Toxicology Unit and Emergency Department, Austin Health, Heidelberg, VIC, Australia.,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.,Centre for Integrated Critical Care, Department of Medicine and Radiology, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
| | - Awat Feizi
- Department of Epidemiology & Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Maracy
- Department of Epidemiology & Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamali Dorooshi
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rokhsareh Meamar
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nastaran Eizadi-Mood
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Enantioseparation, in vitro testing, and structural characterization of triple-binding reactivators of organophosphate-inhibited cholinesterases. Biochem J 2020; 477:2771-2790. [PMID: 32639532 DOI: 10.1042/bcj20200192] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/06/2020] [Accepted: 07/08/2020] [Indexed: 11/17/2022]
Abstract
The enantiomers of racemic 2-hydroxyimino-N-(azidophenylpropyl)acetamide-derived triple-binding oxime reactivators were separated, and tested for inhibition and reactivation of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) inhibited with tabun (GA), cyclosarin (GF), sarin (GB), and VX. Both enzymes showed the greatest affinity toward the methylimidazole derivative (III) of 2-hydroxyimino-N-(azidophenylpropyl)acetamide (I). The crystal structure was determined for the complex of oxime III within human BChE, confirming that all three binding groups interacted with active site residues. In the case of BChE inhibited by GF, oximes I (kr = 207 M-1 min-1) and III (kr = 213 M-1 min-1) showed better reactivation efficiency than the reference oxime 2-PAM. Finally, the key mechanistic steps in the reactivation of GF-inhibited BChE with oxime III were modeled using the PM7R6 method, stressing the importance of proton transfer from Nε of His438 to Oγ of Ser203 for achieving successful reactivation.
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Worek F, Thiermann H, Wille T. Organophosphorus compounds and oximes: a critical review. Arch Toxicol 2020; 94:2275-2292. [PMID: 32506210 PMCID: PMC7367912 DOI: 10.1007/s00204-020-02797-0] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/28/2020] [Indexed: 12/19/2022]
Abstract
Organophosphorus (OP) pesticides and nerve agents still pose a threat to the population. Treatment of OP poisoning is an ongoing challenge and burden for medical services. Standard drug treatment consists of atropine and an oxime as reactivator of OP-inhibited acetylcholinesterase and is virtually unchanged since more than six decades. Established oximes, i.e. pralidoxime, obidoxime, TMB-4, HI-6 and MMB-4, are of insufficient effectiveness in some poisonings and often cover only a limited spectrum of the different nerve agents and pesticides. Moreover, the value of oximes in human OP pesticide poisoning is still disputed. Long-lasting research efforts resulted in the preparation of countless experimental oximes, and more recently non-oxime reactivators, intended to replace or supplement the established and licensed oximes. The progress of this development is slow and none of the novel compounds appears to be suitable for transfer into advanced development or into clinical use. This situation calls for a critical analysis of the value of oximes as mainstay of treatment as well as the potential and limitations of established and novel reactivators. Requirements for a straightforward identification of superior reactivators and their development to licensed drugs need to be addressed as well as options for interim solutions as a chance to improve the therapy of OP poisoning in a foreseeable time frame.
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Affiliation(s)
- Franz Worek
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstrasse 11, 80937, Munich, Germany.
| | - Horst Thiermann
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstrasse 11, 80937, Munich, Germany
| | - Timo Wille
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstrasse 11, 80937, Munich, Germany
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Kranawetvogl T, Steinritz D, Thiermann H, John H. A novel high‐performance liquid chromatography with diode array detector method for the simultaneous quantification of the enzyme‐reactivating oximes obidoxime, pralidoxime, and HI‐6 in human plasma. Drug Test Anal 2020; 12:938-947. [DOI: 10.1002/dta.2800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Tamara Kranawetvogl
- Bundeswehr Institute of Pharmacology and Toxicology Munich Germany
- Walther‐Straub‐Institut, Ludwig‐Maximilians‐Universität Munich Germany
| | - Dirk Steinritz
- Bundeswehr Institute of Pharmacology and Toxicology Munich Germany
- Walther‐Straub‐Institut, Ludwig‐Maximilians‐Universität Munich Germany
| | - Horst Thiermann
- Bundeswehr Institute of Pharmacology and Toxicology Munich Germany
| | - Harald John
- Bundeswehr Institute of Pharmacology and Toxicology Munich Germany
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55
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Reddy BS, Skaria TG, Polepalli S, Vidyasagar S, Rao M, Kunhikatta V, Nair S, Thunga G. Factors associated with outcomes in organophosphate and carbamate poisoning: a retrospective study. Toxicol Res 2020; 36:257-266. [PMID: 32685430 PMCID: PMC7351927 DOI: 10.1007/s43188-019-00029-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/18/2019] [Accepted: 11/27/2019] [Indexed: 10/24/2022] Open
Abstract
Organophosphate and carbamate (OPC) poisoning is a major global health hazard requiring immediate medical intervention. Atropine (ATR) is an essential antidote in organophosphate and carbamate poisoning, with the inclusion of cholinesterase reactivators and other anticholinergics, namely pralidoxime (PAM) and glycopyrrolate (GPR). This study aimed to compare the efficacy of various treatment regimens and identify the factors affecting mortality. The data of patients presented at the emergency unit with the consumption of OPC compounds between the years 2013 and 2017 were retrospectively reviewed. The study population was then categorized into four treatment patterns (1) ATR alone, (2) ATR and PAM, (3) ATR and GPR, (4) ATR, PAM and GPR. The outcome of the patients was assessed in terms of survival, intubation, ICU days, and days of ventilation and hospitalization. Univariate and multivariate analyses were performed to investigate the risk factors associated with mortality and odds ratio (OR). A total of 441 patients were included in the study, of which 69.16% were males, and 375 patients survived. Consumption of poison with a suicidal intention was reported in 98.19% of the patients, and the treatment with ATR and PAM (42.86%) was observed to have lower days of ventilation in comparison to the treatment with ATR and GPR (p = 0.003). Patients requiring intubation were also lowest in the group treated with ATR and PAM (27.51%). The age group of > 50 years (OR 4.275 [CI 2.179-8.387]), male gender (OR 2.608 [CI 1.258-5.406]), and the treatment pattern with ATR, PAM and GPR (OR 2.233 [CI 1.002-4.040]) were independently associated with mortality. In summary, male gender, elderly population, and treatment patterns followed adversely affected the outcome in patients with OPC poisoning.
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Affiliation(s)
- B. Shrikar Reddy
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - Teny Grace Skaria
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - Sravani Polepalli
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - Sudha Vidyasagar
- Department of Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Mahadev Rao
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - Vijayanarayana Kunhikatta
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - Sreedharan Nair
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - Girish Thunga
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
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Mitochondrial respiratory chain complex I dysfunction induced by N-methyl carbamate ex vivo can be alleviated with a cell-permeable succinate prodrug. Toxicol In Vitro 2020; 65:104794. [PMID: 32057835 PMCID: PMC7152559 DOI: 10.1016/j.tiv.2020.104794] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 01/28/2020] [Accepted: 02/11/2020] [Indexed: 01/09/2023]
Abstract
Human exposure to carbamates and organophosphates poses a serious threat to society and current pharmacological treatment is solely targeting the compounds' inhibitory effect on acetylcholinesterase. This toxicological pathway, responsible for acute symptom presentation, can be counteracted with currently available therapies such as atropine and oximes. However, there is still significant long-term morbidity and mortality. We propose mitochondrial dysfunction as an additional cellular mechanism of carbamate toxicity and suggest pharmacological targeting of mitochondria to overcome acute metabolic decompensation. Here, we investigated the effects on mitochondrial respiratory function of N-succinimidyl N-methylcarbamate (NSNM), a surrogate for carbamate insecticides, ex vivo in human platelets. Characterization of the mitochondrial toxicity of NSNM in platelets revealed a dose-dependent decrease in mitochondral oxygen consumption linked to respiratory chain complex I while the pathway through complex II was unaffected. In intact platelets, an increase in lactate production was seen, due to a compensatory shift towards anaerobic metabolism. Treatment with a cell-permeable succinate prodrug restored the NSNM-induced (100 μM) decrease in mitochondrial oxygen consumption and normalized lactate production to the level of control. We have demonstrated that carbamate-induced mitochondrial complex I dysfunction can be alleviated with a mitochondrial targeted countermeasure: a cell-permeable prodrug of the mitochondrial complex II substrate succinate.
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de Koning MC, Horn G, Worek F, van Grol M. Synthesis and in vitro evaluation of novel non-oximes for the reactivation of nerve agent inhibited human acetylcholinesterase. Chem Biol Interact 2020; 326:109139. [PMID: 32454005 DOI: 10.1016/j.cbi.2020.109139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/06/2020] [Accepted: 05/19/2020] [Indexed: 11/18/2022]
Abstract
Since several decades oximes have been used as part of treatment of nerve agent intoxication with the aim to restore the biological function of the enzyme acetylcholinesterase after its covalent inhibition by organophosphorus compounds such as pesticides and nerve agents. Recent findings have illustrated that, besides oximes, certain Mannich phenols can reactivate the inhibited enzyme very effectively, and may therefore represent an attractive complementary class of reactivators. In this paper we further probe the effect of structural variation on the in vitro efficacy of Mannich phenol based reactivators. Thus, we present the synthesis of 14 compounds that are close variants of the previously reported 4-amino-2-(1-pyrrolidinylmethyl)-phenol, a very effective non-oxime reactivator, and 3 dimeric Mannich phenols. All compounds were assessed for their ability to reactivate human acetylcholinesterase inhibited by the nerve agents VX, tabun, sarin, cyclosarin and paraoxon in vitro. It was confirmed that the potency of the compounds is highly sensitive to small structural changes, leading to diminished reactivation potency in many cases. However, the presence of 4-substituted alkylamine substituents (as exemplified with the 4-benzylamine-variant) was tolerated. More surprisingly, the dimeric compounds demonstrated non-typical behavior and displayed some reactivation potency as well. Both findings may open up new avenues for designing more effective non-oxime reactivators.
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Affiliation(s)
| | - Gabriele Horn
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstrasse 11, 80937, Munich, Germany
| | - Franz Worek
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstrasse 11, 80937, Munich, Germany
| | - Marco van Grol
- TNO, Lange Kleiweg 137, 2288, GJ Rijswijk, the Netherlands
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58
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Hayes TR, Blecha JE, Chao CK, Huynh TL, VanBrocklin HF, Zinn KR, Taylor PW, Gerdes JM, Thompson CM. Positron emission tomography evaluation of oxime countermeasures in live rats using the tracer O-(2-[ 18 F]fluoroethyl)-O-(p-nitrophenyl)methylphosphonate [ 18 F]-VXS. Ann N Y Acad Sci 2020; 1479:180-195. [PMID: 32436233 DOI: 10.1111/nyas.14363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/13/2020] [Accepted: 04/17/2020] [Indexed: 11/27/2022]
Abstract
Oxime antidotes regenerate organophosphate-inhibited acetylcholinesterase (AChE). Although they share a common mechanism of AChE reactivation, the rate and amount of oxime that enters the brain are critical to the efficacy, a process linked to the oxime structure and charge. Using a platform based on the organophosphate [18 F]-VXS as a positron emission tomography tracer for active AChE, the in vivo distribution of [18 F]-VXS was evaluated after an LD50 dose (250 μg/kg) of the organophosphate paraoxon (POX) and following oximes as antidotes. Rats given [18 F]-VXS tracer alone had significantly higher radioactivity (two- to threefold) in the heart and lung than rats given LD50 POX at 20 or 60 min prior to [18 F]-VXS. When rats were given LD50 POX followed by 2-PAM (cationic), RS194b (ionizable), or monoisonitrosoacetone (MINA) (neutral), central nervous system (CNS) radioactivity returned to levels at or above untreated naive rats (no POX), whereas CNS radioactivity did not increase in rats given the dication oximes HI-6 or MMB-4. MINA showed a significant, pairwise increase in CNS brain radioactivity compared with POX-treated rats. This new in vivo dynamic platform using [18 F]-VXS tracer measures and quantifies peripheral and CNS relative changes in AChE availability after POX exposure and is suitable for comparing oxime delivery and AChE reactivation in rats.
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Affiliation(s)
- Thomas R Hayes
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Joseph E Blecha
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Chih-Kai Chao
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, Montana
| | - Tony L Huynh
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Henry F VanBrocklin
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Kurt R Zinn
- Departments of Radiology, Small Animal Clinical Sciences, and Biomedical Engineering, Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, Michigan
| | - Palmer W Taylor
- Department of Pharmacology, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California at San Diego, La Jolla, California
| | - John M Gerdes
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, Montana
| | - Charles M Thompson
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, Montana
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Kharel H, Pokhrel NB, Ghimire R, Kharel Z. The Efficacy of Pralidoxime in the Treatment of Organophosphate Poisoning in Humans: A Systematic Review and Meta-analysis of Randomized Trials. Cureus 2020; 12:e7174. [PMID: 32257715 PMCID: PMC7117609 DOI: 10.7759/cureus.7174] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction The benefits of atropine in the treatment of acute organophosphate (OP) poisoning has been well established, while that of oximes is still uncertain. Pralidoxime is the most often used oxime worldwide. In vitro experiments have consistently shown that oximes are effective reactivators of human acetylcholinesterase enzyme, inhibited by OP compounds. However, the clinical benefit of pralidoxime is still unclear. A recent meta-analysis has found that pralidoxime provides no significant improvement in outcome and rather may cause harm while increasing the economic burden in low-income communities where its use is the most prevalent. Objectives This study aimed to provide an updated evaluation of the efficacy of pralidoxime in addition to atropine alone in the treatment of patients with acute OP poisoning in terms of mortality, need for ventilator support, and the incidence of intermediate syndrome. The intermediate syndrome is a clinical syndrome that occurs 24 to 96 hours after the ingestion of an OP compound and is characterized by prominent weakness of neck flexors, muscles of respiration, and proximal limb muscles. Materials and methods We searched MEDLINE, EMBASE, CENTRAL, and ClinicalTrials.gov databases until January 2019 for randomized controlled trials (RCTs) in the English language that evaluated the use of pralidoxime in individuals of any age, gender or nationality presenting with an alleged history of OP intake. The primary outcome was mortality. Secondary outcomes were the need for ventilator support and the incidence of intermediate syndrome. The risk of bias in included studies was assessed using the tool recommended by the Cochrane Handbook of Systematic Review of Interventions. Treatment/control differences in these outcomes across included studies were combined using risk ratios (RR). Results Six randomized controlled trials (n = 646) fulfilled the inclusion criteria, including one further trial missed from the most recent systematic review. The risk of bias varied across studies, with Eddleston 2009 being of the lowest risk and Cherian 2005 being of high risk. The risk of mortality (RR = 1.53, 95% confidence interval (CI) 0.97 to 2.41, P = 0.07) and the need for ventilator support (RR = 1.29, 95% CI 0.97 to 1.71, P = 0.08) were not significantly different between the pralidoxime and the control group. There was a significant increase in the incidence of intermediate syndrome in the pralidoxime group (RR = 1.63; 95% CI 1.01 to 2.62, P = 0.04). Conclusions Based on our meta-analysis of the available RCTs, pralidoxime was not shown to be beneficial in patients with acute OP poisoning. Our findings are consistent with the other literature.
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Affiliation(s)
- Himal Kharel
- Clinical Pharmacology, Tribhuvan University Institute of Medicine, Kathmandu, NPL
| | - Nishan B Pokhrel
- Internal Medicine, Tribhuvan University Institute of Medicine, Kathmandu, NPL
| | - Rakesh Ghimire
- Clinical Pharmacology, Tribhuvan University Institute of Medicine, Kathmandu, NPL
| | - Zeni Kharel
- Internal Medicine, Rochester General Hospital, Rochester, USA
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McGarry KG, Schill KE, Winters TP, Lemmon EE, Sabourin CL, Harvilchuck JA, Moyer RA. Characterization of Cholinesterases From Multiple Large Animal Species for Medical Countermeasure Development Against Chemical Warfare Nerve Agents. Toxicol Sci 2019; 174:124-132. [DOI: 10.1093/toxsci/kfz250] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Organophosphorus (OP) compounds, which include insecticides and chemical warfare nerve agents (CWNAs) such as sarin (GB) and VX, continue to be a global threat to both civilian and military populations. It is widely accepted that cholinesterase inhibition is the primary mechanism for acute OP toxicity. Disruption of cholinergic function through the inhibition of acetylcholinesterase (AChE) leads to the accumulation of the neurotransmitter acetylcholine. Excess acetylcholine at the synapse results in an overstimulation of cholinergic neurons which manifests in the common signs and symptoms of OP intoxication (miosis, increased secretions, seizures, convulsions, and respiratory failure). The primary therapeutic strategy employed in the United States to treat OP intoxication includes reactivation of inhibited AChE with the oxime pralidoxime (2-PAM) along with the muscarinic acetylcholine receptor antagonist atropine and the benzodiazepine, diazepam. CWNAs are also known to inhibit butyrylcholinesterase (BChE) without any apparent toxic effects. Therefore, BChE may be viewed as a “bioscavenger” that stoichiometrically binds CWNAs and removes them from circulation. The degree of inhibition of AChE and BChE and the effectiveness of 2-PAM are known to vary among species. Animal models are imperative for evaluating the efficacy of CWNA medical countermeasures, and a thorough characterization of available animal models is important for translating results to humans. Thus, the objective of this study was to compare the circulating levels of each of the cholinesterases as well as multiple kinetic properties (inhibition, reactivation, and aging rates) of both AChE and BChE derived from humans to AChE and BChE derived from commonly used large animal models.
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Affiliation(s)
| | | | | | - Erin E Lemmon
- Battelle Memorial Institute, Columbus, OH 43201, Ohio
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Potential Health Risks Linked to Emerging Contaminants in Major Rivers and Treated Waters. WATER 2019. [DOI: 10.3390/w11122615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The presence of endocrine-disrupting chemicals (EDCs) in our local waterways is becoming an increasing threat to the surrounding population. These compounds and their degradation products (found in pesticides, herbicides, and plastic waste) are known to interfere with a range of biological functions from reproduction to differentiation. To better understand these effects, we used an in silico ontological pathway analysis to identify the genes affected by the most commonly detected EDCs in large river water supplies, which we grouped together based on four common functions: Organismal injuries, cell death, cancer, and behavior. In addition to EDCs, we included the opioid buprenorphine in our study, as this similar ecological threat has become increasingly detected in river water supplies. Through the identification of the pleiotropic biological effects associated with both the acute and chronic exposure to EDCs and opioids in local water supplies, our results highlight a serious health threat worthy of additional investigations with a potential emphasis on the effects linked to increased DNA damage.
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Parvaz S, Taheri-Ledari R, Esmaeili MS, Rabbani M, Maleki A. A brief survey on the advanced brain drug administration by nanoscale carriers: With a particular focus on AChE reactivators. Life Sci 2019; 240:117099. [PMID: 31760098 DOI: 10.1016/j.lfs.2019.117099] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/16/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022]
Abstract
Obviously, delivery of the medications to the brain is more difficult than other tissues due to the existence of a strong obstacle, which is called blood-brain barrier (BBB). Because of the lipophilic nature of this barrier, it would be a complex (and in many cases impossible) process to cross the medications with hydrophilic behavior from BBB and deliver them to the brain. Thus, novel intricate drug-carriers in nano scales have been recently developed and suitably applied for this purpose. One of the most important categories of these hydrophilic medications, are reactivators for acetyl cholinesterase (AChE) enzyme that facilitates the breakdown of acetylcholine (as a neurotransmitter). The AChE function is inhibited by organophosphorus (OP) nerve agents that are extremely used in military conflicts. In this review, the abilities of the nanosized drug delivery systems to perform as suitable vehicles for AChE reactivators are comprehensively discussed.
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Affiliation(s)
- Sina Parvaz
- Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran
| | - Reza Taheri-Ledari
- Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran
| | - Mir Saeed Esmaeili
- Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran
| | - Mahboubeh Rabbani
- Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran
| | - Ali Maleki
- Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran.
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Yu M, Sun C, Xue Y, Liu C, Qiu D, Cui B, Zhang Y, Cui H, Zeng Z. Tannic acid-based nanopesticides coating with highly improved foliage adhesion to enhance foliar retention. RSC Adv 2019; 9:27096-27104. [PMID: 35528583 PMCID: PMC9070571 DOI: 10.1039/c9ra05843e] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 08/19/2019] [Indexed: 01/14/2023] Open
Abstract
Poor utilization efficiency of conventional pesticide formulation has resulted in overuse, which could increase costs, toxicity to other non-target organisms, concerns about human health and safety, groundwater contamination, causing ecosystem destruction and food pollution. The folia-adhesive formulation is supposed to enhance foliar retention time and utilization efficiency. According to the microstructure of the foliage, the nanopesticides surfaces were modified by affinity groups to improve folia adhesion and decrease the loss from crop foliage. In this study, tannic acid, a bioadhesive natural molecule, has been applied to develop abamectin nanopesticide (Abam-PLA-Tannin-NS) and azoxystrobin nanopesticide (Azox-PLA-Tannin-NS) with strong adhesion to foliage by chemical modification. Abam-PLA-Tannin-NS and Azox-PLA-Tannin-NS presented better photostability and continuous release behavior. The retention rates of Abam-PLA-Tannin-NS and Azox-PLA-Tannin-NS on the foliage was remarkably enhanced by more than 50%, compared with unmodified nanopesticides. Resultantly, the indoor toxicity of Abam-PLA-Tannin-NS and antifungal activity of Azox-PLA-Tannin-NS were enhanced. The interaction force between tannic acid coating nanoparticles and foliage was mainly from hydrogen bonding. Our findings could be beneficial to develop novel leaf-adhesive nanopesticides with high retention time and bioavailability.
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Affiliation(s)
- Manli Yu
- Institute of Plant Protection, Chinese Academy of Agricultural Sciences Beijing 100193 PR China
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences Beijing 100081 PR China +86-1082106004
| | - Changjiao Sun
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences Beijing 100081 PR China +86-1082106004
- Gembloux Agro-Bio Tech, University of Liege Belgium
| | - Yumiao Xue
- School of Materials Science & Engineering, Beijing Institute of Fashion Technology Beijing 100029 PR China
| | - Chang Liu
- School of Materials Science & Engineering, Beijing Institute of Fashion Technology Beijing 100029 PR China
| | - Dewen Qiu
- Institute of Plant Protection, Chinese Academy of Agricultural Sciences Beijing 100193 PR China
| | - Bo Cui
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences Beijing 100081 PR China +86-1082106004
| | - Yan Zhang
- School of Materials Science & Engineering, Beijing Institute of Fashion Technology Beijing 100029 PR China
| | - Haixin Cui
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences Beijing 100081 PR China +86-1082106004
| | - Zhanghua Zeng
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences Beijing 100081 PR China +86-1082106004
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Hulse EJ, Haslam JD, Emmett SR, Woolley T. Organophosphorus nerve agent poisoning: managing the poisoned patient. Br J Anaesth 2019; 123:457-463. [PMID: 31248646 DOI: 10.1016/j.bja.2019.04.061] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/29/2019] [Accepted: 04/05/2019] [Indexed: 10/26/2022] Open
Abstract
Organophosphorus (OP) nerve agent poisoning made the headlines in 2018 with the nerve agent 'Novichok' poisonings in Salisbury, England. This event highlighted a gap in the knowledge of most clinicians in the UK. In response, this special article aims to enlighten and signpost anaesthetists and intensivists towards the general management of OP nerve agent poisoned patients. Drawing on a broad range of sources, we will discuss what OP nerve agents are, how they work, and how to recognise and treat OP nerve agent poisoning. OP nerve agents primarily act by inhibiting the enzyme acetylcholinesterase, causing an acute cholinergic crisis; death usually occurs through respiratory failure. The antimuscarinic agent atropine, oximes (to reactivate acetylcholinesterase), neuroprotective drugs, and critical care remain the mainstays of treatment. The risk to medical staff from OP poisoned patients appears low, especially if there is a thorough decontamination of the poisoned patient and staff wear appropriate personal protective equipment. The events in Salisbury in the past year were shocking, and the staff at Salisbury District General Hospital performed admirably in treating those affected by Novichok nerve agent poisoning. We eagerly anticipate their future clinical publications so that the medical community might learn from their valuable experiences.
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Affiliation(s)
- Elspeth J Hulse
- Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK; Academic Department of Military Anaesthesia and Critical Care, RCDM, Birmingham, UK.
| | - James D Haslam
- Anaesthesia and Intensive Care Medicine, Salisbury NHS Foundation Trust, Salisbury, UK
| | | | - Tom Woolley
- Academic Department of Military Anaesthesia and Critical Care, RCDM, Birmingham, UK
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Zheng A, Shen C, Tang Q, Gong CB, Chow CF. Catalytic Chemosensing Assay for Selective Detection of Methyl Parathion Organophosphate Pesticide. Chemistry 2019; 25:9643-9649. [PMID: 31017704 DOI: 10.1002/chem.201901656] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Indexed: 11/11/2022]
Abstract
Herein, a catalytic chemosensing assay (CCA), based on a bimetallic complex, [RuII (bpy)2 (CN)2 ]2 (CuI I)2 (bpy=2,2'-bipyridine), is described. This complex integrates a task-specific catalyst (CuI -catalyst) and a signaling unit ([RuII (bpy)2 (CN)2 ]) to specifically hydrolyze methyl parathion, a highly toxic organophosphate (OP) pesticide. The bimetallic complex catalyzed the hydrolysis of the phosphate ester to generate o,o-dimethyl thiophosphate (DTP) anion and 4-nitrophenolate. Intrinsically, 4-nitrophenolate absorbed UV/Vis light at λmax =400 nm, creating the first level of the chemosensing signal. DTP interacted with the original complex to displace the chromophore, [RuII (bpy)2 (CN)2 ], which was monitored by spectrofluorometry; this was classified as the second level of chemosensing signal. By integrating both spectroscopic and spectrofluorometric signals with a simple AND logic gate, only methyl parathion was able to provide a positive response. Other aromatic and aliphatic OP pesticides (diazinon, fenthion, meviphos, terbufos, and phosalone) and 4-nitrophenyl acetate provided negative responses. Furthermore, owing to the metal-catalyzed hydrolysis of methyl parathion, the CCA system led to the detoxification of the pesticide. The CCA system also demonstrated its catalytic chemosensing properties in the detection of methyl parathion in real samples, including tap water, river water, and underground water.
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Affiliation(s)
- Anxun Zheng
- Department of Science and Environmental Studies, The Education University of Hong Kong, Southwest University, 10 Lo Ping Road, Tai Po Hong Kong SAR, China and College of, Chemistry and Chemical Engineering, Chong Qing, P. R. China
| | - Chang Shen
- Centre for Education in Environmental Sustainability, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, Hong Kong SAR, P. R. China
| | - Qian Tang
- Department of Science and Environmental Studies, The Education University of Hong Kong, Southwest University, 10 Lo Ping Road, Tai Po Hong Kong SAR, China and College of, Chemistry and Chemical Engineering, Chong Qing, P. R. China
| | - Cheng-Bin Gong
- Department of Science and Environmental Studies, The Education University of Hong Kong, Southwest University, 10 Lo Ping Road, Tai Po Hong Kong SAR, China and College of, Chemistry and Chemical Engineering, Chong Qing, P. R. China
| | - Cheuk-Fai Chow
- Department of Science and Environmental Studies, The Education University of Hong Kong, Southwest University, 10 Lo Ping Road, Tai Po Hong Kong SAR, China and College of, Chemistry and Chemical Engineering, Chong Qing, P. R. China
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Advice on assistance and protection provided by the Scientific Advisory Board of the Organisation for the Prohibition of Chemical Weapons: Part 1. On medical care and treatment of injuries from nerve agents. Toxicology 2019; 415:56-69. [DOI: 10.1016/j.tox.2019.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 01/04/2019] [Accepted: 01/07/2019] [Indexed: 11/19/2022]
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Eddleston M. Novel Clinical Toxicology and Pharmacology of Organophosphorus Insecticide Self-Poisoning. Annu Rev Pharmacol Toxicol 2019; 59:341-360. [DOI: 10.1146/annurev-pharmtox-010818-021842] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Organophosphorus insecticide self-poisoning is a major global health problem, killing over 100,000 people annually. It is a complex multi-organ condition, involving the inhibition of cholinesterases, and perhaps other enzymes, and the effects of large doses of ingested solvents. Variability between organophosphorus insecticides—in lipophilicity, speed of activation, speed and potency of acetylcholinesterase inhibition, and in the chemical groups attached to the phosphorus—results in variable speed of poisoning onset, severity, clinical toxidrome, and case fatality. Current treatment is modestly effective, aiming only to reactivate acetylcholinesterase and counter the effects of excess acetylcholine at muscarinic receptors. Rapid titration of atropine during resuscitation is lifesaving and can be performed in the absence of oxygen. The role of oximes in therapy remains unclear. Novel antidotes have been tested in small trials, but the great variability in poisoning makes interpretation of such trials difficult. More effort is required to test treatments in adequately powered studies.
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Affiliation(s)
- Michael Eddleston
- Pharmacology, Toxicology, and Therapeutics Unit, Centre for Cardiovascular Science, and Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom
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68
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Li X, Cui H, Zeng Z. A Simple Colorimetric and Fluorescent Sensor to Detect Organophosphate Pesticides Based on Adenosine Triphosphate-Modified Gold Nanoparticles. SENSORS 2018; 18:s18124302. [PMID: 30563245 PMCID: PMC6308458 DOI: 10.3390/s18124302] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/12/2018] [Accepted: 12/04/2018] [Indexed: 01/14/2023]
Abstract
A simple and dual modal (colorimetric and fluorescent) sensor for organophosphate pesticides with high sensitivity and selectivity using adenosine triphosphate (ATP)- and rhodamine B-modified gold nanoparticles (RB-AuNPs), was successfully fabricated. This detection for ethoprophos afforded colorimetric and fluorescence imaging changes visualization. The quantitative determination was linearly proportional to the amounts of ethoprophos in the range of a micromolar scale (4.0–15.0 µM). The limit of detection for ethoprophos was as low as 37.0 nM at 3σ/k. Moreover, the extent application of this simple assay was successfully demonstrated in tap water samples with high reliability and applicability, indicating remarkable application in real samples.
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Affiliation(s)
- Xiaoxia Li
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, Beijing 100081, China.
| | - Haixin Cui
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, Beijing 100081, China.
| | - Zhanghua Zeng
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, Beijing 100081, China.
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69
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Neurotoxic effects of organophosphorus pesticides and possible association with neurodegenerative diseases in man: A review. Toxicology 2018; 410:125-131. [DOI: 10.1016/j.tox.2018.09.009] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 09/04/2018] [Accepted: 09/06/2018] [Indexed: 11/18/2022]
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70
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Wei Z, Bi H, Liu YQ, Nie HF, Yao L, Wang SZ, Yang J, Wang YA, Liu X, Zheng ZB. Design, synthesis and evaluation of new classes of nonquaternary reactivators for acetylcholinesterase inhibited by organophosphates. Bioorg Chem 2018; 81:681-688. [DOI: 10.1016/j.bioorg.2018.09.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/13/2018] [Accepted: 09/17/2018] [Indexed: 12/15/2022]
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Beltagy DM, Sadek KM, Hafez AS. Serum β-glucuronidase activity as a biomarker for acute cholinesterase inhibitor pesticide poisoning. Toxicol Ind Health 2018; 34:891-897. [PMID: 30352546 DOI: 10.1177/0748233718802068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
β-glucuronidase (BG) activity is a promising biomarker for diagnosis and prognosis after exposure to organophosphorous (OP) pesticides. The aim of this study was to evaluate the changes in serum BG activity in patients with acute OP poisoning and to determine whether these changes correlate with the severity of poisoning. Thirty patients with anticholinesterase pesticide poisoning were included, besides 10 healthy volunteers as a control group. Serum activities of butyrylcholinesterase (BuChE) and BG were measured for each subject on admission, then after 12 and 24 h. Serum levels of BuChE and BG in poisoned patients were significantly different from the control subjects; these differences persisted in repeated measurements. Moreover, the serum levels showed significant differences within each group of the three time points. A significant negative correlation was found between the serum activities of BuChE and BG in all groups at the three time points. In conclusion, serum BG activity seems a reliable marker for OP poisoning even when measured at 24 h after poisoning.
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Affiliation(s)
- Doha M Beltagy
- Biochemistry division, Department of Chemistry, Faculty of Science, Damanhour University, Damanhour, Egypt
| | - Kadry M Sadek
- Department of Biochemistry, Faculty of Veterinary Medicine, Damanhur University, Damanhour, Egypt
| | - Amal S Hafez
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Horn G, de Koning MC, van Grol M, Thiermann H, Worek F. Interactions between acetylcholinesterase, toxic organophosphorus compounds and a short series of structurally related non-oxime reactivators: Analysis of reactivation and inhibition kinetics in vitro. Toxicol Lett 2018; 299:218-225. [PMID: 30312685 DOI: 10.1016/j.toxlet.2018.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 09/24/2018] [Accepted: 10/05/2018] [Indexed: 12/12/2022]
Abstract
Poisoning by organophosphorus compounds (OP) is characterized by inhibition of the key enzyme acetylcholinesterase (AChE) and potentially fatal outcomes in humans. Insufficient efficacy of the standard therapy with atropine and AChE reactivators (oximes) against certain OP initiated synthesis of novel non-oxime reactivators basing on the common structure 4-amino-2-((diethylamino)methyl)phenol (ADOC). Recently, we reported of a pyrrolidine-bearing ADOC analogue (3 l) with a remarkable ability to reactivate OP-inhibited AChE. This in vitro study was undertaken to determine reactivity, affinity and overall reactivation constants of 3 l, the reference compound ADOC and two structural analogues with human AChE inhibited by paraoxon, sarin, cyclosarin and VX. The data showed a 10 to 34-fold reactivating potency of 3 l compared to ADOC mainly due to improved affinity. Additionally, various interactions between non-oximes, human or guinea pig (GP) AChE and structurally different OP were investigated: OP-inhibited guinea pig AChE was less amenable to reactivation by ADOC and 3 l than human AChE. Compound 3 l was considered as potential pretreatment to prevent AChE from irreversible inhibition by OP: In the presence of 10 μM 3 l inhibition of native human AChE was attenuated resulting in protective indices (PI) ranging from about 2.7 to 6.0. A combination of 3 l and the bispyridinium oxime HI-6 was tested to reactivate OP-inhibited AChE: The superior reactivator of the respective OP-AChE combination dominated the reactivation process and a synergistic effect could not be observed. In conclusion, novel non-oxime reactivators like 3 l may be considered as promising templates for the design of more potent therapeutics against poisoning by highly toxic OP.
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Affiliation(s)
- Gabriele Horn
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstrasse 11, 80937 Munich, Germany
| | | | - Marco van Grol
- TNO, Lange Kleiweg 137, 2288 GJ Rijswijk, the Netherlands
| | - Horst Thiermann
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstrasse 11, 80937 Munich, Germany
| | - Franz Worek
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstrasse 11, 80937 Munich, Germany.
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Marquart K, Prokopchuk O, Worek F, Thiermann H, Martignoni ME, Wille T. Human small bowel as a useful tool to investigate smooth muscle effects of potential therapeutics in organophosphate poisoning. Toxicol Lett 2018; 293:235-240. [PMID: 29154801 DOI: 10.1016/j.toxlet.2017.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/07/2017] [Accepted: 11/12/2017] [Indexed: 11/29/2022]
Abstract
Isolated organs proofed to be a robust tool to study effects of (potential) therapeutics in organophosphate poisoning. Small bowel samples have been successfully used to reveal smooth muscle relaxing effects. In the present study, the effects of obidoxime, TMB-4, HI-6 and MB 327 were investigated on human small bowel tissue and compared with rat data. Hereby, the substances were tested in at least seven different concentrations in the jejunum or ileum both pre-contracted with carbamoylcholine. Additionally, the cholinesterase activity of native tissue was determined. Human small intestine specimens showed classical dose response-curves, similar to rat tissue, with MB 327 exerting the most potent smooth muscle relaxant effect in both species (human EC50=0.7×10-5M and rat EC50=0.7×10-5M). The AChE activity for human and rat samples did not differ significantly (rat jejunum=1351±166 mU/mg wet weight; rat ileum=1078±123 mU/mg wet weight; human jejunum=1030±258 mU/mg wet weight; human ileum=1293±243 mU/mg wet weight). Summarizing, our isolated small bowel setup seems to be a solid tool to investigate the effects of (potential) therapeutics on pre-contracted smooth muscle, with data being transferable between rat and humans.
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Affiliation(s)
- Katharina Marquart
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstr. 11, 80397 Munich, Germany
| | - Olga Prokopchuk
- Technical University of Munich, School of Medicine, Department of Surgery, Ismaninger Str. 22, 81675 Munich, Germany
| | - Franz Worek
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstr. 11, 80397 Munich, Germany
| | - Horst Thiermann
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstr. 11, 80397 Munich, Germany
| | - Marc E Martignoni
- Technical University of Munich, School of Medicine, Department of Surgery, Ismaninger Str. 22, 81675 Munich, Germany
| | - Timo Wille
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstr. 11, 80397 Munich, Germany.
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Antonijevic E, Musilek K, Kuca K, Djukic-Cosic D, Curcic M, Miladinovic DC, Bulat Z, Antonijevic B. Dose-response modeling of reactivating potency of oximes K027 and K203 against a direct acetylcholinesterase inhibitor in rat erythrocytes. Food Chem Toxicol 2018; 121:224-230. [PMID: 30176309 DOI: 10.1016/j.fct.2018.08.065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/18/2018] [Accepted: 08/28/2018] [Indexed: 10/28/2022]
Abstract
Inhibition of acethylcholinesterase (AChE) as a key molecular event induced by organophosphate (OP) pesticides and nerve agents presents a human health concern. In efficacy testing of experimental oximes, potential antidotes in OP poisoning, reactivation of OP-inhibited AChE is used as specific endpoint. However, according to our best knowledge, so far oximes have not been quantitatively evaluated by comprehensive benchmark dose (BMD) approach, that would improve both identification and quantification of the effect and allow more rigorous comparison of efficacies. Thus, we have examined in vivo dose-response relationship for two promising experimental oximes, K203 and K027, concerning reactivation of erythrocyte AChE inhibited by dichlorvos (DDVP). Groups of Wistar rats were treated with six different doses of oximes (i.m) immediately after DDVP challenge (s.c) and AChE was measured 60 min later. Dose-response modeling was done by PROAST software 65.5 (RIVM, The Nederlands). BMD-covariate method resulted in four-parameter model from both exponential and Hill model families as the best estimate of relationship between AChE activity and oxime dose, with potency parameter being oxime-dependent. Oxime K027 was shown to be 1.929-fold more potent considering that 58% increase in AChE activity was achived with the dose BMD58-K027 = 52 μmol/kg in contrast to BMD58-K203 = 100 μmol/kg.
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Affiliation(s)
- Evica Antonijevic
- University of Belgrade, Faculty of Pharmacy, Department of Toxicology "Akademik Danilo Soldatović", Vojvode Stepe 450, 11221, Belgrade, Serbia.
| | - Kamil Musilek
- University of Hradec Kralove, Faculty of Science, Department of Chemistry, Rokitanskeho 62, 500 03, Hradec Kralove, Czech Republic.
| | - Kamil Kuca
- University of Hradec Kralove, Faculty of Science, Department of Chemistry, Rokitanskeho 62, 500 03, Hradec Kralove, Czech Republic.
| | - Danijela Djukic-Cosic
- University of Belgrade, Faculty of Pharmacy, Department of Toxicology "Akademik Danilo Soldatović", Vojvode Stepe 450, 11221, Belgrade, Serbia.
| | - Marijana Curcic
- University of Belgrade, Faculty of Pharmacy, Department of Toxicology "Akademik Danilo Soldatović", Vojvode Stepe 450, 11221, Belgrade, Serbia.
| | - Dejana Cupic Miladinovic
- University of Belgrade, Faculty of Veterinary Medicine, Department of Pharmacology and Toxicology, Bulevar oslobodjenja 18, 11000, Belgrade, Serbia.
| | - Zorica Bulat
- University of Belgrade, Faculty of Pharmacy, Department of Toxicology "Akademik Danilo Soldatović", Vojvode Stepe 450, 11221, Belgrade, Serbia.
| | - Biljana Antonijevic
- University of Belgrade, Faculty of Pharmacy, Department of Toxicology "Akademik Danilo Soldatović", Vojvode Stepe 450, 11221, Belgrade, Serbia.
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Slavica V, Dubravko B, Milan J. Acute organophosphate poisoning: 17 years of experience of the National Poison Control Center in Serbia. Toxicology 2018; 409:73-79. [PMID: 30055297 DOI: 10.1016/j.tox.2018.07.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/05/2018] [Accepted: 07/18/2018] [Indexed: 11/30/2022]
Abstract
Based on human toxicity studies, by appropriate regulatory decisions, the number of organophosphates (OP) on Serbian market has reduced significantly over the last two decades, followed by a gradual decrease in the number of poisonings by organophoshates, treated at the National Poison Control Centre (NPCC). METHODOLOGY The aim of this retrospective study is to present data regarding the clinical management of poisoning with OP pesticides at the NPCC, that we collected during the 17 years period (1998-2014). RESULTS In the period 1998-2014, about 17.250 patients were hospitalized at the NPCC, there were around 14.000 patients treated for poisoning by various toxic agents, and among them 410 cases (3%) due to poisoning with OP pesticides. In this period, 92% of OPI poisonings treated in the NPCC were suicidal by intention, while only 8% were due to accidental ingestion or inhalation. The most common clinical signs of poisoning in patients exposed to anticholinesterase pesticides, observed at Clinic of Toxicology of the NPCC were miosis (63.4%), bronchorrhoea (51.9%), vomiting and diarrhea (44.8%), hypotension (19.5%). Acute respiratory insufficiency was registered in 81 (19.7%) and acute cardiocirculatory failure in 16 (3.9%) patients. There were about 25% of most severely poisoned patients. Besides general supportive measures (decontamination, respiratory support), specific pharmacological treatment (atropine, oxime, diazepam) was applied. The highest total administered dose of atropine at NPCC was 6400 mg. However, the most patients received total doses of atropine up to 500 mg (32%). CONCLUSION Acute poisoning with OP pesticides is not frequent in Serbia, however, it represents important clinical feature due to severity, possible complications and their impact on duration and costs of hospitalization. Initial treatment involves prevention of further absorption and provision of supportive care, followed by administration of specific antidotes. According to its role, the National Poison Control Centre in Belgrade, in addition to treatment of acute poisonings, continuously performs toxicovigilance, i.e. the identification, investigation and evaluation of various toxic risks in the community in order to undertake adequate and timely procedures. Permanent efforts are being made in order to reduce availability and to improve control measures for pesticides marketing.
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Affiliation(s)
- Vučinić Slavica
- National Poison Control Center, Military Medical Academy, Medical Faculty University of Defense, Crnotravska 17, 11000 Belgrade, Serbia.
| | - Bokonjić Dubravko
- National Poison Control Center, Military Medical Academy, Medical Faculty University of Defense, Crnotravska 17, 11000 Belgrade, Serbia
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He F, Wang J, Liu Y, Wang X, Cai N, Wu C, Gao Q. Xuebijing injection induces anti-inflammatory-like effects and downregulates the expression of TLR4 and NF-κB in lung injury caused by dichlorvos poisoning. Biomed Pharmacother 2018; 106:1404-1411. [PMID: 30119213 DOI: 10.1016/j.biopha.2018.07.111] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The mechanism in lung injury caused by acute organophosphate pesticide poisoning (AOPP) and an effective treatment remains unclear. We aim to clarify how the inflammatory lung injury caused by AOPP might be modulated by Xuebijing (XBJ) injection. METHODS AOPP-induced lung injury model was induced by dichlorvos (DDVP) subcutaneous administration in rats and XBJ injection was administered by intraperitoneal injection after DDVP challenge. The effects of XBJ injection were assessed by lung histopathological analysis and lung injury scores, lung wet-to-dry weight ratios (WDR) and oxygenation, differential immune cell count in bronchoalveolar lavage fluid (BALF), IL-6 and TNF-α levels in blood, the levels of TLR4 and NF-κB proteins in lung tissue and blood acetylcholinesterase (AChE) activity. RESULTS DDVP administration resulted in damage of lung histopathology and lower PaO2/FiO2 ratios (P < 0.05), which were notably attenuated by XBJ injection (P < 0.05). Total cell, macrophage, and neutrophils count in BALF and TNF-α and IL-6 levels in blood were significantly increased after DDVP exposure (P < 0.05), which were notably ameliorated by XBJ injection (P < 0.05). TLR4 and NF-κB protein in lung tissue expression after DDVP challenge were markedly increased (P < 0.05), and they were substantially downregulated by XBJ injection (P < 0.05). In addition, blood AChE activity was significantly decreased by DDVP administration (P < 0.05), however, there was no significant improvement after XBJ injection. CONCLUSION XBJ injection prevents DDVP poisoning induced lung injury by attenuating the inflammatory response. The protective effect appears to be mediated through downregulation of the TLR4 and NF-κB expression.
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Affiliation(s)
- Fei He
- Department of Emergency Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Jun Wang
- Department of Emergency Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Yao Liu
- Department of Emergency Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Xiaojing Wang
- Department of Emergency Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Nan Cai
- Department of Emergency Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Chao Wu
- Department of Infectious Disease, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, 210008, China.
| | - Qingling Gao
- Department of Emergency Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China.
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Liang J, Yu M, Guo L, Cui B, Zhao X, Sun C, Wang Y, Liu G, Cui H, Zeng Z. Bioinspired Development of P(St-MAA)-Avermectin Nanoparticles with High Affinity for Foliage To Enhance Folia Retention. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2018; 66:6578-6584. [PMID: 28727420 DOI: 10.1021/acs.jafc.7b01998] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Pesticides are chemical or biological substances to control pests and protect the crop yield. Most pesticides suffering from large amounts of losses in the environment lead to damage of ecological systems and food pollution. To reduce their losses and increase the utilization rate, we have developed bioinspired mussel avermectin nanoparticles [P(St-MAA)-Av-Cat] with strong adhesion to crop foliage by the emulsion-solvent evaporation method and chemical modification. They were near spheres with a diameter of around 120 nm. They displayed remarkable high avermectin content of more than 50% (w/w) and presented excellent storage stability as well as continuous sustained release. The photosensitive avermectins loaded were highly improved against ultraviolet light. Meanwhile, the retention rate of P(St-MAA)-Av-Cat on the crop foliage surfaces was significantly increased. As a result, the indoor toxicity of P(St-MAA)-Av-Cat was highly enhanced. The adhesive property strongly depended upon the functional groups on the nanoparticle surface. The multimodal binding mode of P(St-MAA)-Av-Cat to the crop foliage surface resulted in stronger adhesion and a longer retention time.
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Affiliation(s)
- Jie Liang
- Institute of Environment and Sustainable Development in Agriculture , Chinese Academy of Agricultural Sciences , Beijing 100081 , People's Republic of China
| | - Manli Yu
- Institute of Environment and Sustainable Development in Agriculture , Chinese Academy of Agricultural Sciences , Beijing 100081 , People's Republic of China
| | - Liya Guo
- Institute of Environment and Sustainable Development in Agriculture , Chinese Academy of Agricultural Sciences , Beijing 100081 , People's Republic of China
| | - Bo Cui
- Institute of Environment and Sustainable Development in Agriculture , Chinese Academy of Agricultural Sciences , Beijing 100081 , People's Republic of China
| | - Xiang Zhao
- Institute of Environment and Sustainable Development in Agriculture , Chinese Academy of Agricultural Sciences , Beijing 100081 , People's Republic of China
| | - Changjiao Sun
- Institute of Environment and Sustainable Development in Agriculture , Chinese Academy of Agricultural Sciences , Beijing 100081 , People's Republic of China
| | - Yan Wang
- Institute of Environment and Sustainable Development in Agriculture , Chinese Academy of Agricultural Sciences , Beijing 100081 , People's Republic of China
| | - Guoqiang Liu
- Institute of Environment and Sustainable Development in Agriculture , Chinese Academy of Agricultural Sciences , Beijing 100081 , People's Republic of China
| | - Haixin Cui
- Institute of Environment and Sustainable Development in Agriculture , Chinese Academy of Agricultural Sciences , Beijing 100081 , People's Republic of China
| | - Zhanghua Zeng
- Institute of Environment and Sustainable Development in Agriculture , Chinese Academy of Agricultural Sciences , Beijing 100081 , People's Republic of China
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79
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Zhao X, Cui H, Wang Y, Sun C, Cui B, Zeng Z. Development Strategies and Prospects of Nano-based Smart Pesticide Formulation. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2018; 66:6504-6512. [PMID: 28654254 DOI: 10.1021/acs.jafc.7b02004] [Citation(s) in RCA: 260] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Pesticides are important inputs for enhancing crop productivity and preventing major biological disasters. However, more than 90% of pesticides run off into the environment and reside in agricultural products in the process of application as a result of the disadvantages of conventional pesticide formulation, such as the use of a harmful solvent, poor dispersion, dust drift, etc. In recent years, using nanotechnology to create novel formulations has shown great potential in improving the efficacy and safety of pesticides. The development of nano-based pesticide formulation aims at precise release of necessary and sufficient amounts of their active ingredients in responding to environmental triggers and biological demands through controlled release mechanisms. This paper discusses several scientific issues and strategies regarding the development of nano-based pesticide formulations: (i) construction of water-based dispersion pesticide nanoformulation, (ii) mechanism on leaf-targeted deposition and dose transfer of pesticide nanodelivery system, (iii) mechanism on increased bioavailability of nano-based pesticide formulation, and (iv) impacts of nanoformulation on natural degradation and biosafety of pesticide residues.
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80
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Goettge MN, Cioni JP, Ju KS, Pallitsch K, Metcalf WW. PcxL and HpxL are flavin-dependent, oxime-forming N-oxidases in phosphonocystoximic acid biosynthesis in Streptomyces. J Biol Chem 2018; 293:6859-6868. [PMID: 29540479 PMCID: PMC5936822 DOI: 10.1074/jbc.ra118.001721] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 03/12/2018] [Indexed: 12/13/2022] Open
Abstract
Several oxime-containing small molecules have useful properties, including antimicrobial, insecticidal, anticancer, and immunosuppressive activities. Phosphonocystoximate and its hydroxylated congener, hydroxyphosphonocystoximate, are recently discovered oxime-containing natural products produced by Streptomyces sp. NRRL S-481 and Streptomyces regensis NRRL WC-3744, respectively. The biosynthetic pathways for these two compounds are proposed to diverge at an early step in which 2-aminoethylphosphonate (2AEPn) is converted to (S)-1-hydroxy-2-aminoethylphosphonate ((S)-1H2AEPn) in S. regensis but not in Streptomyces sp. NRRL S-481). Subsequent installation of the oxime moiety into either 2AEPn or (S)-1H2AEPn is predicted to be catalyzed by PcxL or HpxL from Streptomyces sp. NRRL S-481 and S. regensis NRRL WC-3744, respectively, whose sequence and predicted structural characteristics suggest they are unusual N-oxidases. Here, we show that recombinant PcxL and HpxL catalyze the FAD- and NADPH-dependent oxidation of 2AEPn and 1H2AEPn, producing a mixture of the respective aldoximes and nitrosylated phosphonic acid products. Measurements of catalytic efficiency indicated that PcxL has almost an equal preference for 2AEPn and (R)-1H2AEPn. 2AEPn was turned over at a 10-fold higher rate than (R)-1H2AEPn under saturating conditions, resulting in a similar but slightly lower kcat/Km We observed that (S)-1H2AEPn is a relatively poor substrate for PcxL but is clearly the preferred substrate for HpxL, consistent with the proposed biosynthetic pathway in S. regensis. HpxL also used both 2AEPn and (R)-1H2AEPn, with the latter inhibiting HpxL at high concentrations. Bioinformatic analysis indicated that PcxL and HpxL are members of a new class of oxime-forming N-oxidases that are broadly dispersed among bacteria.
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Affiliation(s)
- Michelle N Goettge
- From the Department of Microbiology and the Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, Illinois 61801 and
| | - Joel P Cioni
- From the Department of Microbiology and the Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, Illinois 61801 and
| | - Kou-San Ju
- From the Department of Microbiology and the Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, Illinois 61801 and
| | - Katharina Pallitsch
- the Institute of Organic Chemistry, University of Vienna, 1090 Vienna, Austria
| | - William W Metcalf
- From the Department of Microbiology and the Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, Illinois 61801 and
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Houzé P, Berthin T, Raphalen JH, Hutin A, Baud JF. High Dose of Pralidoxime Reverses Paraoxon-Induced Respiratory Toxicity in Mice. Turk J Anaesthesiol Reanim 2018; 46:131-138. [PMID: 29744248 DOI: 10.5152/tjar.2018.29660] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 12/20/2017] [Indexed: 11/22/2022] Open
Abstract
Objective The efficiency of pralidoxime in the treatment of human organophosphates poisoning is still unclear. In a rat model, we showed that pralidoxime induced a complete but concentration-dependent reversal of paraoxon-induced respiratory toxicity. The aim of this study was to assess the efficiency of pralidoxime in a species other than rats. Methods A dose of diethylparaoxon corresponding to 50% of the median lethal dose was administered subcutaneously to male F1B6D2 mice. Ascending single pralidoxime doses of 10, 50-100 and 150 mg kg-1 were administered intramuscularly 30 min after diethylparaoxon administration. Ventilation at rest was assessed using whole-body plethysmography and mice temperature was assessed using infrared telemetry. Results are expressed as mean±SE. Statistical analysis used non-parametric tests. Results From 30 to 150 min post-injection, diethylparaoxon induced clinical symptoms and a decrease in respiratory frequency, which resulted from an increase in expiratory and inspiratory times associated with an increase in the tidal volume. In the 10-, 50- and 100-mg kg-1 pralidoxime groups, there was a trend towards a non-significant improvement of paraoxon-induced respiratory toxicity. The 150 mg kg-1 dose of pralidoxime induced a significant reversal of all respiratory parameters. Conclusion In the present study, a toxic but non-lethal model of diethylparaoxon in awake, unrestrained mice was observed. By administering an equipotent dose of diethylparaoxon to rats, a 150 mg kg-1 dose of pralidoxime administered alone completely reversed diethylparaoxon-induced respiratory toxicity in mice. The dose dependency of reversal suggests that further studies are needed for assessing plasma concentrations of pralidoxime resulting in reversal of toxicity.
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Affiliation(s)
- Pascal Houzé
- Laboratoire de Biochimie, Hôpital Universitaire Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Thomas Berthin
- Laboratoire de Biochimie, Hôpital Universitaire Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Jean-Herlé Raphalen
- Département d'Anesthésie - Réanimation- SAMU de Paris, Hôpital Universitaire Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Alice Hutin
- Département d'Anesthésie - Réanimation- SAMU de Paris, Hôpital Universitaire Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - J Frédéric Baud
- UMR-8257. Cognitive Action Group. 45, rue des Saint-Pères. 75006. Paris. Université Paris Descartes, Paris, France
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82
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Eddleston M. Are Oximes Still Indicated for Acute Organophosphorus Insecticide Self-Poisoning? J Med Toxicol 2018; 14:1-2. [PMID: 29388062 DOI: 10.1007/s13181-018-0651-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 01/09/2018] [Indexed: 12/19/2022] Open
Affiliation(s)
- Michael Eddleston
- Pharmacology, Toxicology, & Therapeutics, and Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK.
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83
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Effect of six oximes on acutely anticholinesterase inhibitor-induced oxidative stress in rat plasma and brain. Arch Toxicol 2017; 92:745-757. [DOI: 10.1007/s00204-017-2101-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 10/24/2017] [Indexed: 12/16/2022]
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84
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Kim KH, Kim SH, Her C. Methidathion Poisoning. Korean J Crit Care Med 2017; 32:363-369. [PMID: 31723659 PMCID: PMC6786676 DOI: 10.4266/kjccm.2016.00073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 05/17/2016] [Accepted: 08/12/2016] [Indexed: 11/30/2022] Open
Abstract
Although methidathion is an organophosphate insecticide, it is different from the other organophosphates in terms of toxicity. Because of its relatively high fat solubility, the apparent volume of methidathion distribution throughout the body is very high, indicating that hemoperfusion is not effective in removing this organophosphate from the body. Redistribution of methidathion from fat to blood can also occur when plasma levels diminish. Additionally, acetylcholinesterase aging, which is the loss of an alkyl side chain that prevents reactivation by oximes, is very rapid so that the effective reactivation by oximes is thwarted. Thus, methidathion’s effect on acetylcholinesterase inhibition is long lasting, particularly with a high dose. In addition to its parasympatholytic effect and ability to induce muscle paralysis, methidathion poisoning is associated with a profound and long-lasting circulatory collapse due to sympathetic ganglion blockade. This report presents the case of a 55-year-old man who accidentally ingested a high dose of methidathion. He later developed enteroinvasive aspergillosis infection-induced multiple bowel perforations on two separate occasions while on mechanical ventilator support, resulting in a fatal outcome. The renin-angiotensin axis activated by sympathetic ganglion blockade may have reduced the patient’s splanchnic blood flow, contributing to translocation of endotoxin. Also, the effect of excessive acetylcholine on non-neuronal acetylcholine receptors may have contributed to the development of fatal enteroinvasive aspergillosis in this patient.
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Affiliation(s)
- Ki Hoon Kim
- Department of Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Se Hun Kim
- Department of Anesthesiology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Charles Her
- Department of Anesthesiology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
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85
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Becker MD, Young BC. Treatment of severe lipophilic intoxications with intravenous lipid emulsion: a case series (2011-2014). VETERINARY MEDICINE-RESEARCH AND REPORTS 2017; 8:77-85. [PMID: 30050859 PMCID: PMC6042488 DOI: 10.2147/vmrr.s129576] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The objective of this retrospective study was to describe the responses to treatment with intravenous lipid emulsion (ILE) and the outcomes for a variety of severe intoxications. This case series includes 10 client-owned animals, 9 dogs and 1 cat, that underwent treatment with ILE for a variety of severe intoxications over a 4-year period. History, physical examination findings, clinical signs, clinicopathological test results, treatment, response to treatment, and outcome were recorded. Eight of the 10 patients survived to discharge. The toxicities included in this case series were baclofen, ivermectin and spinosad plus milbemycin oxime, baclofen and tadalafil, carbamate, methamphetamine, dextroamphetamine sulfate, amlodipine, bromethalin, and organophosphate. The two patients who died were intoxicated with bromethalin and an organophosphate. Six of the 10 patients developed lipemia secondary to ILE administration, and there were no other known adverse effects. Overall, ILE was a safe therapeutic option. This case series provides clinical evidence of successful treatment with ILE as an antidote for previously unpublished toxicities (amlodipine, carbamate, methamphetamine, and dextroamphetamine sulfate), additional evidence of success in treating baclofen and ivermectin toxicosis, as well as unsuccessful treatment of bromethalin and organophosphate toxicities.
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Affiliation(s)
- Michael D Becker
- Emergency and Critical Care, Animal Specialty Group, Los Angeles, CA, USA,
| | - Brian C Young
- Emergency and Critical Care, Animal Specialty Group, Los Angeles, CA, USA,
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Perwitasari DA, Prasasti D, Supadmi W, Jaikishin SAD, Wiraagni IA. Impact of organophosphate exposure on farmers' health in Kulon Progo, Yogyakarta: Perspectives of physical, emotional and social health. SAGE Open Med 2017; 5:2050312117719092. [PMID: 28839934 PMCID: PMC5548316 DOI: 10.1177/2050312117719092] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 06/07/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The exposure of organophosphate could be caused by the absorption in some parts of the body like skin and breath. Toxicity may cause nausea, vomiting and dizziness which are not too specific related with the pesticide toxicity. The purpose of this study is to understand the association between organophosphate exposure and farmers' health in Kulon Progo County from the perspectives of physical, emotional and social health. METHODS This study was conducted using descriptive observational design. The blood sample was collected during harvesting periods in 2016. The inclusion criterion of farmers was using organophosphate-contained pesticide during the planting period of red onion. The farmers who had renal disease, liver disease and cancer were excluded. The organophosphate exposure parameters were the duration and frequency of pesticide application, width of the area, serum cholinesterase activity and the completeness of personal protective equipment. RESULTS Among 84 farmers, most of them were male (85.7%), and the mean age was 49.1 (standard deviation: 12.5) years; 71.4% of the subjects experienced tremor, 17.86% experienced dizziness and 8.33% subjects experienced nausea-vomiting after pesticide application. According to the pesticide application, in average, subjects used pesticide 1.4 h/day with the area of 1.285 m2. The frequency of pesticide used is three times per week. Around 97.6% subjects used incomplete personal protective equipment. The average of serum cholinesterase activity in subjects with tremor is higher than subjects without tremor (p > 0.05). There is a significant association between serum cholinesterase activity and creatinine content (p < 0.05). The farmers' quality-of-life domain scores are lower than the scores of the normal population in Yogyakarta. CONCLUSION Organophosphate exposure may affect the farmers' physical health and quality of life.
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Affiliation(s)
| | - Dian Prasasti
- Faculty of Pharmacy, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | - Woro Supadmi
- Faculty of Pharmacy, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
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Patočka J, Jelínková R. ATROPINE AND ATROPINE-LIKE SUBSTANCES USABLE IN WARFARE. ACTA ACUST UNITED AC 2017. [DOI: 10.31482/mmsl.2017.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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88
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Deng J, Lu D, Zhang X, Shi G, Zhou T. Highly sensitive GQDs-MnO 2 based assay with turn-on fluorescence for monitoring cerebrospinal acetylcholinesterase fluctuation: A biomarker for organophosphorus pesticides poisoning and management. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 224:436-444. [PMID: 28258856 DOI: 10.1016/j.envpol.2017.02.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 01/12/2017] [Accepted: 02/12/2017] [Indexed: 06/06/2023]
Abstract
In this study, we demonstrated an assay with turn-on fluorescence for monitoring cerebrospinal acetylcholinesterase (AChE) fluctuation as a biomarker for organophosphorus pesticides (OPs) poisoning and management based on single layer MnO2 nanosheets with graphene quantum dots (GQDs) as signal readout. Initially, the fluorescence of GQDs was quenched by MnO2 nanosheets mainly due to the inner filter effect (IFE). However, with the presence of reductive thiocholine (TCh), the enzymatic product, hydrolyzed from acetylthiocholine (ATCh) by AChE, the redox reaction between MnO2 and TCh occurred, leading to the destruction of the MnO2 nanosheets, and thereby IFE was diminished gradually. As a consequence, the turn-on fluorescence of GQDs with the changes in the spectrum of the dispersion constituted a new mechanism for sensing of cerebrospinal AChE. With the method developed here, we could monitor cerebrospinal AChE fluctuation of rats exposed to OPs before and after therapy, and could thereby open up the pathway to a new sensing platform for better understanding the mechanism of brain dysfunctions associate with OPs poisoning.
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Affiliation(s)
- Jingjing Deng
- School of Ecological and Environmental Sciences, East China Normal University, 500 Dongchuan Road, Shanghai 200241, China
| | - Dingkun Lu
- School of Ecological and Environmental Sciences, East China Normal University, 500 Dongchuan Road, Shanghai 200241, China
| | - Xiaolei Zhang
- School of Ecological and Environmental Sciences, East China Normal University, 500 Dongchuan Road, Shanghai 200241, China
| | - Guoyue Shi
- School of Chemistry and Molecular Engineering, East China Normal University, 500 Dongchuan Road, Shanghai 200241, China
| | - Tianshu Zhou
- School of Ecological and Environmental Sciences, East China Normal University, 500 Dongchuan Road, Shanghai 200241, China.
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Snider TH, Babin MC, Jett DA, Platoff GE, Yeung DT. Toxicity and median effective doses of oxime therapies against percutaneous organophosphorus pesticide and nerve agent challenges in the Hartley guinea pig. J Toxicol Sci 2017; 41:511-21. [PMID: 27432237 DOI: 10.2131/jts.41.511] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Anticholinesterases, such as organophosphorus pesticides and warfare nerve agents, present a significant health threat. Onset of symptoms after exposure can be rapid, requiring quick-acting, efficacious therapy to mitigate the effects. The goal of the current study was to identify the safest antidote with the highest therapeutic index (TI = oxime 24-hr LD50/oxime ED50) from a panel of four oximes deemed most efficacious in a previous study. The oximes tested were pralidoxime chloride (2-PAM Cl), MMB4 DMS, HLö-7 DMS, and obidoxime Cl2. The 24-hr median lethal dose (LD50) for the four by intramuscular (IM) injection and the median effective dose (ED50) were determined. In the ED50 study, male guinea pigs clipped of hair received 2x LD50 topical challenges of undiluted Russian VX (VR), VX, or phorate oxon (PHO) and, at the onset of cholinergic signs, IM therapy of atropine (0.4 mg/kg) and varying levels of oxime. Survival was assessed at 3 hr after onset clinical signs. The 3-hr 90th percentile dose (ED90) for each oxime was compared to the guinea pig pre-hospital human-equivalent dose of 2-PAM Cl, 149 µmol/kg. The TI was calculated for each OP/oxime combination. Against VR, MMB4 DMS had a higher TI than HLö-7 DMS, whereas 2-PAM Cl and obidoxime Cl2 were ineffective. Against VX, MMB4 DMS > HLö-7 DMS > 2-PAM Cl > obidoxime Cl2. Against PHO, all performed better than 2-PAM Cl. MMB4 DMS was the most effective oxime as it was the only oxime with ED90 < 149 µmol/kg against all three topical OPs tested.
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Use of IFCC guidelines to verify acetylcholinesterase reference interval in adults determined with ChE check mobile testing system. Clin Chem Lab Med 2017; 55:e268-e270. [DOI: 10.1515/cclm-2017-0207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 03/28/2017] [Indexed: 11/15/2022]
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Yu M, Yao J, Liang J, Zeng Z, Cui B, Zhao X, Sun C, Wang Y, Liu G, Cui H. Development of functionalized abamectin poly(lactic acid) nanoparticles with regulatable adhesion to enhance foliar retention. RSC Adv 2017. [DOI: 10.1039/c6ra27345a] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Functionalized abamectin poly(lactic acid) nanoparticles with different adhesion abilities to crop foliage can regulate folia retention of abamectin.
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Affiliation(s)
- Manli Yu
- Institute of Environment and Sustainable Development in Agriculture
- Chinese Academy of Agricultural Sciences
- Beijing
- PR China
| | - Junwei Yao
- Institute of Environment and Sustainable Development in Agriculture
- Chinese Academy of Agricultural Sciences
- Beijing
- PR China
| | - Jie Liang
- Institute of Environment and Sustainable Development in Agriculture
- Chinese Academy of Agricultural Sciences
- Beijing
- PR China
| | - Zhanghua Zeng
- Institute of Environment and Sustainable Development in Agriculture
- Chinese Academy of Agricultural Sciences
- Beijing
- PR China
| | - Bo Cui
- Institute of Environment and Sustainable Development in Agriculture
- Chinese Academy of Agricultural Sciences
- Beijing
- PR China
| | - Xiang Zhao
- Institute of Environment and Sustainable Development in Agriculture
- Chinese Academy of Agricultural Sciences
- Beijing
- PR China
| | - Changjiao Sun
- Institute of Environment and Sustainable Development in Agriculture
- Chinese Academy of Agricultural Sciences
- Beijing
- PR China
| | - Yan Wang
- Institute of Environment and Sustainable Development in Agriculture
- Chinese Academy of Agricultural Sciences
- Beijing
- PR China
| | - Guoqiang Liu
- Institute of Environment and Sustainable Development in Agriculture
- Chinese Academy of Agricultural Sciences
- Beijing
- PR China
| | - Haixin Cui
- Institute of Environment and Sustainable Development in Agriculture
- Chinese Academy of Agricultural Sciences
- Beijing
- PR China
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Lin CC, Hung DZ, Chen HY, Hsu KH. The effectiveness of patient-tailored treatment for acute organophosphate poisoning. Biomed J 2016; 39:391-399. [PMID: 28043418 PMCID: PMC6138500 DOI: 10.1016/j.bj.2016.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 04/13/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To determine a new pralidoxime (PAM) treatment guideline based on the severity of acute organophosphate intoxication patients, APACHE II score, and dynamic changes in serum butyrylcholinesterase (BuChE) activity. METHODS This is a randomization trial. All patients received supportive care measurements and atropinization. Each enrolled patient was treated with 2 gm PAM intravenously as the loading dose. The control group was treated according to the WHO's recommended PAM regimen, and the experimental group was treated according to their APACHE II scores and dynamic changes in BuChE activity. If a patient's APACHE II score was ≧26 or there was no elevation in BuChE activity at the 12th hour when compared to the 6th, doses of 1 g/h PAM (i.e., doubled WHO's recommended PAM regimen) were given. The levels of the serum BuChE and red blood cells acetylcholinesterase and the serum PAM levels were also measured. RESULTS Forty-six organophosphate poisoning patients were enrolled in this study. There were 24 patients in the control group and 22 patients in the experimental group. The hazard ratio of death in the control group to that of the experimental group was 111.51 (95% CI: 1.17-1.613.45; p = 0.04). The RBC acetylcholinesterase level was elevated in the experimental group but was not in the control group. The experimental group did not exhibit a higher PAM blood level than did the control group. CONCLUSION The use of PAM can be guided by patient severity. Thus, may help to improve the outcomes of organophosphate poisoning patients.
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Affiliation(s)
- Chih-Chuan Lin
- Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Dong-Zong Hung
- Department of Emergency Medicine, Toxicology Center, China Medical University Hospital, Taichung, Taiwan
| | - Hsien-Yi Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Kuang-Hung Hsu
- Laboratory for Epidemiology, Department of Health Care Management, and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
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93
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Jacob RB, Michaels KC, Anderson CJ, Fay JM, Dokholyan NV. Harnessing Nature's Diversity: Discovering organophosphate bioscavenger characteristics among low molecular weight proteins. Sci Rep 2016; 6:37175. [PMID: 27845442 PMCID: PMC5109037 DOI: 10.1038/srep37175] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 10/25/2016] [Indexed: 11/17/2022] Open
Abstract
Organophosphate poisoning can occur from exposure to agricultural pesticides or chemical weapons. This exposure inhibits acetylcholinesterase resulting in increased acetylcholine levels within the synaptic cleft causing loss of muscle control, seizures, and death. Mitigating the effects of organophosphates in our bodies is critical and yet an unsolved challenge. Here, we present a computational strategy that integrates structure mining and modeling approaches, using which we identify novel candidates capable of interacting with a serine hydrolase probe (with equilibrium binding constants ranging from 4 to 120 μM). One candidate Smu. 1393c catalyzes the hydrolysis of the organophosphate omethoate (kcat/Km of (2.0 ± 1.3) × 10-1 M-1s-1) and paraoxon (kcat/Km of (4.6 ± 0.8) × 103 M-1s-1), V- and G-agent analogs respectively. In addition, Smu. 1393c protects acetylcholinesterase activity from being inhibited by two organophosphate simulants. We demonstrate that the utilized approach is an efficient and highly-extendable framework for the development of prophylactic therapeutics against organophosphate poisoning and other important targets. Our findings further suggest currently unknown molecular evolutionary rules governing natural diversity of the protein universe, which make it capable of recognizing previously unseen ligands.
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Affiliation(s)
- Reed B. Jacob
- Department of Biochemistry and Biophysics, University of North Carolina Chapel Hill, 120 Mason Farm Rd, Campus Box 7260, 3rd Floor, Genetic Medicine Building, Chapel Hill, NC 27599, USA
| | - Kenan C. Michaels
- Department of Chemistry, University of North Carolina, 125 South Rd Kenan Rm 225, Campus Box 3290, Chapel Hill, NC 27599, USA
| | - Cathy J. Anderson
- Department of Chemistry, University of North Carolina, 125 South Rd Kenan Rm 225, Campus Box 3290, Chapel Hill, NC 27599, USA
| | - James M. Fay
- Department of Biochemistry and Biophysics, University of North Carolina Chapel Hill, 120 Mason Farm Rd, Campus Box 7260, 3rd Floor, Genetic Medicine Building, Chapel Hill, NC 27599, USA
| | - Nikolay V. Dokholyan
- Department of Biochemistry and Biophysics, University of North Carolina Chapel Hill, 120 Mason Farm Rd, Campus Box 7260, 3rd Floor, Genetic Medicine Building, Chapel Hill, NC 27599, USA
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94
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Amitai G, Gez R, Raveh L, Bar-Ner N, Grauer E, Chapman S. Novel bifunctional hybrid small molecule scavengers for mitigating nerve agents toxicity. Chem Biol Interact 2016; 259:187-204. [DOI: 10.1016/j.cbi.2016.04.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/22/2016] [Accepted: 04/25/2016] [Indexed: 01/09/2023]
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95
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Chen Q, Zeng J, Yan X, Huang Y, Wen C, Liu X, Zhang K. Electrophilic Fluorination of Secondary Phosphine Oxides and Its Application to P–O Bond Construction. J Org Chem 2016; 81:10043-10048. [DOI: 10.1021/acs.joc.6b01932] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Qian Chen
- School of Chemical Engineering
and Light Industry, Guangdong University of Technology, Guangzhou, Guangdong 510006, China
| | - Jiekun Zeng
- School of Chemical Engineering
and Light Industry, Guangdong University of Technology, Guangzhou, Guangdong 510006, China
| | - Xinxing Yan
- School of Chemical Engineering
and Light Industry, Guangdong University of Technology, Guangzhou, Guangdong 510006, China
| | - Yulin Huang
- School of Chemical Engineering
and Light Industry, Guangdong University of Technology, Guangzhou, Guangdong 510006, China
| | - Chunxiao Wen
- School of Chemical Engineering
and Light Industry, Guangdong University of Technology, Guangzhou, Guangdong 510006, China
| | - Xingguo Liu
- School of Chemical Engineering
and Light Industry, Guangdong University of Technology, Guangzhou, Guangdong 510006, China
| | - Kun Zhang
- School of Chemical Engineering
and Light Industry, Guangdong University of Technology, Guangzhou, Guangdong 510006, China
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96
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Neumaier K, Worek F, Thiermann H, Wille T. Bispyridinium non-oximes: An evaluation of cardiac effects in isolated hearts and smooth muscle relaxing effects in jejunum. Toxicol In Vitro 2016; 35:11-6. [DOI: 10.1016/j.tiv.2016.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 05/10/2016] [Accepted: 05/11/2016] [Indexed: 10/21/2022]
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97
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Snider TH, Wilhelm CM, Babin MC, Platoff GE, Yeung DT. Assessing the therapeutic efficacy of oxime therapies against percutaneous organophosphorus pesticide and nerve agent challenges in the Hartley guinea pig. J Toxicol Sci 2016; 40:759-75. [PMID: 26558457 DOI: 10.2131/jts.40.759] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Given the rapid onset of symptoms from intoxication by organophosphate (OP) compounds, a quick-acting, efficacious therapeutic regimen is needed. A primary component of anti-OP therapy is an oxime reactivator to rescue OP-inhibited acetylcholinesterases. Male guinea pigs, clipped of hair, received neat applications of either VR, VX, parathion, or phorate oxon (PHO) at the 85(th) percentile lethal dose, and, beginning with presentation of toxicosis, received the human equivalent dose therapy by intramuscular injection with two additional follow-on treatments at 3-hr intervals. Each therapy consisted of atropine free base at 0.4 mg/kg followed by one of eight candidate oximes. Lethality rates were obtained at 24 hr after VR, VX and PHO challenges, and at 48 hr after challenge with parathion. Lethality rates among symptomatic, oxime-treated groups were compared with that of positive control (OP-challenged and atropine-only treated) guinea pigs composited across the test days. Significant (p ≤ 0.05) protective therapy was afforded by 1,1-methylene bis(4(hydroxyimino- methyl)pyridinium) dimethanesulfonate (MMB4 DMS) against challenges of VR (p ≤ 0.001) and VX (p ≤ 0.05). Lethal effects of VX were also significantly (p ≤ 0.05) mitigated by treatments with oxo-[[1-[[4-(oxoazaniumylmethylidene)pyridin-1-yl]methoxymethyl]pyridin-4-ylidene]methyl]azanium dichloride (obidoxime Cl2) and 1-(((4-(aminocarbonyl) pyridinio)methoxy)methyl)-2,4-bis((hydroxyimino)methyl)pyridinium dimethanesulfonate (HLö-7 DMS). Against parathion, significant protective therapy was afforded by obidoxime dichloride (p ≤ 0.001) and 1,1'-propane-1,3-diylbis{4-[(E)-(hydroxyimino)methyl]pyridinium} dibromide (TMB-4, p ≤ 0.01). None of the oximes evaluated was therapeutically effective against PHO. Across the spectrum of OP chemicals tested, the oximes that offered the highest level of therapy were MMB4 DMS and obidoxime dichloride.
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98
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Pharmacognostic, physicochemical and chromatographic characterization of Samasharkara Churna. J Ayurveda Integr Med 2016; 7:88-99. [PMID: 27460817 PMCID: PMC4969313 DOI: 10.1016/j.jaim.2015.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 11/16/2015] [Accepted: 11/30/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Samasharkara Churna, a polyherbal Ayurvedic formulation, is prescribed for treating various conditions such as asthma and cough. Literature review suggested that characterization parameters of Samasharkara Churna are not reported. OBJECTIVE To report characteristic parameters of Samasharkara Churna to conform its identity, quality and purity. MATERIALS AND METHODS Samasharkara Churna was evaluated for pharmacognostic, physicochemical, microbiological, and chromatographic parameters. RESULTS The chromatographic analysis was able to showed presence of all ingredients in Samasharkara Churna. CONCLUSION The characterization parameters presented in this paper may serve as standard reference for the quality control analysis of Samasharkara Churna.
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99
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Shadnia S, Esmaily H, Sasanian G, Pajoumand A, Hassanian-Moghaddam H, Abdollahi M. Pattern of acute poisoning in Tehran-Iran in 2003. Hum Exp Toxicol 2016; 26:753-6. [DOI: 10.1177/0960327107083017] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To characterize the poisoning cases admitted to the Loghman-Hakim Hospital Poison Center (a teaching reference hospital of poisoning) in Tehran, Iran. All admitted acutely poisoned patients from January to December 2003 were evaluated retrospectively. Information of socio-demographic characteristics, agents and cause of poisoning, and the mortality rate were collected from medical records of the hospital. During this period, 24 179 cases were referred to the emergency department that 10 206 of them were admitted. Of the admitted cases, 51% were male and 49% female. The majority (38%) of cases were in the age range of 21—30 years. Most (79%) of poisonings were intentional and 21% were unintentional. The most important agents of acute poisoning were drugs (69.13%) especially sedative-hypnotics followed by opioids (12.34%) and pesticides especially organophosphates (OPs) (6.21%). The mortality rate was 1.3% (318 patients). Death was mostly occurred by opioids (41.54%), followed by drugs (28%) and pesticides especially OPs (12%). The prevention and treatment of poisoning due to opioids, pesticides specially OPs and sedative-hypnotics drugs should merit high priority in the health care of the indigenous population of Tehran. Human & Experimental Toxicology (2007) 26, 753— 756
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Affiliation(s)
- Shahin Shadnia
- Loghman-Hakim Hospital Poison Center, Faculty of Medicine and Toxicological Research Center, Shaheed-Beheshti University of Medical Sciences, Tehran
| | - Hadi Esmaily
- Faculty of Pharmacy and Pharmaceutical Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazal Sasanian
- Faculty of Pharmacy and Pharmaceutical Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolkarim Pajoumand
- Loghman-Hakim Hospital Poison Center, Faculty of Medicine and Toxicological Research Center, Shaheed-Beheshti University of Medical Sciences, Tehran
| | - Hosein Hassanian-Moghaddam
- Loghman-Hakim Hospital Poison Center, Faculty of Medicine and Toxicological Research Center, Shaheed-Beheshti University of Medical Sciences, Tehran
| | - Mohammad Abdollahi
- Faculty of Pharmacy and Pharmaceutical Research Center, Tehran University of Medical Sciences, Tehran, Iran,
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100
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Betten DP, Vohra RB, Cook MD, Matteucci MJ, Clark RF. Antidote Use in the Critically Ill Poisoned Patient. J Intensive Care Med 2016; 21:255-77. [PMID: 16946442 DOI: 10.1177/0885066606290386] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The proper use of antidotes in the intensive care setting when combined with appropriate general supportive care may reduce the morbidity and mortality associated with severe poisonings. The more commonly used antidotes that may be encountered in the intensive care unit ( N-acetylcysteine, ethanol, fomepizole, physostigmine, naloxone, flumazenil, sodium bicarbonate, octreotide, pyridoxine, cyanide antidote kit, pralidoxime, atropine, digoxin immune Fab, glucagon, calcium gluconate and chloride, deferoxamine, phytonadione, botulism antitoxin, methylene blue, and Crotaline snake antivenom) are reviewed. Proper indications for their use and knowledge of the possible adverse effects accompanying antidotal therapy will allow the physician to appropriately manage the severely poisoned patient.
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Affiliation(s)
- David P Betten
- Department of Emergency Medicine, Sparrow Health System, Michigan State University College of Human Medicine, Lansing, Michigan 48912-1811, USA.
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