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Cheng J, Yang L, Zhang Z, Xu D, Hua R, Chen H, Li X, Duan J, Li Q. Diquat causes mouse testis injury through inducing heme oxygenase-1-mediated ferroptosis in spermatogonia. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 280:116562. [PMID: 38850704 DOI: 10.1016/j.ecoenv.2024.116562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/14/2024] [Accepted: 06/04/2024] [Indexed: 06/10/2024]
Abstract
Diquat dibromide (DQ) is a globally used herbicide in agriculture, and its overuse poses an important public health issue, including male reproductive toxicity in mammals. However, the effects and molecular mechanisms of DQ on testes are limited. In vivo experiments, mice were intraperitoneally injected with 8 or 10 mg/kg/ day of DQ for 28 days. It has been found that heme oxygenase-1 (HO-1) mediates DQ-induced ferroptosis in mouse spermatogonia, thereby damaging testicular development and spermatogenesis. Histopathologically, we found that DQ exposure caused seminiferous tubule disorders, reduced germ cells, and increased sperm malformation, in mice. Reactive oxygen species (ROS) staining of frozen section and transmission electron microscopy (TEM) displayed DQ promoted ROS generation and mitochondrial morphology alterations in mouse testes, suggesting that DQ treatment induced testicular oxidative stress. Subsequent RNA-sequencing further showed that DQ treatment might trigger ferroptosis pathway, attributed to disturbed glutathione metabolism and iron homeostasis in spermatogonia cells in vitro. Consistently, results of western blotting, measurements of MDA and ferrous iron, and ROS staining confirmed that DQ increased oxidative stress and lipid peroxidation, and accelerated ferrous iron accumulation both in vitro and in vivo. Moreover, inhibition of ferroptosis by deferoxamine (DFO) markedly ameliorated DQ-induced cell death and dysfunction. By RNA-sequencing, we found that the expression of HO-1 was significantly upregulated in DQ-treated spermatogonia, while ZnPP (a specific inhibitor of HO-1) blocked spermatogonia ferroptosis by balancing intracellular iron homeostasis. In mice, administration of the ferroptosis inhibitor ferrostatin-1 effectively restored the increase of HO-1 levels in the spermatogonia, prevented spermatogonia death, and alleviated the spermatogenesis disorders induced by DQ. Overall, these findings suggest that HO-1 mediates DQ-induced spermatogonia ferroptosis in mouse testes, and targeting HO-1 may be an effective protective strategy against male reproductive disorders induced by pesticides in agriculture.
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Affiliation(s)
- Jianyong Cheng
- College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China
| | - Li Yang
- Health Management Center, Shenzhen University General Hospital, Shenzhen 518055, China
| | - Zelin Zhang
- College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China
| | - Dejun Xu
- Chongqing Key Laboratory of Herbivore Science, College of Animal Science and Technology, Southwest University, Chongqing 400715, China
| | - Rongmao Hua
- College of Pharmacy, Shenzhen Technology University, Shenzhen 518000, China
| | - Huali Chen
- School of Life Science and Engineering, Southwest University of Science and Technology, Mianyang 621000, China
| | - Xiaoya Li
- College of Animal Science and Technology, Qingdao Agricultural University, Qingdao 266109, China
| | - Jiaxin Duan
- College of Animal Science, Shanxi Agricultural University, Taiyuan 030801, China
| | - Qingwang Li
- College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China.
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Li H, Liu Z, Sun W, Li T, Dong X. Interpretable machine learning for the prediction of death risk in patients with acute diquat poisoning. Sci Rep 2024; 14:16101. [PMID: 38997450 PMCID: PMC11245468 DOI: 10.1038/s41598-024-67257-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 07/09/2024] [Indexed: 07/14/2024] Open
Abstract
The aim of this study was to develop and validate predictive models for assessing the risk of death in patients with acute diquat (DQ) poisoning using innovative machine learning techniques. Additionally, predictive models were evaluated through the application of SHapley Additive ExPlanations (SHAP). A total of 201 consecutive patients from the emergency departments of the First Hospital and Shengjing Hospital of China Medical University admitted for deliberate oral intake of DQ from February 2018 to August 2023 were analysed. The initial clinical data of the patients with acute DQ poisoning were collected. Machine learning methods such as logistic regression, random forest, support vector machine (SVM), and gradient boosting were applied to build the prediction models. The whole sample was split into a training set and a test set at a ratio of 8:2. The performances of these models were assessed in terms of discrimination, calibration, and clinical decision curve analysis (DCA). We also used the SHAP interpretation tool to provide an intuitive explanation of the risk of death in patients with DQ poisoning. Logistic regression, random forest, SVM, and gradient boosting models were established, and the areas under the receiver operating characteristic curves (AUCs) were 0.91, 0.98, 0.96 and 0.94, respectively. The net benefits were similar across all four models. The four machine learning models can be reliable tools for predicting death risk in patients with acute DQ poisoning. Their combination with SHAP provides explanations for individualized risk prediction, increasing the model transparency.
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Affiliation(s)
- Huiyi Li
- Department of Emergency Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Zheng Liu
- Department of Emergency Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Wenming Sun
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tiegang Li
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Xuesong Dong
- Department of Emergency Medicine, The First Hospital of China Medical University, Shenyang, China.
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Zhou N, Cao Y, Luo Y, Wang L, Li R, Di H, Gu T, Cao Y, Zeng T, Zhu J, Chen L, An D, Ma Y, Xu W, Tian Y, Lu L. The Effects of Resveratrol and Apigenin on Jejunal Oxidative Injury in Ducks and on Immortalized Duck Intestinal Epithelial Cells Exposed to H 2O 2. Antioxidants (Basel) 2024; 13:611. [PMID: 38790716 PMCID: PMC11117746 DOI: 10.3390/antiox13050611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/12/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
Oxidative stress increases the apoptosis of intestinal epithelial cells and impairs intestinal epithelial cell renewal, which further promotes intestinal barrier dysfunction and even death. Extensive evidence supports that resveratrol and apigenin have antioxidant, anti-inflammatory, and antiproliferative properties. Here, we investigated the ability of these two compounds to alleviate diquat-induced jejunal oxidative stress and morphological injury, using the duck as a model, as well as the effects of apigenin on oxidative stress induced by H2O2 in immortalized duck intestinal epithelial cells (IDECs). Ducks were randomly assigned to the following four groups, with five replicates: a control (CON) group, a diquat-challenged (DIQ) group, a resveratrol (500 mg/kg) + diquat (RES) group, and an apigenin (500 mg/kg) + diquat (API) group. We found that serum catalase (CAT) activity and total antioxidant capacity (T-AOC) markedly reduced in the RES and API groups as compared to the DIQ group (p < 0.05); moreover, serum S superoxide dismutase (SOD) levels increased significantly in the API group as compared to the DIQ group (p < 0.05). In jejunal mucosa, the malondialdehyde (MDA) content in the RES and API groups decreased more than that in the DIQ group (p < 0.05). In addition, the jejunal expression levels of the NRF2 and GCLM genes in the RES and API groups increased notably compared with those in the DIQ group (p < 0.05); meanwhile, CAT activity in the RES and API groups was markedly elevated compared with that in the CON group (p < 0.05). In IDECs, apigenin significantly restrained the H2O2-mediated increase in MDA content and decrease in CAT levels (p < 0.05). Furthermore, apigenin increased the protein expression of p-NRF2, NRF2, p-AKT, and p-P38; downregulated that of cleaved caspase-3 and cleaved caspase-9; and reduced the ratio of Bax/Bcl-2 in H2O2-treated IDECs (p < 0.05). In conclusion, resveratrol and apigenin can be used as natural feed additives to protect against jejunal oxidative stress in ducks.
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Affiliation(s)
- Ning Zhou
- College of Pet Sciences, Jiangsu Agri-Animal Husbandry Vocational College, Taizhou 225300, China; (N.Z.); (Y.L.); (L.W.); (H.D.); (Y.C.); (J.Z.); (D.A.); (Y.M.)
- College of Animal Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
| | - Yongqing Cao
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Institute of Animal Science & Veterinary, Zhejiang Academy of Agricultural Sciences, Hangzhou 310000, China; (Y.C.); (R.L.); (T.G.); (T.Z.); (L.C.); (W.X.)
| | - Youwen Luo
- College of Pet Sciences, Jiangsu Agri-Animal Husbandry Vocational College, Taizhou 225300, China; (N.Z.); (Y.L.); (L.W.); (H.D.); (Y.C.); (J.Z.); (D.A.); (Y.M.)
| | - Lihua Wang
- College of Pet Sciences, Jiangsu Agri-Animal Husbandry Vocational College, Taizhou 225300, China; (N.Z.); (Y.L.); (L.W.); (H.D.); (Y.C.); (J.Z.); (D.A.); (Y.M.)
| | - Ruiqing Li
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Institute of Animal Science & Veterinary, Zhejiang Academy of Agricultural Sciences, Hangzhou 310000, China; (Y.C.); (R.L.); (T.G.); (T.Z.); (L.C.); (W.X.)
| | - Heshuang Di
- College of Pet Sciences, Jiangsu Agri-Animal Husbandry Vocational College, Taizhou 225300, China; (N.Z.); (Y.L.); (L.W.); (H.D.); (Y.C.); (J.Z.); (D.A.); (Y.M.)
| | - Tiantian Gu
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Institute of Animal Science & Veterinary, Zhejiang Academy of Agricultural Sciences, Hangzhou 310000, China; (Y.C.); (R.L.); (T.G.); (T.Z.); (L.C.); (W.X.)
| | - Yun Cao
- College of Pet Sciences, Jiangsu Agri-Animal Husbandry Vocational College, Taizhou 225300, China; (N.Z.); (Y.L.); (L.W.); (H.D.); (Y.C.); (J.Z.); (D.A.); (Y.M.)
| | - Tao Zeng
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Institute of Animal Science & Veterinary, Zhejiang Academy of Agricultural Sciences, Hangzhou 310000, China; (Y.C.); (R.L.); (T.G.); (T.Z.); (L.C.); (W.X.)
| | - Jianping Zhu
- College of Pet Sciences, Jiangsu Agri-Animal Husbandry Vocational College, Taizhou 225300, China; (N.Z.); (Y.L.); (L.W.); (H.D.); (Y.C.); (J.Z.); (D.A.); (Y.M.)
| | - Li Chen
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Institute of Animal Science & Veterinary, Zhejiang Academy of Agricultural Sciences, Hangzhou 310000, China; (Y.C.); (R.L.); (T.G.); (T.Z.); (L.C.); (W.X.)
| | - Dong An
- College of Pet Sciences, Jiangsu Agri-Animal Husbandry Vocational College, Taizhou 225300, China; (N.Z.); (Y.L.); (L.W.); (H.D.); (Y.C.); (J.Z.); (D.A.); (Y.M.)
| | - Yue Ma
- College of Pet Sciences, Jiangsu Agri-Animal Husbandry Vocational College, Taizhou 225300, China; (N.Z.); (Y.L.); (L.W.); (H.D.); (Y.C.); (J.Z.); (D.A.); (Y.M.)
| | - Wenwu Xu
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Institute of Animal Science & Veterinary, Zhejiang Academy of Agricultural Sciences, Hangzhou 310000, China; (Y.C.); (R.L.); (T.G.); (T.Z.); (L.C.); (W.X.)
| | - Yong Tian
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Institute of Animal Science & Veterinary, Zhejiang Academy of Agricultural Sciences, Hangzhou 310000, China; (Y.C.); (R.L.); (T.G.); (T.Z.); (L.C.); (W.X.)
| | - Lizhi Lu
- College of Pet Sciences, Jiangsu Agri-Animal Husbandry Vocational College, Taizhou 225300, China; (N.Z.); (Y.L.); (L.W.); (H.D.); (Y.C.); (J.Z.); (D.A.); (Y.M.)
- College of Animal Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Institute of Animal Science & Veterinary, Zhejiang Academy of Agricultural Sciences, Hangzhou 310000, China; (Y.C.); (R.L.); (T.G.); (T.Z.); (L.C.); (W.X.)
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Fan CY, Zhang CG, Zhang PS, Chen Y, He JQ, Yin H, Gong XJ. Acute diquat poisoning case with multiorgan failure and a literature review: A case report. World J Clin Cases 2023; 11:6565-6572. [PMID: 37900248 PMCID: PMC10600979 DOI: 10.12998/wjcc.v11.i27.6565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/11/2023] [Accepted: 08/25/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND With the withdrawal of paraquat from the market, diquat is widely used, so the treatment of diquat poisoning has become one of the focuses of emergency poisoning diagnosis and treatment. CASE SUMMARY We studied the case of a 17-year-old male patient who drank 200 mL (20 g/100 mL) of diquat solution two hours before arriving at the hospital. Despite the use of treatments such as gastric lavage, hemoperfusion, continuous hemodialysis, glucocorticoids, and organ support, the patient's condition rapidly progressed to multiorgan failure, and he died 23.5 h after admission. CONCLUSION We summarized the clinical characteristics and treatment strategies of diquat poisoning through this case and performed a literature review to provide a basis and direction for clinical treatment.
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Affiliation(s)
- Chun-Yang Fan
- Emergency Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Chen-Guang Zhang
- Emergency Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Peng-Shu Zhang
- Emergency Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Yu Chen
- Emergency Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Jian-Qiang He
- Emergency Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - He Yin
- Emergency Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Xiao-Jie Gong
- Emergency Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
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5
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Pterostilbene Confers Protection against Diquat-Induced Intestinal Damage with Potential Regulation of Redox Status and Ferroptosis in Broiler Chickens. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2023; 2023:8258354. [PMID: 36733420 PMCID: PMC9889155 DOI: 10.1155/2023/8258354] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/15/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023]
Abstract
Oxidative stress causes damage to macromolecules, including proteins, DNA, and lipid, and has been recognized as a crucial driver of the onset and progression of several intestinal disorders. Pterostilbene, one of the natural antioxidants, has attracted considerable attention owing to its multiple biological activities. In the present study, we established an oxidative stress model in broiler chickens via injection with diquat to investigate whether pterostilbene could attenuate diquat-induced intestinal damage and reveal the underlying mechanisms. We found that diquat-induced decreases in the activities of superoxide dismutase and glutathione peroxidase and the level of reduced glutathione and the increase in hydrogen peroxide content in plasma and jejunum were significantly alleviated by pterostilbene (P < 0.05). Pterostilbene supplementation also decreased intestinal permeability and jejunal apoptosis rate, improved jejunal villus height and the ratio of villus height to crypt depth, and promoted the transcription and translation of jejunal tight junction proteins occludin and zona occludens 1 in diquat-challenged broilers (P < 0.05). Furthermore, pterostilbene reversed diquat-induced mitochondrial injury in the jejunum, as indicated by the decreased reactive oxygen species level and elevated activities of superoxide dismutase 2 and mitochondrial respiratory complexes (P < 0.05). Importantly, administering pterostilbene maintained iron homeostasis, inhibited lipid peroxidation, and regulated the expression of the markers of ferroptosis in the jejunum of diquat-exposed broilers (P < 0.05). The nuclear factor erythroid 2-related factor 2 signaling pathway in the jejunum of diquat-exposed broilers was also activated by pterostilbene (P < 0.05). In conclusion, our study provides evidence that pterostilbene alleviates diquat-induced intestinal mucosa injury and barrier dysfunction by strengthening antioxidant capacity and regulating ferroptosis of broiler chickens.
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Feng D, Fu L, Du X, Yao L. Acute diquat poisoning causes rhabdomyolysis. Am J Med Sci 2022; 364:472-480. [PMID: 35508282 DOI: 10.1016/j.amjms.2022.04.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 01/15/2022] [Accepted: 04/26/2022] [Indexed: 01/25/2023]
Abstract
We studied the case of a 36-year-old female patient who self-administered about 30 ml of diquat solution (200 g/L) during a suicide attempt. She developed nausea, vomiting, dizziness, and weakness in her limbs and was admitted to the emergency department of our hospital 4 h later. The patient developed progressive swelling and pain in both calves 12 h after admission. Based on symptoms, lower limb color Doppler ultrasound, and elevated levels of myoglobin and creatine kinase, the patient was diagnosed with rhabdomyolysis caused by diquat poisoning. The patient recovered and was discharged after treatment with hemoperfusion, continuous venovenous hemodialysis, acid suppression, liver protection, low-dose glucocorticoids, etc. Rhabdomyolysis caused by diquat poisoning has not been previously reported. We attempted to analyze the mechanism of this symptom through a literature review. We recommend the routine monitoring of creatine phosphokinase (CK) and myoglobin (MYO) in patients with diquat poisoning to avoid missed diagnosis. Further, the mechanism of this poisoning symptom was discussed through the literature review.
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Affiliation(s)
- Dongyang Feng
- Department of Emergency Medicine, Fifth Affiliated Hospital of Sun Yat-Sen University, Guangdong, China
| | - Linlin Fu
- Department of Emergency Medicine, Fifth Affiliated Hospital of Sun Yat-Sen University, Guangdong, China
| | - Xinyu Du
- Department of Emergency Medicine, Fifth Affiliated Hospital of Sun Yat-Sen University, Guangdong, China
| | - Lan Yao
- Department of Emergency Medicine, Fifth Affiliated Hospital of Sun Yat-Sen University, Guangdong, China.
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7
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Wang G, Wang JJ, Xu XN, Shi F, Fu XL. Targeting cellular energy metabolism- mediated ferroptosis by small molecule compounds for colorectal cancer therapy. J Drug Target 2022; 30:819-832. [PMID: 35481396 DOI: 10.1080/1061186x.2022.2071909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Alterations in cellular energy metabolism, including glycolysis, glutamine and lipid metabolism that affects ferroptosis in the tumour microenvironment (TME), play a critical role in the development and progression of colorectal cancer (CRC) and offer evolutionary advantages to tumour cells and even enhance their aggressive phenotype. This review summarises the findings on the dysregulated energy metabolism pathways, including lipid and fatty acid metabolism especially for regulating the ferroptosis in TME. Moreover, the cellular energy metabolism and tumour ferroptosis to be regulated by small molecule compounds, which targeting the different aspects of metabolic pathways of energy production as well as metabolic enzymes that connect with the tumour cell growth and ferroptosis in CRC are also discussed. In this review, we will provide a comprehensive summary on small molecule compounds regulatory function of different energy metabolic routes on ferroptosis in tumour cells and discuss those metabolic vulnerabilities for the development of potential ferroptosis-based tumour therapies for colorectal cancer.
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Affiliation(s)
- Gang Wang
- Department of Pharmaceutics, Shanghai Eighth People's Hospital, Jiangsu University, Shanghai, China
| | - Jun-Jie Wang
- Department of Pharmaceutics, Shanghai Eighth People's Hospital, Jiangsu University, Shanghai, China
| | - Xiao-Na Xu
- Department of Medicine, Jiangsu University, Zhenjiang City, China
| | - Feng Shi
- Department of Medicine, Jiangsu University, Zhenjiang City, China
| | - Xing-Li Fu
- Department of Medicine, Jiangsu University, Zhenjiang City, China
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8
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Wang D, Zhang G, Zhang W, Luo J, Zhu L, Hu J. Successful extracorporeal membrane oxygenation support for severe acute diquat and glyphosate poisoning: A case report. Medicine (Baltimore) 2019; 98:e14414. [PMID: 30732194 PMCID: PMC6380784 DOI: 10.1097/md.0000000000014414] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/08/2019] [Accepted: 01/15/2019] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Because of the lack of an antidote or effective treatment, patients with severe acute diquat and glyphosate poisoning always died within a few hours. Extracorporeal membrane pulmonary oxygenation (ECMO), as an artificial heart-lung supporting system, can be applied to support lung that is expected to recover from reversible pathological damage. However, to our knowledge, the application of ECMO for patients with diquat and glyphosate poisoning has not been reported. PATIENT CONCERNS A 40-year-old man ingested in 100 ml of diquat (20 g/100 ml) and 400 ml glyphosate (41 g/100 ml) was admitted to the intensive care unit (ICU), immediately complicated by the development of ventricular fibrillation, respiratory failure, renal failure, and multi-organ failure. DIAGNOSIS Diquat and glyphosate poisoning were diagnosed by stated ingestion history, and the diagnostic criteria for acute respiratory distress syndrome (ARDS) and multi-organ dysfunction syndrome were also met. INTERVENTIONS He was treated with veno-venous ECMO. OUTCOMES He was successfully transferred out of the ICU on day 46 and discharged on day 67. The computed tomography scan showed no obvious pulmonary fibrosis 2 months after poisoning. LESSONS ECMO may be effective in the treatment of patients with severe ARDS caused by diquat and glyphosate poisoning when conventional management does not work.
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Affiliation(s)
- Danqiong Wang
- Department of Critical Care Medicine, Quzhou People's Hospital, Quzhou
| | - Guozheng Zhang
- Zhejiang Chinese Medical University, Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People's Republic of China
| | - Weiwen Zhang
- Department of Critical Care Medicine, Quzhou People's Hospital, Quzhou
| | - Jian Luo
- Department of Critical Care Medicine, Quzhou People's Hospital, Quzhou
| | - Lihua Zhu
- Department of Critical Care Medicine, Quzhou People's Hospital, Quzhou
| | - Jianhua Hu
- Department of Critical Care Medicine, Quzhou People's Hospital, Quzhou
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Magalhães N, Carvalho F, Dinis-Oliveira RJ. Human and experimental toxicology of diquat poisoning: Toxicokinetics, mechanisms of toxicity, clinical features, and treatment. Hum Exp Toxicol 2018; 37:1131-1160. [PMID: 29569487 DOI: 10.1177/0960327118765330] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Diquat (1,1'-ethylene-2,2'-bipyridinium ion; DQ) is a nonselective quick-acting herbicide, which is used as contact and preharvest desiccant to control terrestrial and aquatic vegetation. Several cases of human poisoning were reported worldwide mainly due to intentional ingestion of the liquid formulations. Its toxic potential results from its ability to produce reactive oxygen and nitrogen species through redox cycling processes that can lead to oxidative stress and potentially cell death. Kidney is the main target organ due to DQ toxicokinetics and redox cycling. There is no antidote against DQ intoxications, and the efficacy of treatments currently applied is still unsatisfactory. The aim of this work was to review the most relevant human and experimental findings related to DQ, characterizing its chemistry, activity as herbicide, mechanisms of toxicity, consequences of poisoning, and potential therapeutic approaches taking into account previous experience in developing antidotes for paraquat, a more toxic bipyridinium herbicide.
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Affiliation(s)
- N Magalhães
- 1 UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - F Carvalho
- 1 UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - R J Dinis-Oliveira
- 1 UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,2 IINFACTS-Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS-CESPU), Gandra, Portugal.,3 Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
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