1
|
Schmitt JS, Knight LD. Method Validation Study of Dipstick Urinalysis as a Screening Tool for Sodium Nitrite Toxicity. Am J Forensic Med Pathol 2024; 45:210-214. [PMID: 38754175 DOI: 10.1097/paf.0000000000000940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
ABSTRACT The incidence of suicide by intentional nitrite ingestion has increased since 2017. Limited options exist for commercial laboratory analysis for nitrite/nitrate. This study investigates the use of urine dipsticks for screening at autopsy for potential toxicity with sodium nitrite and, less commonly, alkyl nitrite. Archived samples of blood, urine, vitreous fluid, and gastric contents from 4 sodium nitrite/nitrate cases, 3 alkyl nitrite cases, and 4 control cases were tested using dipsticks. A rapid, strong positive result for nitrite was in the vitreous fluid of all 4-sodium nitrite/nitrate cases, along with 2 positive urine and 1 positive gastric. The 2 alkyl nitrite inhalation toxicity cases had no positive results. One alkyl nitrite ingestion case had a positive urine. The 4 controls had negative urine: equivocal results in 2 vitreous, and 1 positive gastric. Urine dipsticks are a useful adjunct to laboratory testing for nitrite toxicity and provide a rapid, cost-effective tableside result that may guide the need for further testing. Vitreous fluid and urine appear to be the most reliable specimens, although testing of gastric liquid may be useful to corroborate oral ingestion. Dipsticks may not be a reliable adjunct for testing for alkyl nitrite toxicity via inhalation route, likely due to the much lower nitrite concentration compared to nitrite ingestion cases.
Collapse
Affiliation(s)
- Jessicia S Schmitt
- From the University of Utah and ARUP Laboratories, Department of Pathology, Salt Lake City, UT
| | - Laura D Knight
- Washoe County Regional Medical Examiner's Office, and University of Nevada-Reno School of Medicine, Departments of Pathology and Pediatrics, Reno, NV
| |
Collapse
|
2
|
Suzuki Y, Arakida Y, Sakai H, Enoki Y, Matsumoto K, Taguchi K. Elucidating the binding properties of methemoglobin in red blood cell to cyanide, hydrosulfide, and azide ions using artificial red blood cell. Toxicol Appl Pharmacol 2023; 481:116752. [PMID: 37956930 DOI: 10.1016/j.taap.2023.116752] [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: 10/07/2023] [Revised: 11/01/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
Methemoglobin (metHb), the oxidized form of hemoglobin, lacks the ability of reversible oxygen binding; however, it has a high binding affinity to toxic substances such as cyanide, hydrosulfide, and azide. This innate property of metHb offers the clinical option to treat patients poisoned with these toxins, by oxidizing the endogenous hemoglobin in the red blood cells (RBCs). The binding properties of naked metHb (isolated from RBC) with these toxins has been studied; however, the binding behaviors of metHb under the intracellular conditions of RBC are unclear because of the difficulty in detecting metHb status changes in RBC. This study aimed to elucidate the binding properties of metHb in RBC under physiological and poisoned conditions using artificial RBC, which was hemoglobin encapsulated in a liposome. The mimic-circumstances of metHb in RBC (metHb-V) was prepared by oxidizing the hemoglobin in artificial RBC. Spectroscopic analysis indicated that the metHb in metHb-V exhibited a binding behavior different from that of naked metHb, depending on the toxic substance: When the pH decreased, (i) the cyanide binding affinity of metHb-V remained unchanged, but that of naked metHb decreased (ii) the hydrosulfide binding affinity was increased in metHb-V but was decreased in naked metHb. (iii) Azide binding was increased in metHb-V, which was similar to that in naked metHb, irrespective of the pH change. Thus, the binding behavior of intracellular metHb in the RBC with cyanide, hydrosulfide, and azide under physiological and pathological conditions were partly elucidated using the oxidized artificial RBC.
Collapse
Affiliation(s)
- Yuto Suzuki
- Division of Pharmacodynamics, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan
| | - Yo Arakida
- Division of Pharmacodynamics, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan
| | - Hiromi Sakai
- Department of Chemistry, Nara Medical University, Shijo-cho 840, Kashihara, Nara 634-8521, Japan
| | - Yuki Enoki
- Division of Pharmacodynamics, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan
| | - Kazuaki Matsumoto
- Division of Pharmacodynamics, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan
| | - Kazuaki Taguchi
- Division of Pharmacodynamics, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan.
| |
Collapse
|
3
|
Suzuki Y, Taguchi K, Okamoto W, Enoki Y, Komatsu T, Matsumoto K. Pharmaceutical stability of methemoglobin-albumin cluster as an antidote for hydrogen sulfide poisoning after one-year storage in freeze-dried form. Int J Pharm 2023; 645:123433. [PMID: 37739098 DOI: 10.1016/j.ijpharm.2023.123433] [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: 07/17/2023] [Revised: 08/23/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023]
Abstract
Long-term stability during storage is an important requirement for pharmaceutical preparations. The methemoglobin (metHb)-albumin cluster, in which bovine metHb is covalently enveloped with an average of three human albumin molecules, is a promising antidote for hydrogen sulfide (H2S) poisoning. In this study, we investigated the pharmaceutical stability of metHb-albumin cluster after storage for one year in solution and as freeze-dried powder. The lyophilized powder of metHb-albumin cluster stored for one year was readily reconstituted in sterile water for injection, yielding a homogeneous brown solution. Physicochemical measurements revealed that the overall structure of the metHb-albumin cluster was still maintained after preservation. Results of the pharmacological study showed that 100 % of the H2S-poisoned mice survived after treatment with the reconstituted solution of metHb-albumin cluster powder. Furthermore, the solution did not cause any toxic reactions. The antidotal efficacy of metHb-albumin cluster for H2S poisoning was preserved in freeze-dried powder form for at least one year.
Collapse
Affiliation(s)
- Yuto Suzuki
- Division of Pharmacodynamics, Faculty of Pharmacy, Keio University, Tokyo 105-8512, Japan
| | - Kazuaki Taguchi
- Division of Pharmacodynamics, Faculty of Pharmacy, Keio University, Tokyo 105-8512, Japan.
| | - Wataru Okamoto
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo 112-8551, Japan
| | - Yuki Enoki
- Division of Pharmacodynamics, Faculty of Pharmacy, Keio University, Tokyo 105-8512, Japan
| | - Teruyuki Komatsu
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo 112-8551, Japan
| | - Kazuaki Matsumoto
- Division of Pharmacodynamics, Faculty of Pharmacy, Keio University, Tokyo 105-8512, Japan
| |
Collapse
|
4
|
Suzuki Y, Taguchi K, Okamoto W, Enoki Y, Komatsu T, Matsumoto K. Methemoglobin-albumin clusters for cyanide detoxification. Toxicol Appl Pharmacol 2023; 466:116472. [PMID: 36934860 DOI: 10.1016/j.taap.2023.116472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023]
Abstract
Sodium nitrite (NaNO2) is a universal antidote for patients with cyanide poisoning. However, its use has serious drawbacks in terms of efficacy and safety. Herein, we present a promising antidote: methemoglobin (metHb)-albumin clusters. The metHb-albumin cluster is made by a metHb core wrapped by covalently bound human serum albumin. Spectral analyses proved that the metHb-albumin clusters possessed cyanide-binding properties similar to those of naked metHb. In vitro cell experiments showed that metHb-albumin clusters prevented the cyanide-induced inhibition of cytochrome c oxidase activity, resulting in a strong cytoprotective effect. In mice subjected to cyanide poisoning, metHb-albumin clusters reduced mortality and alleviated metabolic acidosis, while maintaining the activity of cytochrome c oxidase in organs; their efficacy was better than that of NaNO2. Furthermore, the oxygen carrying capacity was maintained in poisoned mice treated with metHb-albumin clusters and was low in those treated with NaNO2. These results indicate that metHb-albumin clusters could be a more effective and safer antidote against cyanide poisoning than NaNO2.
Collapse
Affiliation(s)
- Yuto Suzuki
- Faculty of Pharmacy, Keio University, Tokyo, Japan
| | | | - Wataru Okamoto
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Yuki Enoki
- Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Teruyuki Komatsu
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | | |
Collapse
|
5
|
Jones AD, Sapatnekar S, Bakdash S. Drugs and Conditions That May Mimic Hemolysis. Am J Clin Pathol 2023; 159:34-42. [PMID: 36367367 DOI: 10.1093/ajcp/aqac130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/12/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Visual inspection of posttransfusion plasma for hemolysis is a key laboratory method in the investigation of possible acute hemolytic transfusion reactions (AHTRs). Many substances and physiologic conditions can mimic hemolysis in vitro. Isolated reports describe specific cases of interference, but a comprehensive listing is lacking. METHODS Using an illustrative case, we summarize available literature on substances and conditions that may mimic hemolysis in vitro. We further describe other substances and conditions that may discolor plasma but are unlikely to be mistaken for hemolysis on visual inspection. RESULTS At least 11 substances and conditions have been reported to discolor plasma, in colors ranging from orange to red to brown, including relatively common therapies (eg, eltrombopag, hydroxocobalamin, iron dextran). Other substances are unlikely to be encountered in everyday practice but may mimic hemolysis in particular patient populations. Additional substances may cause plasma discoloration, ranging from blue to green to white, and are associated with a wide variety of therapies and conditions. CONCLUSIONS An awareness of the possible preanalytic confounding factors that may mimic hemolysis can aid in the workup of a suspected AHTR. Review of the medical record, use of ancillary testing, and consideration for nonimmune causes of hemolysis can aid in ruling out AHTR.
Collapse
Affiliation(s)
- Andrew D Jones
- From the Section of Transfusion Medicine, The Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Suneeti Sapatnekar
- From the Section of Transfusion Medicine, The Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Suzanne Bakdash
- From the Section of Transfusion Medicine, The Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|
6
|
Liposomal methemoglobin as a potent antidote for hydrogen sulfide poisoning. Toxicol Appl Pharmacol 2022; 450:116159. [PMID: 35803436 DOI: 10.1016/j.taap.2022.116159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 06/30/2022] [Accepted: 07/03/2022] [Indexed: 11/21/2022]
Abstract
Hydrogen sulfide (H2S) induces acute and lethal toxicity at high concentrations. However, no specific antidotes for H2S poisoning have been approved. Liposomal methemoglobin (metHb@Lipo) was developed as an antidote for cyanide poisoning. As the toxic mechanism of H2S poisoning is the same as that of cyanide poisoning, metHb@Lipo could potentially be used as an antidote for H2S poisoning. In this study, we evaluated the antidotal efficacy of metHb@Lipo against H2S poisoning. Stopped-flow rapid-scan spectrophotometry clearly showed that metHb@Lipo scavenged H2S rapidly. Additionally, metHb@Lipo showed cytoprotective effects against H2S exposure in H9c2 cells by maintaining mitochondrial function. MetHb@Lipo treatment also improved the survival rate after H2S exposure in vivo, with the maintenance of cytochrome c oxidase activity and suppression of metabolic acidosis. Moreover, metHb@Lipo therapy maintained significant antidotal efficacy even after 1-year-storage at 4-37 °C. In conclusion, metHb@Lipo is a candidate antidote for H2S poisoning.
Collapse
|
7
|
McMichael MA, Singletary M, Akingbemi BT. Toxidromes for Working Dogs. Front Vet Sci 2022; 9:898100. [PMID: 35909672 PMCID: PMC9334742 DOI: 10.3389/fvets.2022.898100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022] Open
Abstract
Terrorist attacks with biological and chemical warfare agents are increasing in frequency worldwide. Additionally, hazardous chemical accidents, illicit drug laboratories and intentional poisonings are potential sites for exposure to working dogs. Working dogs play a crucial role in law enforcement, military and search and rescue teams. Their intelligence, agility and strength make them ideal partners to be deployed to these natural disaster sites, terrorist attacks and industrial accidents. This, unfortunately, leads to increasing exposure to chemical and biological weapons and other hazardous substances. First responders have little to no training in emergency care of working dogs and veterinarians have very little training on recognition of the clinical signs of many of these agents. In order to ensure a rapid medical response at the scene first responders and veterinarians need a primer on these agents. Identifying a specific agent amidst the chaos of a mass casualty event is challenging. Toxidromes are a constellation of clinical and/or laboratory findings that allow for rapid identification of the clinical signs associated with a class of toxin and have been helpful in human medical triage. Focusing on a class of agents rather than on each individual toxin, allows for more expedient administration of antidotes and appropriate supportive care. This article reviews toxidromes for the most common chemical weapons with a special emphasis on clinical signs that are specific (and different) for canines as well as appropriate antidotes for working canines. To our knowledge, there are no publications describing toxidromes for working dogs.
Collapse
Affiliation(s)
- Maureen A. McMichael
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, United States
- *Correspondence: Maureen A. McMichael
| | - Melissa Singletary
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, United States
- Canine Performance Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, United States
| | - Benson T. Akingbemi
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, United States
| |
Collapse
|
8
|
Suzuki Y, Taguchi K, Okamoto W, Enoki Y, Komatsu T, Matsumoto K. Methemoglobin-albumin clusters for the treatment of hydrogen sulfide intoxication. J Control Release 2022; 349:304-314. [PMID: 35809661 DOI: 10.1016/j.jconrel.2022.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 11/28/2022]
Abstract
Hydrogen sulfide (H2S) has attracted significant attention as a seed in drug development. However, H2S is toxic and induces lethal acute intoxication. Here, we developed methemoglobin (metHb)-albumin clusters as detoxifying agents for H2S intoxication, which were designed based on the inherent binding property of metHb with H2S. The metHb-albumin clusters comprising an autoxidized ferric Hb center wrapped covalently with an average of three human serum albumins showed a similar H2S binding affinity to that of naked metHb. Owing to the H2S binding capability, metHb-albumin clusters suppressed cell death induced by H2S exposure while maintaining mitochondrial function in H9c2 cells. In addition, lethal H2S intoxication model mice were rescued by a single administration of metHb-albumin clusters, resulting from the recovery of cytochrome c oxidase activity. Furthermore, the metHb-albumin clusters possessed essential characteristics, such as adequate pharmacokinetic properties and biocompatibility, for their use as detoxifying agents against H2S intoxication. In conclusion, the results obtained in this study suggest that metHb-albumin clusters are promising detoxifying agents for H2S intoxication and that harnessing the inherent H2S binding properties of metHb is an innovative approach to develop detoxifying agents for H2S intoxication.
Collapse
Affiliation(s)
- Yuto Suzuki
- Faculty of Pharmacy, Keio University, Tokyo 105-8512, Japan
| | - Kazuaki Taguchi
- Faculty of Pharmacy, Keio University, Tokyo 105-8512, Japan.
| | - Wataru Okamoto
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo 112-8551, Japan
| | - Yuki Enoki
- Faculty of Pharmacy, Keio University, Tokyo 105-8512, Japan
| | - Teruyuki Komatsu
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo 112-8551, Japan
| | | |
Collapse
|
9
|
Itakorode BO, Okonji RE, Torimiro N. Cyanide bioremediation potential of Klebsiella oxytoca JCM 1665 rhodanese immobilized on alginate-glutaraldehyde beads. BIOCATAL BIOTRANSFOR 2022. [DOI: 10.1080/10242422.2022.2087510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- B. O. Itakorode
- Department of Chemical Sciences, Oduduwa University Ipetumodu, Ile-Ife, Nigeria
- Department of Biochemistry and Molecular Biology, Faculty of Science, Obafemi Awolowo University Ile-Ife, Nigeria
| | - R. E. Okonji
- Department of Biochemistry and Molecular Biology, Faculty of Science, Obafemi Awolowo University Ile-Ife, Nigeria
| | - N. Torimiro
- Department of Microbiology, Faculty of Science, Obafemi Awolowo University Ile-Ife, Nigeria
| |
Collapse
|
10
|
Suzuki Y, Taguchi K, Hanyu S, Kure T, Enoki Y, Otagiri M, Sakai H, Matsumoto K. Oxidized liposomal artificial red blood cells rescue azide-poisoned mice from lethal toxidrome by recovering cytochrome c oxidase activity. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
11
|
Schultz BV, Rolley MEpi A, Doan TN, Isoardi K. Epidemiology of out-of-hospital cardiac arrests that occur secondary to chemical asphyxiants: a retrospective series. Resuscitation 2022; 175:113-119. [DOI: 10.1016/j.resuscitation.2022.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/01/2022] [Accepted: 03/16/2022] [Indexed: 10/18/2022]
|
12
|
Cumpston KL, Rodriguez V, Nguyen T, MacLasco A, Zin C, Rose SR, Ferguson J, Wills BK. Evaluation of prehospital hydroxocobalamin use in the setting of smoke inhalation. Am J Emerg Med 2021; 50:365-368. [PMID: 34461397 DOI: 10.1016/j.ajem.2021.08.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/15/2021] [Accepted: 08/22/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND The indications for prehospital hydroxocobalamin are not well defined. The aim of this study was to evaluate prehospital signs and symptoms in patients who received hydroxocobalamin to improve future use. METHODS In this retrospective study, all patients who received prehospital Hydroxocobalamin at a tertiary care burn center from December 2012 to March 2018 were reviewed. Each case was evaluated for evidence of suspected cyanide toxicity: hypotension, syncope, CNS depression/altered mentation, seizures, respiratory or cardiac arrest. A determination was made whether or not hydroxocobalamin was indicated. RESULTS In this study, EMS providers administered hydroxocobalamin to 42 patients between December 2012 and March 2018. The majority (71%) of suspected cyanide exposures were from house fires. The most common prehospital findings were coma or depressed CNS (36%), followed by hypotension (16%) and cardiac arrest (12%). Sixty percent of patients treated with hydroxocobalamin had none of the six clinical indicators for potential cyanide toxicity. Carboxyhemoglobin and serum lactate were significantly different in patients that had a clinical indication for hydroxocobalamin compared to those who did not. CONCLUSIONS Prehospital hydroxocobalamin was used empirically however, indications are unclear. Using defined clinical indications may provide greater clarity for providers and reduce unnecessary use of hydroxocobalamin.
Collapse
Affiliation(s)
- Kirk L Cumpston
- Division of Clinical Toxicology, Department of Emergency Medicine, VCU Medical Center, Richmond, VA, United States of America; Virginia Poison Center, Richmond, VA, United States of America; Department of Emergency Medicine, VCU Medical Center, Richmond, VA, United States of America
| | - Viviana Rodriguez
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Tammy Nguyen
- Department of Emergency Medicine, VCU Medical Center, Richmond, VA, United States of America
| | - Adam MacLasco
- Department of Emergency Medicine, VCU Medical Center, Richmond, VA, United States of America
| | - Carolyn Zin
- School of Medicine, Virginia Commonwealth University, Richmond, VA, United States of America
| | - S Rutherfoord Rose
- Division of Clinical Toxicology, Department of Emergency Medicine, VCU Medical Center, Richmond, VA, United States of America; Virginia Poison Center, Richmond, VA, United States of America; Department of Emergency Medicine, VCU Medical Center, Richmond, VA, United States of America
| | - Jeffrey Ferguson
- Department of Emergency Medicine, VCU Medical Center, Richmond, VA, United States of America
| | - Brandon K Wills
- Division of Clinical Toxicology, Department of Emergency Medicine, VCU Medical Center, Richmond, VA, United States of America; Virginia Poison Center, Richmond, VA, United States of America; Department of Emergency Medicine, VCU Medical Center, Richmond, VA, United States of America.
| |
Collapse
|
13
|
Praekunatham H, Garrett KK, Bae Y, Cronican AA, Frawley KL, Pearce LL, Peterson J. A Cobalt Schiff-Base Complex as a Putative Therapeutic for Azide Poisoning. Chem Res Toxicol 2020; 33:333-342. [PMID: 31599574 DOI: 10.1021/acs.chemrestox.9b00229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
There is presently no antidote available to treat azide poisoning. Here, the Schiff-base compound Co(II)-2,12-dimethyl-3,7,11,17-tetraazabicyclo-[11.3.1]heptadeca-1(17)2,11,13,15-pentaenyl dibromide (Co(II)N4[11.3.1]) is investigated to determine if it has the capability to antagonize azide toxicity through a decorporation mechanism. The stopped-flow kinetics of azide binding to Co(II)N4[11.3.1] in the absence of oxygen exhibited three experimentally observable phases: I (fast); II (intermediate); and III (slow). The intermediate phase II accounted for ∼70% of the overall absorbance changes, representing the major process observed, with second-order rate constants of 29 (±4) M-1 s-1 at 25 °C and 70 (±10) M-1 s-1 at 37 °C. The data demonstrated pH independence of the reaction around neutrality, suggesting the unprotonated azide anion to be the attacking species. The binding of azide to Co(II)N4[11.3.1] appears to have a complicated mechanism leading to less than ideal antidotal capability; nonetheless, this cobalt complex does protect against azide intoxication. Administration of Co(II)N4[11.3.1] at 5 min post sodium azide injection (ip) to mice resulted in a substantial decrease of righting-recovery times, 12 (±4) min, compared to controls, 40 (±8) min. In addition, only two out of seven mice "knocked down" when the antidote was administered compared to the controls given toxicant only (100% knockdown).
Collapse
Affiliation(s)
- Hirunwut Praekunatham
- Department of Environmental and Occupational Health, Graduate School of Public Health , The University of Pittsburgh , Pittsburgh , Pennsylvania 15261 , United States
| | - Kimberly K Garrett
- Department of Environmental and Occupational Health, Graduate School of Public Health , The University of Pittsburgh , Pittsburgh , Pennsylvania 15261 , United States
| | - Yookyung Bae
- Department of Environmental and Occupational Health, Graduate School of Public Health , The University of Pittsburgh , Pittsburgh , Pennsylvania 15261 , United States
| | - Andrea A Cronican
- Department of Environmental and Occupational Health, Graduate School of Public Health , The University of Pittsburgh , Pittsburgh , Pennsylvania 15261 , United States
| | - Kristin L Frawley
- Department of Environmental and Occupational Health, Graduate School of Public Health , The University of Pittsburgh , Pittsburgh , Pennsylvania 15261 , United States
| | - Linda L Pearce
- Department of Environmental and Occupational Health, Graduate School of Public Health , The University of Pittsburgh , Pittsburgh , Pennsylvania 15261 , United States
| | - Jim Peterson
- Department of Environmental and Occupational Health, Graduate School of Public Health , The University of Pittsburgh , Pittsburgh , Pennsylvania 15261 , United States
| |
Collapse
|
14
|
Ojeda J, Baeza P, Goddard M, Fernanda Cavieres M. Sulfur or Pollen? Chemical, Biological, and Toxicological Basis for the Correct Risk Communication of Urban Yellow Dust Deposition. REVIEWS OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2020; 250:69-84. [PMID: 32940760 DOI: 10.1007/398_2020_50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Urban yellow dust deposition is a common phenomenon in many parts of the world, which is sometimes called "sulfur shower," "sulfur rain," or "pollen storm." Most people, especially those living in the vicinity of industrial facilities, wrongly perceive the yellow dust as sulfur when in fact it is pollen. The misunderstanding increases risk perception as people believe the "yellow powder" is a serious threat to their health. Based on simple observations, it is virtually impossible to differentiate sulfur from pollen, so risk communication should consider the chemical, biological, and toxicological aspects of these agents. In this review, we clarify that industrial emissions of sulfur are under the form of sulfides, oxides, and other volatile compounds which are gaseous and noncolored, and we explain that it is chemically impossible for gaseous sulfur to become solid yellow sulfur under normal environmental conditions. We also describe pollen and its release from trees, shrubs, and herbs a process influenced by atmospheric conditions. We suggest take-home messages that risk communicators may use when explaining the phenomenon to their communities.
Collapse
Affiliation(s)
- Juan Ojeda
- Escuela de Nutrición, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso, Chile
| | - Patricio Baeza
- Instituto de Química, Facultad de Ciencias, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Marcela Goddard
- Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso, Chile
| | - M Fernanda Cavieres
- Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso, Chile.
| |
Collapse
|
15
|
Stefana E, Marciano F, Cocca P, Rossi D, Tomasoni G. Oxygen deficiency hazard in confined spaces in the steel industry: assessment through predictive models. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2019; 27:990-1004. [PMID: 31530255 DOI: 10.1080/10803548.2019.1669954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective. In the steel industry, performing activities in confined spaces where potential oxygen displacement can occur may expose workers to fatal consequences. To the best of our knowledge, no quantitative exposure assessment of oxygen deficiency in steel industry confined spaces is available in the literature. To overcome this gap, we performed oxygen deficiency hazard (ODH) assessments in real confined spaces using two existing models to identify the most critical parameters responsible for ODH, and suggest controls for mitigating the asphyxiation risk. Methods. We applied a well-mixed model and a near field-far field approach to estimate the indoor oxygen level with time during and following release of simple asphyxiants. Model inputs were mainly gathered thanks to audits and instrumental tests in three firms. Results. The most severe ODH exposures are posed in spaces with restricted volume and where accidental releases of inert gases can occur. Such exposures can be controlled through early release detections and augmented reality systems. Conclusions. ODH assessments in confined spaces of steel firms allow the identification of the most critical parameters from an oxygen depletion perspective, focusing on which data need careful measurement, and help to establish controls compatible with the operations conducted in these areas.
Collapse
Affiliation(s)
- Elena Stefana
- Department of Mechanical and Industrial Engineering, University of Brescia, Italy
| | - Filippo Marciano
- Department of Mechanical and Industrial Engineering, University of Brescia, Italy
| | - Paola Cocca
- Department of Mechanical and Industrial Engineering, University of Brescia, Italy
| | - Diana Rossi
- Department of Mechanical and Industrial Engineering, University of Brescia, Italy
| | - Giuseppe Tomasoni
- Department of Mechanical and Industrial Engineering, University of Brescia, Italy
| |
Collapse
|
16
|
Affiliation(s)
- Fred M Henretig
- From the Division of Emergency Medicine and Poison Control Center, Children's Hospital of Philadelphia, and the Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (F.M.H.); the Department of Homeland Security, Washington, DC (M.A.K.); and the Division of Medical Toxicology, Department of Emergency Medicine, University of Connecticut Health Center and Hartford Hospital, Hartford (C.A.M.)
| | - Mark A Kirk
- From the Division of Emergency Medicine and Poison Control Center, Children's Hospital of Philadelphia, and the Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (F.M.H.); the Department of Homeland Security, Washington, DC (M.A.K.); and the Division of Medical Toxicology, Department of Emergency Medicine, University of Connecticut Health Center and Hartford Hospital, Hartford (C.A.M.)
| | - Charles A McKay
- From the Division of Emergency Medicine and Poison Control Center, Children's Hospital of Philadelphia, and the Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia (F.M.H.); the Department of Homeland Security, Washington, DC (M.A.K.); and the Division of Medical Toxicology, Department of Emergency Medicine, University of Connecticut Health Center and Hartford Hospital, Hartford (C.A.M.)
| |
Collapse
|
17
|
Hendry-Hofer TB, Ng PC, Witeof AE, Mahon SB, Brenner M, Boss GR, Bebarta VS. A Review on Ingested Cyanide: Risks, Clinical Presentation, Diagnostics, and Treatment Challenges. J Med Toxicol 2018; 15:128-133. [PMID: 30539383 DOI: 10.1007/s13181-018-0688-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/06/2018] [Accepted: 11/19/2018] [Indexed: 12/30/2022] Open
Abstract
Cyanide, a metabolic poison, is a rising chemial threat and ingestion is the most common route of exposure. Terrorist organizations have threatened to attack the USA and international food and water supplies. The toxicokinetics and toxicodynamics of oral cyanide are unique, resulting in high-dose exposures, severe symptoms, and slower onset of symptoms. There are no FDA-approved therapies tested for oral cyanide ingestions and no approved intramuscular or oral therapies, which would be valuable in mass casualty settings. The aim of this review is to evaluate the risks of oral cyanide and its unique toxicokinetics, as well as address the lack of available rapid diagnostics and treatments for mass casualty events. We will also review current strategies for developing new therapies. A review of the literature using the PRISMA checklist detected 7284 articles, screened 1091, and included 59 articles or other reports. Articles referenced in this review were specific to risk, clinical presentation, diagnostics, current treatments, and developing therapies. Current diagnostics of cyanide exposure can take hours or days, which can delay treatment. Moreover, current therapies for cyanide poisoning are administered intravenously and are not specifically tested for oral exposures, which can result in higher cyanide doses and unique toxicodynamics. New therapies developed for oral cyanide exposures that are easily delivered, safe, and can be administered quickly by first responders in a mass casualty event are needed. Current research is aimed at identifying an antidote that is safe, effective, easy to administer, and has a rapid onset of action.
Collapse
Affiliation(s)
- Tara B Hendry-Hofer
- Department of Emergency Medicine and Toxicology, University of Colorado School of Medicine, 12700 E. 19th Ave., Aurora, CO, 80045, USA.
| | - Patrick C Ng
- Department of Emergency Medicine and Toxicology, University of Colorado School of Medicine, 12700 E. 19th Ave., Aurora, CO, 80045, USA.,Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USA
| | - Alyssa E Witeof
- Department of Emergency Medicine and Toxicology, University of Colorado School of Medicine, 12700 E. 19th Ave., Aurora, CO, 80045, USA
| | - Sari B Mahon
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Matthew Brenner
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, CA, USA
| | - Vikhyat S Bebarta
- Department of Emergency Medicine and Toxicology, University of Colorado School of Medicine, 12700 E. 19th Ave., Aurora, CO, 80045, USA.,Office of the Chief Scientist, USAF Reserve, 59th MDW, JB, San Antonio, TX, USA
| |
Collapse
|
18
|
|
19
|
Akyol S, Yuksel S, Pehlivan S, Erdemli HK, Gulec MA, Adam B, Akyol O. Possible role of antioxidants and nitric oxide inhibitors against carbon monoxide poisoning: Having a clear conscience because of their potential benefits. Med Hypotheses 2016; 92:3-6. [PMID: 27241244 DOI: 10.1016/j.mehy.2016.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/19/2016] [Accepted: 04/08/2016] [Indexed: 01/09/2023]
Abstract
Carbon monoxide poisoning is one of the important emergency situations manifested by primarily acute and chronic anoxic central nervous system (CNS) injuries and other organ damages. Current descriptions and therapeutic approaches have been focused on the anoxic pathophysiology. However, this point of view incompletely explains some of the outcomes and needs to be investigated extensively. Considering this, we propose that reactive oxygen species (ROS) including especially nitric oxide (NO) are likely to be a key concept to understand the emergency related to CO poisoning and to discover new therapeutic modalities in CO toxicity. If we consider the hypothesis that ROS is involved greatly in acute and chronic toxic effects of CO on CNS and some other vital organs such as heart, it follows that the antioxidant and anti-NO therapies might give the clinicians more opportunities to prevent deep CNS injury. In support of this, we review the subject in essence and summarize clinical and experimental studies that support a key role of ROS in the explanation of pathophysiology of CO toxicity as well as new treatment modalities after CO poisoning.
Collapse
Affiliation(s)
- Sumeyya Akyol
- Department of Medical Biology, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey.
| | - Sevda Yuksel
- Department of Child Development, School of Health, Turgut Ozal University, Ankara, Turkey
| | - Sultan Pehlivan
- Ankara Regional Office of Council of Forensic Medicine, Morgue Department, Ankara, Turkey
| | - Haci Kemal Erdemli
- Department of Biochemistry Laboratory, Corum Training and Research Hospital, Corum, Turkey
| | - Mehmet Akif Gulec
- Department of Medical Biochemistry, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey
| | - Bahattin Adam
- Department of Biochemistry & Molecular Medicine, University of California, Davis, California, United States
| | - Omer Akyol
- Department of Medical Biochemistry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
20
|
Scaglione M, Linsenmaier U, Schueller G, Berger F, Wirth S. Airway Disease. EMERGENCY RADIOLOGY OF THE CHEST AND CARDIOVASCULAR SYSTEM 2016. [PMCID: PMC7119984 DOI: 10.1007/174_2016_39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Mariano Scaglione
- Dept of Radiology, Pineta Grande Medical Center, Castel Volturno, Caserta, Italy
| | | | | | - Ferco Berger
- VU University Medical Center, Amsterdam, The Netherlands
| | | |
Collapse
|