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HPLC-MS/MS determination and the postmortem distribution or postmortem redistribution of paraquat and its metabolites in four fatal intoxication cases. Forensic Sci Int 2023; 345:111606. [PMID: 36857988 DOI: 10.1016/j.forsciint.2023.111606] [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: 06/09/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 02/15/2023]
Abstract
HPLC-MS/MS analysis and postmortem distribution or postmortem redistribution of paraquat and its two metabolites in poisoning death cases were reported. Paraquat, monoquat, and paraquat monopyridone were extracted from the sample with acetonitrile or methanol, respectively, detected by ZORBAX HILIC Plus (4.6 × 100 mm, 3.5 μm) chromatographic column, with 0.1 % formic acid aqueous solution - 0.1 % formic acid acetonitrile solution (v/v) as mobile phase. Paraquat, monoquat, and paraquat monopyridone had a good linear relationship within the range of 10-1000, 1-400, and 1-1000 ng/mL (or g), the correlation coefficient (r) were all ≥ 0.9996. Their detection limits were lower than 1 ng/mL (or g). The detection accuracy was 91.25∼113.44 %. The intra-day and inter-day precision were 1.51-3.99 % and 1.92-4.93 %, respectively. This method was used to detect and analyze four rare paraquat poisoning cases. The distribution of paraquat, monoquat, and paraquat monopyridone is uneven, which is relatively high in the heart, blood, lung, and kidney. Heart blood/Peripheral blood ratio of paraquat, monoquat, paraquat monopyridone concentration in two poisoned cases were 1.4, 2.0, 1.5 and 1.9, 1.3, 1.2, which showed a location dependent postmortem redistribution. This is the first time that HPLC-MS/MS and the postmortem distribution or postmortem redistribution of paraquat metabolites in poisoned death cases have been reported. This research provides scientific basis for forensic identification of paraquat poisoning cases and extraction of biological specimen.
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Fama F, Feltracco M, Moro G, Barbaro E, Bassanello M, Gambaro A, Zanardi C. Pesticides monitoring in biological fluids: Mapping the gaps in analytical strategies. Talanta 2023; 253:123969. [PMID: 36191513 DOI: 10.1016/j.talanta.2022.123969] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 12/13/2022]
Abstract
Pesticides play a key-role in the development of the agrifood sector allowing controlling pest growth and, thus, improving the production rates. Pesticides chemical stability is responsible of their persistency in environmental matrices leading to bioaccumulation in animal tissues and hazardous several effects on living organisms. The studies regarding long-term effects of pesticides exposure and their toxicity are still limited to few studies focusing on over-exposed populations, but no extensive dataset is currently available. Pesticides biomonitoring relies mainly on chromatographic techniques coupled with mass spectrometry, whose large-scale application is often limited by feasibility constraints (costs, time, etc.). On the contrary, chemical sensors allow rapid, in-situ screening. Several sensors were designed for the detection of pesticides in environmental matrices, but their application in biological fluids needs to be further explored. Aiming at contributing to the implementation of pesticides biomonitoring methods, we mapped the main gaps between screening and chromatographic methods. Our overview focuses on the recent advances (2016-2021) in analytical methods for the determination of commercial pesticides in human biological fluids and provides guidelines for their application.
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Affiliation(s)
- Francesco Fama
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, Via Torino 155, 30172, Venezia, Italy
| | - Matteo Feltracco
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, Via Torino 155, 30172, Venezia, Italy
| | - Giulia Moro
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, Via Torino 155, 30172, Venezia, Italy.
| | - Elena Barbaro
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, Via Torino 155, 30172, Venezia, Italy; Istituto di Scienze Polari (ISP-CNR), Via Torino 155, 30172, Venezia, Italy
| | - Marco Bassanello
- Health Direction Monastier di Treviso Hospital, Via Giovanni XXIII 7, 31050, Treviso, Italy
| | - Andrea Gambaro
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, Via Torino 155, 30172, Venezia, Italy; Istituto di Scienze Polari (ISP-CNR), Via Torino 155, 30172, Venezia, Italy.
| | - Chiara Zanardi
- Department of Molecular Sciences and Nanosystems, Ca' Foscari University of Venice, Via Torino 155, 30172, Venezia, Italy; Institute for the Organic Synthesis and Photosynthesis, Research National Council, 40129, Bologna, Italy
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Paraquat and Diquat: Recent Updates on Their Pretreatment and Analysis Methods since 2010 in Biological Samples. MOLECULES (BASEL, SWITZERLAND) 2023; 28:molecules28020684. [PMID: 36677742 PMCID: PMC9866389 DOI: 10.3390/molecules28020684] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/02/2023] [Accepted: 01/05/2023] [Indexed: 01/12/2023]
Abstract
Paraquat (PQ) and diquat (DQ) are quaternary ammonium herbicides which have been used worldwide for controlling the growth of weeds on land and in water. However, PQ and DQ are well known to be toxic. PQ is especially toxic to humans. Moreover, there is no specific antidote for PQ poisoning. The main treatment for PQ poisoning is hemoperfusion to reduce the PQ concentration in blood. Therefore, it is essential to be able to detect PQ and DQ concentrations in biological samples. This critical review summarizes the articles published from 2010 to 2022 and can help researchers to understand the development of the sample treatment and analytical methods for the determination of PQ and DQ in various types of biological samples. The sample preparation includes liquid-liquid extraction, solid-phase extraction based on different novel materials, microextration methods, and other methods. Analytical methods for quantifying PQ and DQ, such as different chromatography and spectroscopy methods, electrochemical methods, and immunological methods, are illustrated and compared. We focus on the latest advances in PQ and DQ treatment and the application of new technologies for these analyses. In our opinion, tandem mass spectrometry is a good choice for the determination of PQ and DQ, due to its high sensitivity, high selectivity, and high accuracy. As far as we are concerned, the best LOD of 4 pg/mL for PQ in serum can be obtained.
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Li ZM, Lakuleswaran M, Kannan K. LC-MS/MS methods for the determination of 30 quaternary ammonium compounds including benzalkonium and paraquat in human serum and urine. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1214:123562. [PMID: 36495685 PMCID: PMC9839631 DOI: 10.1016/j.jchromb.2022.123562] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/09/2022] [Accepted: 11/29/2022] [Indexed: 12/07/2022]
Abstract
Benzalkyldimethylammonium (or benzalkonium; BACs), alkyltrimethylammonium (ATMACs), and dialkyldimethylammonium compounds (DDACs) have been widely used for over six decades as disinfectants, especially during the COVID-19 pandemic. Here we describe methods for the determination of 7 BACs, 6 ATMACs, 6 DDACs, 8 BAC metabolites, and the structurally similar quaternary ammonium compound (QAC) herbicides diquat, paraquat, and difenzoquat in human serum and urine using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The methods were optimized using isotopically labelled internal standards and solid-phase extraction with weak cation-exchange cartridges. We separated diquat and paraquat chromatographically using a mixed-mode LC column, and BACs, ATMACs, DDACs, difenzoquat, and BAC metabolites using reversed-phase (C8 and C18) LC columns. Method limits of detection (MLODs) and quantification (MLOQs) were 0.002-0.42 and 0.006-1.40 ng/mL, respectively. Recoveries of all analytes fortified at 1, 5, and 20 ng/mL concentrations in serum and urine matrices were 61-129%, with standard deviations of 0-20%. Repeated analysis of similarly fortified serum and urine samples yielded intra-day and inter-day variations of 0.22-17.4% and 0.35-17.3%, respectively. Matrix effects for analytes spiked into serum and urine matrices ranged from -27% to 15.4%. Analysis of real urine and serum samples revealed the presence of several QACs in human serum. Although no parent BACs were found in urine, we detected, for the first time, several ω-hydroxy and ω-carboxylic acid metabolites of BACs at average concentrations in the range of 0.05-0.35 ng/mL. The developed method is suitable for application in large-scale biomonitoring of human exposure to QACs and their metabolites in human serum and urine.
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Affiliation(s)
- Zhong-Min Li
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016, United States; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10016, United States
| | - Mathusa Lakuleswaran
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016, United States; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10016, United States
| | - Kurunthachalam Kannan
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016, United States; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10016, United States.
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Rajaram R, Neelakantan L. Recent advances in estimation of paraquat using various analytical techniques: A review. RESULTS IN CHEMISTRY 2022. [DOI: 10.1016/j.rechem.2022.100703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Kovalchuk N, Jilek JL, Van Winkle LS, Cherrington NJ, Ding X. Role of Lung P450 Oxidoreductase in Paraquat-Induced Collagen Deposition in the Lung. Antioxidants (Basel) 2022; 11:219. [PMID: 35204102 PMCID: PMC8868258 DOI: 10.3390/antiox11020219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 02/04/2023] Open
Abstract
Paraquat (PQ) is an agrochemical known to cause pulmonary fibrosis. PQ-induced collagen deposition in the lung is thought to require enzymatic formation of PQ radicals, but the specific enzymes responsible for this bioactivation event in vivo have not been identified. We tested the hypothesis that lung P450 oxidoreductase (POR or CPR) is important in PQ-induced lung fibrosis in mice. A lung-Cpr-null mouse model was utilized, which undergoes doxycycline-induced, Cre recombinase-mediated deletion of the Por gene specifically in airway Club cells and alveolar type 2 cells in the lung. The lungs of lung-Cpr-null mice and their wild-type littermates were collected on day 15 after a single intraperitoneal injection of saline (control) or PQ (20 mg/kg). Lung tissue sections were stained with picrosirius red for detection of collagen fibrils. Fibrotic lung areas were found to be significantly smaller (1.6-fold for males and 1.4-fold for females) in PQ-treated lung-Cpr-null mice than in sex- and treatment-matched wild-type mice. The levels of collagen in lung tissue homogenate were also lower (1.4-2.3-fold; p < 0.05) in PQ-treated lung-Cpr-null mice compared to PQ-treated wild-type mice. In contrast, plasma PQ toxicokinetic profiles were not different between sex-matched wild-type and lung-Cpr-null mice. Taken together, these results indicate that lung POR plays an important role in PQ-induced pulmonary fibrosis.
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Affiliation(s)
- Nataliia Kovalchuk
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA; (N.K.); (J.L.J.); (N.J.C.)
| | - Joseph L. Jilek
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA; (N.K.); (J.L.J.); (N.J.C.)
| | - Laura S. Van Winkle
- Department of Anatomy, Physiology and Cell Biology, Center for Comparative Respiratory Biology and Medicine, School of Veterinary Medicine and Center for Health and the Environment, University of California at Davis, Davis, CA 95616, USA;
| | - Nathan J. Cherrington
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA; (N.K.); (J.L.J.); (N.J.C.)
| | - Xinxin Ding
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA; (N.K.); (J.L.J.); (N.J.C.)
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Development and validation of a sensitive and high throughput UPLC–MS/MS method for determination of paraquat and diquat in human plasma and urine: application to poisoning cases at emergency departments of hospitals. Forensic Toxicol 2021; 40:102-110. [DOI: 10.1007/s11419-021-00603-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/29/2021] [Indexed: 10/19/2022]
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8
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Erkmen C, Gebrehiwot WH, Uslu B. Hydrophilic Interaction Liquid Chromatography (HILIC): Latest Applications in the Pharmaceutical Researches. CURR PHARM ANAL 2021. [DOI: 10.2174/1573412916666200402101501] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background:
Significant advances have been occurred in analytical research since the 1970s
by Liquid Chromatography (LC) as the separation method. Reverse Phase Liquid Chromatography
(RPLC) method, using hydrophobic stationary phases and polar mobile phases, is the most commonly
used chromatographic method. However, it is difficult to analyze some polar compounds with this
method. Another separation method is the Normal Phase Liquid Chromatography (NPLC), which involves
polar stationary phases with organic eluents. NPLC presents low-efficiency separations and
asymmetric chromatographic peak shapes when analyzing polar compounds. Hydrophilic Interaction
Liquid Chromatography (HILIC) is an interesting and promising alternative method for the analysis of
polar compounds. HILIC is defined as a separation method that combines stationary phases used in the
NPLC method and mobile phases used in the RPLC method. HILIC can be successfully applied to all
types of liquid chromatographic separations such as pharmaceutical compounds, small molecules, metabolites,
drugs of abuse, carbohydrates, toxins, oligosaccharides, peptides, amino acids and proteins.
Objective:
This paper provides a general overview of the recent application of HILIC in the pharmaceutical
research in the different sample matrices such as pharmaceutical dosage form, plasma, serum,
environmental samples, animal origin samples, plant origin samples, etc. Also, this review focuses on
the most recent and selected papers in the drug research from 2009 to the submission date in 2020,
dealing with the analysis of different components using HILIC.
Results and Conclusion:
The literature survey showed that HILIC applications are increasing every
year in pharmaceutical research. It was found that HILIC allows simultaneous analysis of many compounds
using different detectors.
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Affiliation(s)
- Cem Erkmen
- Department of Analytical Chemistry, Faculty of Pharmacy, Ankara University, 06560, Ankara,Turkey
| | | | - Bengi Uslu
- Department of Analytical Chemistry, Faculty of Pharmacy, Ankara University, 06560, Ankara,Turkey
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Yuan J, Li A, Chen T, Du J, Ma A, Pan J. Micelle-dominated distribution strategy for non-matrix matched calibration without an internal standard: "Extract-and-shoot" approach for analyzing hydrophilic targets in blood and cell samples. Anal Chim Acta 2020; 1102:24-35. [PMID: 32043993 DOI: 10.1016/j.aca.2019.12.041] [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] [Received: 09/07/2019] [Revised: 11/19/2019] [Accepted: 12/15/2019] [Indexed: 10/25/2022]
Abstract
The analysis of trace hydrophilic targets in complex aqueous-rich matrices is considerably challenging, generally requiring matrix-matched calibration, internal standard, or time-and-labor-intensive sample preparation. To address this analytical bottleneck, a non-matrix-matched calibration strategy without using internal standard was reported for the first time to analyze complicated biosamples such as whole blood, plasma, serum, and cell samples. This strategy, termed micelle-dominated distribution, also aimed at realizing the simple "extract-and-shoot" analytical process for such complex matrices. The micelle-matrix interaction was found to efficiently eliminate the matrix effect by dominating phase separation and analyte distribution between the extraction and matrix phases. Thus, calibration linear curves prepared in water were applicable to the analysis of all the above-mentioned sample types. Rapid distribution equilibrium within 4 min was achieved. This strategy could tolerate direct large volume injection, thereby providing two-order-of-magnitude enhancement in the sensitivity of ion-pair chromatography. The analytical method integrated cell rupture, matrix cleanup, analyte extraction, and on-column preconcentration into a fast and high-throughput operation. The successful application to the determination of exogenous pesticides and endogenous glutathione exhibited low limits of detection (0.0085-0.015 μg mL-1 for pesticides; 0.52 μg mL-1 for glutathione), wide linear ranges (0.028-50 μg mL-1 and 0.049-50 μg mL-1 for pesticides; 1.7-1000 μg mL-1 for glutathione), good linearies (R2 = 0.9994-0.9999), excellent accuracy (recoveries of 91.3-105.2%), and good precision (0.7-6.2% at the levels of 0.028 (or 0.049), 0.1, 0.5, and 50 μg mL-1 for pesticides; 0.5-8.7% at 1.7, 500, and 1000 μg mL-1 for glutathione).
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Affiliation(s)
- Jiahao Yuan
- Department of Hygiene Detection Center, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Anqi Li
- Department of Hygiene Detection Center, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Tingting Chen
- Department of Hygiene Detection Center, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Juan Du
- Department of Hygiene Detection Center, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Ande Ma
- Department of Hygiene Detection Center, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China.
| | - Jialiang Pan
- Department of Hygiene Detection Center, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China.
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Huang C, Bai L, Xue X, Peng L, Jiang J, Zhang X. Hyperamylasemia as an early predictor of mortality in patients with acute paraquat poisoning. J Int Med Res 2020; 48:300060520910037. [PMID: 32223576 PMCID: PMC7133085 DOI: 10.1177/0300060520910037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/27/2020] [Indexed: 12/12/2022] Open
Abstract
Objective This study aimed to evaluate the relationship between elevated serum amylase levels and the prognosis of paraquat poisoning. Methods Patients were categorized into the elevated and non-elevated serum amylase groups according to serum amylase levels. Demographics, mortality, risk factors of elevated serum amylase levels, and injury to the pancreas were analyzed. Results A total of 457 patients were enrolled in this study and the overall mortality rate was 51.9%. Patients in the elevated group had worse indices than those in the non-elevated group. Kaplan–Meier survival analysis showed that the mortality rate in the elevated group was significantly higher than that in the non-elevated group (hazard ratio: 10.65, 95% confidence interval [CI]: 7.55–15.02). Multivariate Cox proportional hazards analysis showed that elevated serum amylase levels were related to mortality (hazard ratio: 2.066, 95% CI: 1.239–3.444). The receiver operating characteristic curve showed that the area under the curve was 0.724 (95% CI: 0.666–0.783) for serum amylase levels with 70.4% sensitivity and 74.0% specificity. Conclusion Elevated serum amylase levels are observed in PQ poisoning. This elevation might be one of the most accurate early prognostic factors for predicting severity and mortality.
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Affiliation(s)
- Changbao Huang
- Department of Emergency Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, P.R. China
| | - Lina Bai
- Department of Emergency Medicine, the 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiang Xue
- Department of Emergency Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, P.R. China
| | - Liangfei Peng
- Department of Emergency Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, P.R. China
| | - Jinghan Jiang
- Department of Emergency Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, P.R. China
| | - Xigang Zhang
- Department of Emergency Medicine, the 5th Medical Center of Chinese PLA General Hospital, Beijing, China
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Pan S, Zhang J, He Q, Chen X, Jin M. Fabrication of benzenesulfonic acid groups modified magnetic microspheres as an MSPE adsorbent for fast determination of paraquat and diquat in human urine combined with UPLC-HRMS. J Chromatogr B Analyt Technol Biomed Life Sci 2020; 1136:121880. [DOI: 10.1016/j.jchromb.2019.121880] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/25/2019] [Accepted: 11/12/2019] [Indexed: 10/25/2022]
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Usui K, Minami E, Fujita Y, Kobayashi H, Hanazawa T, Kamijo Y, Funayama M. A fast paraquat quantitation method in human serum using probe electrospray ionization–tandem mass spectrometry for emergency settings. J Pharmacol Toxicol Methods 2019; 100:106610. [DOI: 10.1016/j.vascn.2019.106610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/04/2019] [Accepted: 07/06/2019] [Indexed: 11/25/2022]
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Serial hyphenation of dried spot, reversed phase liquid chromatography, hydrophilic interaction liquid chromatography, and tandem mass spectrometry towards direct chemical profiling of herbal medicine-derived liquid matrices, an application in Cistanche sinensis. J Pharm Biomed Anal 2019; 174:34-42. [DOI: 10.1016/j.jpba.2019.05.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 04/25/2019] [Accepted: 05/21/2019] [Indexed: 02/06/2023]
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Metabolitic profiling of amino acids in paraquat-induced acute kidney injury. Clin Exp Nephrol 2019; 23:474-483. [PMID: 30859350 DOI: 10.1007/s10157-019-01702-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 05/19/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND The herbicide paraquat (1, 1'-dimethyl-4, 4'-bipyridylium dichloride; PQ) is a poison well-known to cause delayed mortality due to acute kidney injuries (AKI). This study examines the changes in serum amino acids (AAs) metabolite profiles as surrogate markers of renal cell metabolism and function after paraquat poisoning. METHODS To identify the metabolic profiling of free serum AAs and its metabolites, serum from 40 paraquat-poisoned patients with or without AKI is collected. LC-MS/GC-MS is performed to analyze AA molecules. A Cox proportional hazard model was used to assess for incidence of AKI. Receiver operating characteristic (ROC) curve is applied to evaluate AKI occurrence and prognosis. RESULTS A total of 102 serum AAs and its metabolites were identified. Compared with non-AKI patients, 37 varied significantly in AKI patients. The univariate Cox proportional hazard model analysis revealed that the estimated PQ amount, plasma PQ concentration, urine PQ concentration, APACHE, SOFA scores and 16 amino acids correlated with the incidence of AKI. Further analyses revealed that 3-methylglutarylcarnitine, 1-methylimidazoleacetate, and urea showed higher cumulative hazard ratios for the occurrence of AKI during follow-up (P < 0.05). The area under the curve (AUC) of 3-methylglutarylcarnitine, 1-methylimidazoleacetate and urea were 0.917, 0.857, 0.872, respectively. CONCLUSION 3-methylglutarylcarnitine, 1-methylimidazoleacetate and urea were associated with AKI in patients with paraquat intoxication.
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A novel approach for determination of paraquat based on dried blood spot (DBS) extraction and UHPLC-HRMS analysis. J Pharm Biomed Anal 2018; 159:11-17. [DOI: 10.1016/j.jpba.2018.06.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 06/19/2018] [Accepted: 06/21/2018] [Indexed: 01/14/2023]
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16
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Paraquat Exposure of Pregnant Women and Neonates in Agricultural Areas in Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061163. [PMID: 29865285 PMCID: PMC6025106 DOI: 10.3390/ijerph15061163] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 05/30/2018] [Accepted: 06/01/2018] [Indexed: 01/23/2023]
Abstract
This study aimed to assess paraquat concentrations in the urine of women at 28 weeks of pregnancy, delivery and 2 months postpartum and in the meconium of neonates. In all, 79 pregnant women were recruited from three hospitals located in agricultural areas in Thailand. The subjects were interviewed about personal characteristics, agricultural activities and pesticide use patterns. Paraquat was analyzed in urine and meconium using high performance liquid chromatography equipped with a fluorescence detector. The geometric mean (GSD) of urinary paraquat concentrations at 28 weeks of pregnancy, delivery and 2 months postpartum were 2.04 (4.22), 2.06 (5.04) and 2.42 (5.33) ng/mL, respectively. The urinary paraquat concentrations at 28 weeks of pregnancy, delivery and 2 months postpartum between agriculturist and non-agriculturist were not significantly different (p = 0.632, p = 0.915, p = 0.57, respectively). The geometric mean (GSD) of paraquat concentration in the meconium was 33.31 (4.59) ng/g. The factors predicting paraquat exposures among pregnant women and neonates included working outside, living near farmland, having family members who work on a farm, drinking well water and using herbicides or paraquat.
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Suzuki Y, Kaneko T, Saito K. The internal standard diquat-d4 causes errors in diquat analysis by LC–MS/MS. Forensic Toxicol 2018. [DOI: 10.1007/s11419-018-0423-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wan X, Zhou C, Kang X, Hu D, Xue W, Li X, Bao H, Peng A. Metabolic Profiling of Amino Acids Associated with Mortality in Patients with Acute Paraquat Poisoning. Med Sci Monit 2018. [PMID: 29513648 PMCID: PMC5854108 DOI: 10.12659/msm.905843] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Paraquat is a major cause of fatal poisoning after ingestion in many parts of Asia and the Pacific nations. However, optimal prognostic indicators to evaluate patient mortality have not been unequivocally established. Following acute paraquat poisoning, a number of amino acids (AA), are abnormally expressed in metabolic pathways. However, the alterations in AA metabolite levels after paraquat poisoning remain unknown in humans. Material/Methods In the present study, 40 patients were enrolled, of whom 16 survived and 24 died. A metabolomics approach was used to assess changes in AA metabolites in plasma and its potential prognostic value following paraquat poisoning. Mass spectrometry (MS) based on metabolite identification was conducted. Results Twenty-five AA levels in plasma were abnormally expressed in non-survivor patients. Among them, creatinine, indolelactate, and 3-(4-hydroxyphenyl)lactate were found to be highly correlated with paraquat death prediction. It was noted that the intensity levels of these 3 AA metabolites in the non-survivor group were substantially higher than in the survivor group. Furthermore, we examined receiver operating characteristic (ROC) curves for clinical validation. ROC results showed that 3-(4-hydroxyphenyl)lactate had the highest AUC of 0.84, while indolelactate and creatinine had AUCs of 0.75 and 0.83, respectively, suggesting that they can be used to predict the clinical outcome (although this methodology is expensive to implement). Conclusions Metabolic profiling of AA levels could be a reliable tool to identify effective indicators for the early high precision prognosis of paraquat poisoning.
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Affiliation(s)
- Xiuxian Wan
- Department of Nephrology and Rheumatology, Affiliated Shanghai Tenth Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Department of Nephrology, Lianyungang Oriental Hospital, Lianyungang, Jiangsu, China (mainland)
| | - Chunyu Zhou
- Center for Nephrology and Clinical Metabolomics, Tongji University School of Medicine, Shanghai, China (mainland)
| | - Xin Kang
- Center for Nephrology and Clinical Metabolomics, Tongji University School of Medicine, Shanghai, China (mainland)
| | - Dayong Hu
- Center for Nephrology and Clinical Metabolomics, Tongji University School of Medicine, Shanghai, China (mainland)
| | - Wen Xue
- Center for Nephrology and Clinical Metabolomics, Tongji University School of Medicine, Shanghai, China (mainland)
| | - Xinhua Li
- Center for Nephrology and Clinical Metabolomics, Tongji University School of Medicine, Shanghai, China (mainland)
| | - Hui Bao
- Department of Nephrology and Rheumatology, Affiliated Shanghai Tenth Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Center for Nephrology and Clinical Metabolomics, Tongji University School of Medicine, Shanghai, China (mainland)
| | - Ai Peng
- Department of Nephrology and Rheumatology, Affiliated Shanghai Tenth Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Center for Nephrology and Clinical Metabolomics, Tongji University School of Medicine, Shanghai, China (mainland)
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Gawarammana I, Buckley NA, Mohamed F, Naser K, Jeganathan K, Ariyananada PL, Wunnapuk K, Dobbins TA, Tomenson JA, Wilks MF, Eddleston M, Dawson AH. High-dose immunosuppression to prevent death after paraquat self-poisoning – a randomised controlled trial. Clin Toxicol (Phila) 2017; 56:633-639. [DOI: 10.1080/15563650.2017.1394465] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Indika Gawarammana
- Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Nicholas A. Buckley
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Pharmacology, University of Sydney, Sydney, Australia
- Royal Prince Alfred Hospital, Sydney, Australia
| | - Fahim Mohamed
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Pharmacology, University of Sydney, Sydney, Australia
| | | | - K. Jeganathan
- Anuradhapura Hospitals, Anuradhapura, Sri Lanka
- Rathnapura Hospitals, Rathnapura, Sri Lanka
| | | | - Klintean Wunnapuk
- Therapeutics Research Centre, School of Medicine, University of Queensland, Brisbane, Australia
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Timothy A. Dobbins
- Department of Pharmacology, University of Sydney, Sydney, Australia
- National Drug and Alcohol Research Centre, Sydney, Australia
| | | | - Martin F. Wilks
- Swiss Centre for Applied Human Toxicology, University of Basel, Basel, Switzerland
| | - Michael Eddleston
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Pharmacology, Toxicology and Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh and National Poisons Information Service – Edinburgh Unit, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Andrew H. Dawson
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Pharmacology, University of Sydney, Sydney, Australia
- Royal Prince Alfred Hospital, Sydney, Australia
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Tsao YC, Lai YC, Liu HC, Liu RH, Lin DL. Simultaneous Determination and Quantitation of Paraquat, Diquat, Glufosinate and Glyphosate in Postmortem Blood and Urine by LC-MS-MS. J Anal Toxicol 2016; 40:427-36. [PMID: 27339477 DOI: 10.1093/jat/bkw042] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
A simple method, incorporating protein-precipitation/organic backwashing and liquid chromatography-tandem mass spectrometry (LC-MS-MS), has been successfully developed for the simultaneous analysis of four highly water-soluble and less volatile herbicides (paraquat, diquat, glufosinate and glyphosate) in ante- and postmortem blood, urine and gastric content samples. Respective isotopically labeled analogs of these analytes were adopted as internal standards. Acetonitrile and dichloromethane were used for protein precipitation and organic solvent backwashing, respectively, followed by injecting the upper aqueous phase into the LC-MS-MS system. Chromatographic separation was achieved using an Agilent Zorbax SB-Aq analytical column, with gradient elution of 15 mM heptafluorobutyric acid and acetonitrile. Mass spectrometric analysis was performed under electrospray ionization in positive-ion multiple reaction monitoring mode. The precursor ions and the two transition ions (m/z) adopted for each of these four analytes were paraquat (185; 169 and 115), diquat (183; 157 and 78), glufosinate (182; 136 and 119) and glyphosate (170; 88 and 60), respectively. Analyte-free blood and urine samples, fortified with the analytes of interest, were used for method development/validation and yielded acceptable recoveries of the analytes; interday and intraday precision and accuracy data; calibration linearity and limits of detection and quantitation. This method was successfully incorporated into an overall analytical scheme, designed for the analysis of a broad range of compounds present in postmortem samples, helpful to medical examiners' efforts to determine victims' causes of death.
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Affiliation(s)
- Yun-Chen Tsao
- Department of Forensic Toxicology, Institute of Forensic Medicine, Ministry of Justice, No. 123, Min'an St., Zhonghe Dist., New Taipei City 235, Taiwan School of Pharmacy, College of Medicine, National Taiwan University, No. 33, Linsen S. Rd., Zhongzheng Dist., Taipei City 100, Taiwan
| | - Yung-Chun Lai
- Department of Forensic Toxicology, Institute of Forensic Medicine, Ministry of Justice, No. 123, Min'an St., Zhonghe Dist., New Taipei City 235, Taiwan
| | - Hsiu-Chuan Liu
- Department of Forensic Toxicology, Institute of Forensic Medicine, Ministry of Justice, No. 123, Min'an St., Zhonghe Dist., New Taipei City 235, Taiwan
| | - Ray H Liu
- Department of Justice Sciences, University of Alabama at Birmingham, 1720 2nd Ave South Birmingham, AL 35294, USA
| | - Dong-Liang Lin
- Department of Forensic Toxicology, Institute of Forensic Medicine, Ministry of Justice, No. 123, Min'an St., Zhonghe Dist., New Taipei City 235, Taiwan
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Optimized ultra performance liquid chromatography tandem high resolution mass spectrometry method for the quantification of paraquat in plasma and urine. J Chromatogr B Analyt Technol Biomed Life Sci 2016; 1027:96-102. [PMID: 27270261 DOI: 10.1016/j.jchromb.2016.05.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 04/18/2016] [Accepted: 05/20/2016] [Indexed: 11/21/2022]
Abstract
A simple, sensitive and specific ultra performance liquid chromatography coupled to electrospray tandem high resolution mass spectrometry (UPLC-ESI-HRMS/MS) method has been developed and validated for quantification of paraquat in plasma and urine. The sample preparation was carried out by one-step protein precipitation with acetonitrile. The paraquat was separated with a HILIC column in 10min. Detection was performed using Q Exactive Orbitrap mass spectrometer by Targeted-MS/MS scan mode. Methodological parameters, such as ammonium formate concentration, formic acid concentration, spray voltage, capillary temperature, heater temperature and normalized collision energy were optimized to achieve the highest sensitivity. The calibration curve was linear over the concentration range of LOQ-1000ng/mL. LOD was 0.1 and 0.3ng/mL, LOQ was 0.3 and 0.8ng/mL for urine and plasma, respectively. The intra- and inter-day precisions were <7.97% and 4.78% for plasma and urine. The accuracies were within the range 93.51-100.90%. The plasma and urine matrices had negligible relative matrix effect in this study. This method was successfully applied to determine paraquat concentration in plasma samples with hemoperfusion from 5 suspected paraquat poisoning patients.
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Hong G, Hu L, Tang Y, Zhang T, Kang X, Zhao G, Lu Z. Prognosis and survival analysis of paraquat poisoned patients based on improved HPLC-UV method. J Pharmacol Toxicol Methods 2016; 80:75-81. [PMID: 27216136 DOI: 10.1016/j.vascn.2016.05.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 04/29/2016] [Accepted: 05/18/2016] [Indexed: 02/08/2023]
Abstract
UNLABELLED Paraquat (PQ) has caused deaths of numerous people around the world. In order to assess the lethal plasma concentration, the patients who acquired acute PQ intoxication were analyzed by plasma concentration monitoring. The plasma PQ concentrations were determined by high performance liquid chromatography (HPLC) which used 5-bromopyrimidine as internal standard and trichloroacetic acid-methanol (1:9) as protein precipitant. The liver, kidney and coagulation function were determined by automatic biochemical analyzer. According to plasma PQ concentration, 90 patients were divided into four groups: trace PQ group (<50ng/mL), low PQ group (<1000ng/mL), medium PQ group (1000-5000ng/mL) and high PQ group (>5000ng/mL). The clinical data from the four groups was statistically analyzed. The results showed the developed HPLC methods exhibited a high degree of accuracy and good linearity within 50-25000ng/mL (R=0.9998). The Spearman's correlation analysis showed PQ concentration had a strong relationship to total bilirubin, direct bilirubin, aspartic transaminase, urea nitrogen, prothrombin time, prothrombin activity, and international normalized ratio (P<0.01). The cured or survival PQ poisoned patients among the trace PQ group, the low PQ group, the medium PQ group, and the high PQ group were 19/19 (100%), 19/21 (90.47%), 11/25 (44.0%), and 0/25 (0%) respectively. The mean hospital days were (10.37±8.04), (18.76±12.06), (16.76±14.44), and (4.04±5.41) days respectively. The Cox regression analysis indicated that plasma PQ concentration was highly related to prognosis (P<0.05). In conclusion, no patient presenting with a PQ concentration over 5000ng/mL survived. The plasma PQ level is related to liver, kidney and coagulation function, which can be used as an important clinical index to judge the prognosis of PQ poisoned patients. CHEMICAL COMPOUNDS Paraquat (PubChem CID: 15938), 5-bromopyrimidine (PubChem CID: 78344), acetonitrile (PubChem CID: 6342), sodium dihydrogen phosphate (PubChem CID: 23672064), sodium heptanesulfonate (PubChem CID: 23672332), methylprednisolone (PubChem CID: 6741), cyclophosphamide (PubChem CID: 2907).
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Affiliation(s)
- Guangliang Hong
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Lufeng Hu
- Department of Pharmacy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Yahui Tang
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Tao Zhang
- Department of Intensive Care Unit, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China
| | - Xiaowen Kang
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Guangju Zhao
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Zhongqiu Lu
- Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
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Zhu Y, Wu J, Gao H, Liu G, Tian Z, Feng J, Guo L, Xie J. Rapid on-site detection of paraquat in biologic fluids by iodide-facilitated pinhole shell-isolated nanoparticle-enhanced Raman spectroscopy. RSC Adv 2016. [DOI: 10.1039/c6ra06954a] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We report a sensitive iodide-facilitated SERS method on paraquat without any tedious pretreatment in biologic fluids, which clinical diagnosis prefers.
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Affiliation(s)
- Yingjie Zhu
- State Key Laboratory of Toxicology and Medical Countermeasures
- Laboratory of Toxicant Analysis
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- Beijing 100850
| | - Jianfeng Wu
- State Key Laboratory of Toxicology and Medical Countermeasures
- Laboratory of Toxicant Analysis
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- Beijing 100850
| | - Haiyue Gao
- State Key Laboratory of Toxicology and Medical Countermeasures
- Laboratory of Toxicant Analysis
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- Beijing 100850
| | - Guokun Liu
- College of the Environment and Ecology
- Xiamen University
- Xiamen 361005
- China
| | - Zhongqun Tian
- State Key Laboratory of Physical Chemistry of Solid Surfaces
- College of Chemistry and Chemical Engineering
- Xiamen University
- Xiamen 361005
- China
| | - Jianlin Feng
- State Key Laboratory of Toxicology and Medical Countermeasures
- Laboratory of Toxicant Analysis
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- Beijing 100850
| | - Lei Guo
- State Key Laboratory of Toxicology and Medical Countermeasures
- Laboratory of Toxicant Analysis
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- Beijing 100850
| | - Jianwei Xie
- State Key Laboratory of Toxicology and Medical Countermeasures
- Laboratory of Toxicant Analysis
- Institute of Pharmacology and Toxicology
- Academy of Military Medical Sciences
- Beijing 100850
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Mohamed F, Buckley NA, Jayamanne S, Pickering JW, Peake P, Palangasinghe C, Wijerathna T, Ratnayake I, Shihana F, Endre ZH. Kidney damage biomarkers detect acute kidney injury but only functional markers predict mortality after paraquat ingestion. Toxicol Lett 2015; 237:140-50. [DOI: 10.1016/j.toxlet.2015.06.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 06/02/2015] [Accepted: 06/07/2015] [Indexed: 11/25/2022]
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Wunnapuk K, Mohammed F, Gawarammana I, Liu X, Verbeeck RK, Buckley NA, Roberts MS, Musuamba FT. Prediction of paraquat exposure and toxicity in clinically ill poisoned patients: a model based approach. Br J Clin Pharmacol 2015; 78:855-66. [PMID: 24697850 DOI: 10.1111/bcp.12389] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 03/25/2014] [Indexed: 11/28/2022] Open
Abstract
AIMS Paraquat poisoning is a medical problem in many parts of Asia and the Pacific. The mortality rate is extremely high as there is no effective treatment. We analyzed data collected during an ongoing cohort study on self-poisoning and from a randomized controlled trial assessing the efficacy of immunosuppressive therapy in hospitalized paraquat-intoxicated patients. The aim of this analysis was to characterize the toxicokinetics and toxicodynamics of paraquat in this population. METHODS A non-linear mixed effects approach was used to perform a toxicokinetic/toxicodynamic population analysis in a cohort of 78 patients. RESULTS The paraquat plasma concentrations were best fitted by a two compartment toxicokinetic structural model with first order absorption and first order elimination. Changes in renal function were used for the assessment of paraquat toxicodynamics. The estimates of toxicokinetic parameters for the apparent clearance, the apparent volume of distribution and elimination half-life were 1.17 l h(-1) , 2.4 l kg(-1) and 87 h, respectively. Renal function, namely creatinine clearance, was the most significant covariate to explain between patient variability in paraquat clearance.This model suggested that a reduction in paraquat clearance occurred within 24 to 48 h after poison ingestion, and afterwards the clearance was constant over time. The model estimated that a paraquat concentration of 429 μg l(-1) caused 50% of maximum renal toxicity. The immunosuppressive therapy tested during this study was associated with only 8% improvement of renal function. CONCLUSION The developed models may be useful as prognostic tools to predict patient outcome based on patient characteristics on admission and to assess drug effectiveness during antidote drug development.
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Affiliation(s)
- Klintean Wunnapuk
- Therapeutics Research Centre, School of Medicine, The University of Queensland, Brisbane, QLD, Australia; Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Mohamed F, Endre Z, Jayamanne S, Pianta T, Peake P, Palangasinghe C, Chathuranga U, Jayasekera K, Wunnapuk K, Shihana F, Shahmy S, Buckley N. Mechanisms underlying early rapid increases in creatinine in paraquat poisoning. PLoS One 2015; 10:e0122357. [PMID: 25815837 PMCID: PMC4376530 DOI: 10.1371/journal.pone.0122357] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 02/18/2015] [Indexed: 01/17/2023] Open
Abstract
Background Acute kidney injury (AKI) is common after severe paraquat poisoning and usually heralds a fatal outcome. The rapid large increases in serum creatinine (Cr) exceed that which can be explained by creatinine kinetics based on loss of glomerular filtration rate (GFR). Methods and Findings This prospective multi-centre study compared the kinetics of two surrogate markers of GFR, serum creatinine and serum cystatin C (CysC), following paraquat poisoning to understand and assess renal functional loss after paraquat poisoning. Sixty-six acute paraquat poisoning patients admitted to medical units of five hospitals were included. Relative changes in creatinine and CysC were monitored in serial blood and urine samples, and influences of non-renal factors were also studied. Results Forty-eight of 66 patients developed AKI (AKIN criteria), with 37 (56%) developing moderate to severe AKI (AKIN stage 2 or 3). The 37 patients showed rapid increases in creatinine of >100% within 24 hours, >200% within 48 hours and >300% by 72 hours and 17 of the 37 died. CysC concentration increased by 50% at 24 hours in the same 37 patients and then remained constant. The creatinine/CysC ratio increased 8 fold over 72 hours. There was a modest fall in urinary creatinine and serum/urine creatinine ratios and a moderate increase in urinary paraquat during first three days. Conclusion Loss of renal function contributes modestly to the large increases in creatinine following paraquat poisoning. The rapid rise in serum creatinine most probably represents increased production of creatine and creatinine to meet the energy demand following severe oxidative stress. Minor contributions include increased cyclisation of creatine to creatinine because of acidosis and competitive or non-competitive inhibition of creatinine secretion. Creatinine is not a good marker of renal functional loss after paraquat poisoning and renal injury should be evaluated using more specific biomarkers of renal injury.
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Affiliation(s)
- Fahim Mohamed
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Clinical Pharmacology and Toxicology Group, Professorial Medicine Unit, The Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
- Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Nephrology, Prince Of Wales Hospital and Clinical School, University of New South Wales, Sydney, Australia
| | - Zoltan Endre
- Department of Nephrology, Prince Of Wales Hospital and Clinical School, University of New South Wales, Sydney, Australia
- * E-mail:
| | - Shaluka Jayamanne
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Timothy Pianta
- Department of Nephrology, Prince Of Wales Hospital and Clinical School, University of New South Wales, Sydney, Australia
| | - Philip Peake
- Department of Nephrology, Prince Of Wales Hospital and Clinical School, University of New South Wales, Sydney, Australia
| | - Chathura Palangasinghe
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Umesh Chathuranga
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Kithsiri Jayasekera
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Klintean Wunnapuk
- Therapeutics Research Centre, School of Medicine, University of Queensland, Brisbane, Australia
| | - Fathima Shihana
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Seyed Shahmy
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Nicholas Buckley
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Clinical Pharmacology and Toxicology Group, Professorial Medicine Unit, The Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
- Department of Pharmacology, School of Medical Sciences, Sydney Medical School, University of Sydney, Sydney, Australia
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Clearance rate and BP-ANN model in paraquat poisoned patients treated with hemoperfusion. BIOMED RESEARCH INTERNATIONAL 2015; 2015:298253. [PMID: 25695058 PMCID: PMC4324821 DOI: 10.1155/2015/298253] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 01/04/2015] [Accepted: 01/12/2015] [Indexed: 12/18/2022]
Abstract
In order to investigate the effect of hemoperfusion (HP) on the clearance rate of paraquat (PQ) and develop a clearance model, 41 PQ-poisoned patients who acquired acute PQ intoxication received HP treatment. PQ concentrations were determined by high performance liquid chromatography (HPLC). According to initial PQ concentration, study subjects were divided into two groups: Low-PQ group (0.05–1.0 μg/mL) and High-PQ group (1.0–10 μg/mL). After initial HP treatment, PQ concentrations decreased in both groups. However, in the High-PQ group, PQ levels remained in excess of 0.05 μg/mL and increased when the second HP treatment was initiated. Based on the PQ concentrations before and after HP treatment, the mean clearance rate of PQ calculated was 73 ± 15%. We also established a backpropagation artificial neural network (BP-ANN) model, which set PQ concentrations before HP treatment as input data and after HP treatment as output data. When it is used to predict PQ concentration after HP treatment, high prediction accuracy (R = 0.9977) can be obtained in this model. In conclusion, HP is an effective way to clear PQ from the blood, and the PQ concentration after HP treatment can be predicted by BP-ANN model.
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Recent advances in hydrophilic interaction chromatography for quantitative analysis of endogenous and pharmaceutical compounds in plasma samples. Bioanalysis 2014; 6:2421-39. [DOI: 10.4155/bio.14.173] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
There is an increasing need for new analytical methods that can handle a large number of analytes in complex matrices. Hydrophilic interaction chromatography (HILIC) has recently been demonstrated as an important supplement to reversed-phase liquid chromatography for polar analytes, particularly endogenous compounds. With the increasing popularity of HILIC, progressively more polar phases with diverse functional groups have been developed. In addition, the coupling of HILIC to mass spectrometry offers the advantages of improved sensitivity by employing an organic-rich mobile phase. This article reviews recent applications of HILIC for the analysis of endogenous and pharmaceutical compounds in plasma samples. Furthermore, based on recent studies, we provide a discussion of column selection, sample pretreatment for HILIC analysis, and detection sensitivity.
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29
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Garcia-Febrero R, Salvador JP, Sanchez-Baeza F, Marco MP. Rapid method based on immunoassay for determination of paraquat residues in wheat, barley and potato. Food Control 2014. [DOI: 10.1016/j.foodcont.2014.01.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Nemoto T, Lee XP, Kumazawa T, Hasegawa C, Fujishiro M, Marumo A, Shouji Y, Inagaki K, Sato K. High-throughput determination of nonsteroidal anti-inflammatory drugs in human plasma by HILIC-MS/MS. J Pharm Biomed Anal 2014; 88:71-80. [DOI: 10.1016/j.jpba.2013.08.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 08/07/2013] [Accepted: 08/13/2013] [Indexed: 01/07/2023]
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Wunnapuk K, Liu X, Peake P, Gobe G, Endre Z, Grice JE, Roberts MS, Buckley NA. Renal biomarkers predict nephrotoxicity after paraquat. Toxicol Lett 2013; 222:280-8. [PMID: 23954200 DOI: 10.1016/j.toxlet.2013.08.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 07/31/2013] [Accepted: 08/06/2013] [Indexed: 12/11/2022]
Abstract
Paraquat is a widely used herbicide which has been involved in many accidental and intentional deaths. Nephrotoxicity is common in severe acute paraquat poisoning. We examined seven renal injury biomarkers, including cystatin-C, kidney injury molecule-1, β2-microglobulin, clusterin, albumin, neutrophil gelatinase-associated lipocalin and osteopontin, to develop a non-invasive method to detect early renal damage and dysfunction and to compare with the conventional endogenous marker creatinine. Male Wistar rats were dosed orally with four different doses of paraquat, and the biomarker patterns in urine and plasma were investigated at 8, 24 and 48h after paraquat exposure. By Receiver Operating Characteristic analysis, urinary kidney injury molecule-1 was the best marker at predicting histological changes, with areas under the Receiver Operating Characteristic curve of 0.81 and 0.98 at 8 and 24h (best cut-off value>0.000326μg/ml), respectively. Urinary kidney injury molecule-1, urinary albumin and urinary Cystatin-C elevations correlated with the degree of renal damage and injury development. Further study is required to compare biomarkers changes in rats with those seen in human poisoning.
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Affiliation(s)
- Klintean Wunnapuk
- Therapeutics Research Centre, School of Medicine, The University of Queensland, Brisbane, QLD, Australia; Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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