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Hu Y, Qian C, Sun H, Li Q, Wang J, Hua H, Dai Z, Li J, Li T, Ding Y, Yang X, Zhang W. Differences in epithelial-mesenchymal-transition in paraquat-induced pulmonary fibrosis in BALB/C and BALB/C (nu/nu) nude mice. Biomed Pharmacother 2021; 143:112153. [PMID: 34507117 DOI: 10.1016/j.biopha.2021.112153] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022] Open
Abstract
Exposure to the toxic herbicide paraquat (PQ) can lead to the active absorption and enrichment of alveolar epithelial cells, resulting in pulmonary fibrosis and respiratory failure. At present, no effective clinical treatment is available. Notably, however, patients infected with human acquired immunodeficiency virus (HIV) (with T lymphocyte deficiency) do not show pulmonary fibrosis after PQ poisoning, suggesting that T lymphocytes may be involved in the occurrence and pathological development of lung fibers following PQ exposure, although relevant studies remain limited. Here, we found that the degree of pulmonary fibrosis induced by intragastric administration of PQ in congenital immunodeficiency BALB/C (nu/nu) nude (T lymphocyte loss) mice was lower than that in normal mice. However, pulmonary fibrosis was aggravated after transplantation of BALB/C (nu/nu) T lymphocytes into congenital immunodeficiency mice. This study is the first to report on the involvement of T lymphocytes in the occurrence and pathological development of lung fibers induced by PQ exposure. Thus, T cells may be an important cellular target for the clinical treatment of pulmonary fibrosis caused by PQ.
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Affiliation(s)
- Yegang Hu
- Emergency Department, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, 650032 Kunming, Yunnan, China
| | - Chuanyun Qian
- Emergency Department, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, 650032 Kunming, Yunnan, China
| | - Huiling Sun
- Department of Anatomy and Histology & Embryology, Faculty of Basic Medical Science, Kunming Medical University, 650500 Kunming, Yunnan, China
| | - Qiankui Li
- School of Food and Drug, Shandong Institute of Commerce and Technology, 250014 Jinan, Shandong, China
| | - Jinde Wang
- Kunming Medical University, 650500 Kunming, Yunnan, China
| | - Hairong Hua
- Kunming Medical University, 650500 Kunming, Yunnan, China
| | - Zichao Dai
- Kunming Medical University, 650500 Kunming, Yunnan, China
| | - Jintao Li
- Kunming Medical University, 650500 Kunming, Yunnan, China
| | - Tao Li
- Department of Critical Care Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 250014 Jinan, Shandong, China
| | - Yi Ding
- Department of Pathophysiology, Weifang Medical University, 261000 Weifang, Shandong, China
| | - Xinwang Yang
- Department of Anatomy and Histology & Embryology, Faculty of Basic Medical Science, Kunming Medical University, 650500 Kunming, Yunnan, China.
| | - Wei Zhang
- Emergency Department, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, 650032 Kunming, Yunnan, China.
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Subbiah R, Tiwari RR. The herbicide paraquat-induced molecular mechanisms in the development of acute lung injury and lung fibrosis. Crit Rev Toxicol 2021; 51:36-64. [PMID: 33528289 DOI: 10.1080/10408444.2020.1864721] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The herbicide paraquat (PQ; 1,1'-dimethyl-4,4'-bipyridylium dichloride) is a highly toxic organic heterocyclic herbicide that has been widely used in agricultural settings. Since its commercial introduction in the early 1960s, numerous cases of fatal PQ poisonings attributed to accidental and/or intentional ingestion of PQ concentrated formulations have been reported. The clinical manifestations of the respiratory system during the acute phase of PQ poisoning mainly include acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), followed by pulmonary fibrosis in a later phase. The focus of this review is to summarize the most recent publications related to PQ-induced lung toxicity as well as the underlying molecular mechanisms for PQ-mediated pathologic processes. Growing sets of data from in vitro and in vivo models have demonstrated the involvement of the PQ in regulating lung oxidative stress, inflammatory response, epigenetics, apoptosis, autophagy, and the progression of lung fibrosis. The article also summarizes novel therapeutic avenues based on a literature review, which can be explored as potential means to combat PQ-induced lung toxicity. Finally, we also presented clinical studies on the association of PQ exposure with the incidence of lung injury and pulmonary fibrosis.
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Affiliation(s)
- Rajasekaran Subbiah
- Department of Biochemistry, ICMR-National Institute for Research in Environmental Health, Bhopal, India
| | - Rajnarayan R Tiwari
- Department of Biochemistry, ICMR-National Institute for Research in Environmental Health, Bhopal, India
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Gao Y, Guo S, Wang Y, Yu S, Wang M, Lu X, Li Y. Lymphocyte and its CD4+ and CD8+ subgroup changes after paraquat poisoning. Hum Exp Toxicol 2019; 38:1024-1030. [PMID: 31104516 DOI: 10.1177/0960327119851252] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Paraquat (PQ) poisoning is a significant cause of mortality and morbidity in developing countries. Poor prognostic outcomes have been attributed to the herbicide's toxicity and the lack of effective treatments. Our study aims to investigate the changes in lymphocyte count in both patients who survived and died from PQ poisoning and explore the prognostic value. METHOD This is a retrospective case serials observational study. Adult patients admitted with acute PQ poisoning. The notes of 1000 patients who presented with acute PQ poisoning were reviewed. One hundred thirty patients having the T lymphocyte met the inclusion criteria and were grouped into those that survived the poisoning (95) and non-survivors (35). RESULTS On admission, non-survivors had a higher ingestion volume of PQ and urine PQ concentration as well as higher severity indices (Acute Physiology and Chronic Health Evaluation 2, Sequential Organ Failure Assessment, and Poisoning Severity Score). Patients in the survival group had a higher dosage of immunosuppressant and a longer hospital stay. Leukocytes, especially neutrophils, were higher among non-survivors; however, the converse was found with lymphocytes. T lymphocyte (CD3) count was consistently higher among survivors as well as the subgroups CD4+ and CD8+. No differences in the ratio of CD4/CD8 were found between the groups. CONCLUSION Our study has shown that changes in lymphocyte count as its subgroups could indicate a host's immune status and lymphocytes play an important role as a surrogate marker of host immunity, which could be a useful prognostic tool in the assessment of this disease.
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Affiliation(s)
- Y Gao
- 1 Emergency Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - S Guo
- 2 Oxford Centre for Enablement, Nuffield Orthopaedic Centre, Oxford, UK
| | - Y Wang
- 1 Emergency Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - S Yu
- 3 Emergency Department, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - M Wang
- 4 Hospital Affairs Office, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - X Lu
- 3 Emergency Department, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Y Li
- 3 Emergency Department, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
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Abstract
Though the cases of HIV patients with paraquat (PQ) poisoning are rare, we still found the common features. These recovered HIV patients tended to result in much less lung injury, and had low CD4+ T lymphocyte levels due to HIV infection, which meant they were under the immunosuppressive condition during treatment. This may be conducive to relieve the acute inflammation and lung fibrosis induced by PQ. Thus, we consider the immunosuppressive therapy for PQ poisoning to be appropriate. However, the drugs used currently may be not optimal for toxic patient. As next step, we will add the CD4+ T lymphocyte-targeted immunosuppressive drug to treat PQ poisoning patients.
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Affiliation(s)
- Yuan-Qiang Lu
- Department of Emergency Medicine, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
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Wu Q, Xu Q, Jian X, Wang H, He X, Gao B, Wang K, Kan B. A new sight for paraquat poisoning from immunology. Immunopharmacol Immunotoxicol 2018; 40:269-272. [PMID: 30040510 DOI: 10.1080/08923973.2018.1490319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Paraquat (methyl viologen, PQ) is highly toxic to humans. Pulmonary fibrosis is the most common cause of death after PQ poisoning. However, no effective therapy is available. The current treatment dilemma and pathology suggest that we should reconsider how to treat the poisoning using other methods, such as immunization. Some clues indicate that immune mechanisms may play important roles in the pathology of PQ poisoning. We implemented a simple experiment to test the hypothesis that activated innate immunity was involved in acute lung injury induced by PQ. Six rats were randomly distributed to two groups: PQ poisoning group and Immunosuppression group (cyclophosphamide pretreatment). Forty-eight hours after PQ administration, rats were anesthetized. The right lungs were excised for histopathology. The experimental results confirmed that in the set of immune deficiency, the inflammatory response in Immunosuppression group could not be effectively triggered so the lung pathology was much better than PQ poisoning group. The immunopathogenic mechanism of PQ poisoning may be essentially a sterile inflammation triggered and amplified by damage-associated molecular patterns (DAMPs). If the hypothesis is established, it may change the therapeutic regimen of PQ poisoning and the prognosis of patients.
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Affiliation(s)
- Qiang Wu
- a Departments of Poisoning and Occupational Diseases , Qilu Hospital, Shandong University , Jinan , Shandong , P.R. China.,b Department of Intensive Care Medicine , The First Affiliated Hospital of Bengbu Medical College , Bengbu , Anhui , P.R. China
| | - Qinliang Xu
- a Departments of Poisoning and Occupational Diseases , Qilu Hospital, Shandong University , Jinan , Shandong , P.R. China
| | - Xiangdong Jian
- a Departments of Poisoning and Occupational Diseases , Qilu Hospital, Shandong University , Jinan , Shandong , P.R. China
| | - Huaxue Wang
- b Department of Intensive Care Medicine , The First Affiliated Hospital of Bengbu Medical College , Bengbu , Anhui , P.R. China
| | - Xiandi He
- b Department of Intensive Care Medicine , The First Affiliated Hospital of Bengbu Medical College , Bengbu , Anhui , P.R. China
| | - Beijun Gao
- a Departments of Poisoning and Occupational Diseases , Qilu Hospital, Shandong University , Jinan , Shandong , P.R. China
| | - Ke Wang
- c Public Health School of Shandong University , Jinan , Shandong , P.R. China
| | - Baotian Kan
- a Departments of Poisoning and Occupational Diseases , Qilu Hospital, Shandong University , Jinan , Shandong , P.R. China
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