John H, Thiermann H. Poisoning by organophosphorus nerve agents and pesticides: An overview of the principle strategies and current progress of mass spectrometry-based procedures for verification.
J Mass Spectrom Adv Clin Lab 2021;
19:20-31. [PMID:
34820662 PMCID:
PMC8601002 DOI:
10.1016/j.jmsacl.2021.01.002]
[Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/02/2020] [Accepted: 01/03/2021] [Indexed: 02/07/2023] Open
Abstract
Evidence of poisoning with organophosphorus (OP) nerve agents requires biomedical verification.
OP nerve agents undergo common biotransformation pathways producing valuable biomarkers.
Internationally accepted methods target remaining poison, hydrolysis products and protein-adducts.
Mass spectrometry-based methods provide optimum selectivity and sensitivity for identification.
Methods, strategies, current proceedings, quality criteria and real cases of poisoning are presented.
Intoxication by organophosphorus (OP) poisons, like nerve agents and pesticides, is characterized by the life-threatening inhibition of acetylcholinesterase (AChE) caused by covalent reaction with the serine residue of the active site of the enzyme (phosphylation). Similar reactions occur with butyrylcholinesterase (BChE) and serum albumin present in blood as dissolved proteins. For forensic purposes, products (adducts) with the latter proteins are highly valuable long-lived biomarkers of exposure to OP agents that are accessible by diverse mass spectrometric procedures. In addition, the evidence of poison incorporation might also succeed by the detection of remaining traces of the agent itself, but more likely its hydrolysis and/or enzymatic degradation products. These relatively short-lived molecules are distributed in blood and tissue, and excreted via urine. This review presents the mass spectrometry-based methods targeting the different groups of biomarkers in biological samples, which are already internationally accepted by the Organisation for the Prohibition of Chemical Weapons (OPCW), introduces novel approaches in the field of biomedical verification, and outlines the strict quality criteria that must be fulfilled for unambiguous forensic analysis.
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