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Jayasudha P, Manivannan R, Kim W, Lim H, Patra SK, Son YA. Tailored fluorophore design: Enhancing selectivity for cyanide ion sensing in water and food samples, and innovative device development. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2024; 314:124196. [PMID: 38555821 DOI: 10.1016/j.saa.2024.124196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 02/22/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024]
Abstract
A rigid fluorophore unit of Julolidine/coumarin fused with an indolium-conjugated system was built for the immediate and effective recognition of cyanide ions in a 90 % aq. DMSO solution. The probes are capable of displaying better sensitivity/selectivity for the cyanide ion over a wide range of other interfering ions. The probe JI showed an instant colorimetric variation, whereas the modified probe JCI showed both colorimetric and fluorimetric variation with cyanide ion. The observed detection limit values indicated excellent sensitivity of the probe to the cyanide ion. HRMS and 1H NMR studies confirmed that the mechanism of detection of CN- is via the nucleophilic attack on the electron-deficient indolium moiety of the molecule. Moreover, the probes are well proficient in selective recognition of cyanide in various real time applications (test strips, electronic sensor kit, food and water sample analysis).
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Affiliation(s)
- Palanisamy Jayasudha
- Department of Advanced Organic Materials Engineering, Chungnam National University, 220 Gung-dong, Yuseong-gu, Daejeon 305-764, South Korea
| | - Ramalingam Manivannan
- Department of Advanced Organic Materials Engineering, Chungnam National University, 220 Gung-dong, Yuseong-gu, Daejeon 305-764, South Korea
| | - Wonbin Kim
- Department of Advanced Organic Materials Engineering, Chungnam National University, 220 Gung-dong, Yuseong-gu, Daejeon 305-764, South Korea
| | - Hyeongcheon Lim
- Department of Advanced Organic Materials Engineering, Chungnam National University, 220 Gung-dong, Yuseong-gu, Daejeon 305-764, South Korea
| | - Sumit Kumar Patra
- Department of Advanced Organic Materials Engineering, Chungnam National University, 220 Gung-dong, Yuseong-gu, Daejeon 305-764, South Korea
| | - Young-A Son
- Department of Advanced Organic Materials Engineering, Chungnam National University, 220 Gung-dong, Yuseong-gu, Daejeon 305-764, South Korea.
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Geiken A, Banz L, Kock M, Schwendicke F, Graetz C. Does information about MIH on dental homepages in Germany offer high quality? A systematic search and analysis. Eur Arch Paediatr Dent 2024; 25:127-135. [PMID: 38300412 PMCID: PMC10942881 DOI: 10.1007/s40368-023-00857-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/11/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE The internet is increasingly used to seek health information. A dental condition of increasing concern and public interest is molar incisor hypomineralisation (MIH), why we evaluated the information quality of German dentists 'websites on the topic of MIH. METHODS A systematic search was performed by two independent investigators using three search engines. The information content of websites on MIH and technical, functional aspects, overall quality, and risk of bias were assessed using validated instruments (LIDA, DISCERN). Practice-related characteristics (practice type, specialization, setting, number and mean age of dentists) were recorded, and associations of these characteristics with websites' overall quality were explored using multivariable linear regression modelling. RESULTS 70 sites were included. 52% were multipractices in urban areas (49%). The most common age group was middle-aged individuals (41-50 years). The average number of dentists/practice was 2.5. The majority met more than 50% of the DISCERN and LIDA criteria (90%, 91%). The MIH definition was frequently used (67%), MIH symptoms were described (64%), and 58% mentioned therapies. The prevalence of MIH was mentioned less frequently (48%). MIH example photographs were rarely shown (14%). In multivariable analysis, most practice-related factors were not significant for overall site quality. Only chain practices had slightly higher quality in this regard (2.2; 95% CI of 0.3-4.1). CONCLUSIONS MIH is mentioned on a large proportion of dentists' websites. Overall technical, functional, and generic quality was high. Risk of bias is limited. While most websites provided a basic definition of MIH and its symptoms, important information for patients was missing.
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Affiliation(s)
- A Geiken
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - L Banz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - M Kock
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - F Schwendicke
- Clinic for Conservative Dentistry and Periodontology, University Hospital of Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany
| | - C Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
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Yu J, Lee J, Cho Y, Oh J, Kang H, Lim TH, Ko BS. Correlation between Carboxyhemoglobin Levels Measured by Blood Gas Analysis and by Multiwave Pulse Oximetry. J Pers Med 2024; 14:168. [PMID: 38392600 PMCID: PMC10890311 DOI: 10.3390/jpm14020168] [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: 12/18/2023] [Revised: 01/17/2024] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
Carbon monoxide (CO) poisoning is difficult to diagnose owing to its nonspecific symptoms. Multiwave pulse oximetry can be used to quickly screen patients for CO poisoning. However, few studies have analyzed patients with CO poisoning who presented to the emergency department (ED). The primary aim of our study was to determine the correlation between COHb levels measured in blood gas analysis and COHb levels measured in multiwave pulse oximetry. Secondary aims were the sensitivity and specificity of the COHb level cutoff value using multiwave pulse oximetry to predict a 25% COHb level in blood gas analysis. This single-center retrospective observational study included patients with CO poisoning who visited the ED of a university-affiliated hospital in Seoul, Korea between July 2021 and June 2023. COHb poisoning was determined using blood gas analysis and multiwave pulse oximetry. The correlation of COHb levels between the two tests was evaluated using correlation analysis. The area under the receiver operating characteristic curve (AUC) of multiwave pulse oximetry was calculated to predict COHb levels from the blood gas analysis. The optimal cutoff values, sensitivity, and specificity of COHb were determined. A total of 224 patients who had COHb levels measured using both multiwave pulse oximetry and blood gas analysis were included in the analysis. In the correlation analysis, COHb showed a high positive correlation with COHb measured using blood gas analysis (Spearman correlation coefficient = 0.86, p < 0.001). The AUC of COHb measured by multiwave pulse oximetry to predict 25% of the COHb level (which can be an indication of hyperbaric oxygen treatment) measured by blood gas analysis was 0.916. When the COHb levels measured with multiwave pulse oximetry were 20% the sensitivity was 81% and the specificity was 83%, and when the COHb levels were 25% the sensitivity was 50% and the specificity was 95%. The COHb value measured using multiwave pulse oximetry blood gas analysis showed a high correlation. However, additional research using large-scale studies is required for validation.
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Affiliation(s)
- Jisu Yu
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Juncheol Lee
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Yongil Cho
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Jaehoon Oh
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Hyunggoo Kang
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Tae Ho Lim
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Byuk Sung Ko
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
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Nguyen TPL, Nguyen CHT, Nguyen TQ, Tran CD, Nguyen TH, Nguyen LTT, Nguyen HT. A Novel Colorimetric and Fluorometric Dual-Channel Chemosensor based on A Conjugated Perylene-Benzothiazole System for Highly Selective Detection of Cyanide in Aqueous Media. Chempluschem 2023; 88:e202300264. [PMID: 37540494 DOI: 10.1002/cplu.202300264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/05/2023]
Abstract
A novel cyanine compound based on the conjugated perylene-benzothiazole system (PBI) as a colorimetric and fluorometric dual-channel sensor for cyanide (CN- ) detection was synthesized and characterized via UV-vis and fluorescence spectroscopy. PBI exhibited a high sensitivity and rapid optical response for CN- due to the intramolecular charge transfer (ICT) mechanism. The detection limit of PBI for CN- was 1.15×10-7 M in the mixture of DMSO/H2 O (1 : 1, v/v). Moreover, probe PBI demonstrated high selectivity and sensitivity for CN- over other common anions, including Cl- , Br- , F- , I- , AcO- , ClO4 - , HSO4 - , SO4 2- , NO2 - , NO3 - and SCN- . This work provided a simple and effective approach to trace the toxic CN- ion with rapid response, high selectivity, and sensitivity that is possibly applied in environmental control and agricultural management.
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Affiliation(s)
- Thao Phuong Le Nguyen
- National Key Laboratory of Polymer and Composite Materials, Ho Chi Minh City University of Technology (HCMUT), Vietnam National University - Ho Chi Minh City (VNU-HCM), 268 Ly Thuong Kiet, District 10, Ho Chi Minh City, 700000, Vietnam
| | - Cam Hong Thi Nguyen
- National Key Laboratory of Polymer and Composite Materials, Ho Chi Minh City University of Technology (HCMUT), Vietnam National University - Ho Chi Minh City (VNU-HCM), 268 Ly Thuong Kiet, District 10, Ho Chi Minh City, 700000, Vietnam
| | - Thiet-Quoc Nguyen
- Institute of Applied Materials Science, Vietnam Academy of Science and Technology, 1B TL29, District 12, Ho Chi Minh City, Vietnam
| | - Chau Duc Tran
- Department Faculty of Materials Technology, Ho Chi Minh City University of Technology (HCMUT), VNU-HCM, 268 Ly Thuong Kiet, District 10, Ho Chi Minh City, 700000, Vietnam
| | - Tam Huu Nguyen
- National Key Laboratory of Polymer and Composite Materials, Ho Chi Minh City University of Technology (HCMUT), Vietnam National University - Ho Chi Minh City (VNU-HCM), 268 Ly Thuong Kiet, District 10, Ho Chi Minh City, 700000, Vietnam
| | - Le-Thu T Nguyen
- Department Faculty of Materials Technology, Ho Chi Minh City University of Technology (HCMUT), VNU-HCM, 268 Ly Thuong Kiet, District 10, Ho Chi Minh City, 700000, Vietnam
| | - Ha Tran Nguyen
- National Key Laboratory of Polymer and Composite Materials, Ho Chi Minh City University of Technology (HCMUT), Vietnam National University - Ho Chi Minh City (VNU-HCM), 268 Ly Thuong Kiet, District 10, Ho Chi Minh City, 700000, Vietnam
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Pshenichnyuk SA, Asfandiarov NL, Rakhmeyev RG, Safronov AM, Komolov AS. On delicate balance between formation and decay of tetracyanoethylene molecular anion triggered by resonance electron attachment. J Chem Phys 2023; 158:2887211. [PMID: 37114708 DOI: 10.1063/5.0149262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Low-energy (0-15 eV) resonance electron interaction with isolated tetracyanoethylene (TCNE) molecules is studied in vacuo by means of dissociative electron attachment (DEA) spectroscopy. Despite this molecule being relatively small, the long-lived molecular anions TCNE- are formed not only at thermal electron energy via a vibrational Feshbach resonance mechanism but also via shape resonances with the occupation of the π4* and π5* molecular orbitals by an incident electron. Dissociative decays of TCNE- are mostly observed at incident electron energy above the π7* temporary anion state predicted to lie at 1.69 eV by means of B3LYP/6-31G(d) calculations combined with the empirical scaling procedure. Electron attachment to the π6* orbital (predicted at 0.85 eV) leads to the generation of long-lived TCNE- species, which can decay via two competing processes: extra electron detachment, which appears in hundreds of microseconds, or elimination of two cyano groups to form the [TCNE - 2(CN)]- negative fragment on a tens of microsecond timescale. The latter is accompanied by the generation of a highly toxic cyanogen molecule as a neutral counterpart. Since the electron transfer to the acceptor molecule TCNE plays a key role in the formation of single-molecule magnets, the present data are of importance to understand the long-term behavior and likely harmful effects produced by cyanide-based prospective materials.
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Affiliation(s)
- Stanislav A Pshenichnyuk
- Institute of Molecule and Crystal Physics, Ufa Federal Research Centre, Russian Academy of Sciences, Prospekt Oktyabrya 151, 450075 Ufa, Russia
| | - Nail L Asfandiarov
- Institute of Molecule and Crystal Physics, Ufa Federal Research Centre, Russian Academy of Sciences, Prospekt Oktyabrya 151, 450075 Ufa, Russia
| | - Rustam G Rakhmeyev
- Institute of Molecule and Crystal Physics, Ufa Federal Research Centre, Russian Academy of Sciences, Prospekt Oktyabrya 151, 450075 Ufa, Russia
| | - Aleksey M Safronov
- Institute of Molecule and Crystal Physics, Ufa Federal Research Centre, Russian Academy of Sciences, Prospekt Oktyabrya 151, 450075 Ufa, Russia
| | - Alexei S Komolov
- St. Petersburg State University, Universitetskaya nab. 7/9, 199034 St. Petersburg, Russia
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Bebarta VS, Shi X, Zheng S, Hendry-Hofer TB, Severance CC, Behymer MM, Boss GR, Mahon S, Brenner M, Knipp GT, Davisson VJ, Peterson RT, MacRae CA, Rutter J, Gerszten RE, Nath AK. Intramuscular administration of glyoxylate rescues swine from lethal cyanide poisoning and ameliorates the biochemical sequalae of cyanide intoxication. Toxicol Sci 2023; 191:90-105. [PMID: 36326479 PMCID: PMC9887668 DOI: 10.1093/toxsci/kfac116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Cyanide-a fast-acting poison-is easy to obtain given its widespread use in manufacturing industries. It is a high-threat chemical agent that poses a risk of occupational exposure in addition to being a terrorist agent. FDA-approved cyanide antidotes must be given intravenously, which is not practical in a mass casualty setting due to the time and skill required to obtain intravenous access. Glyoxylate is an endogenous metabolite that binds cyanide and reverses cyanide-induced redox imbalances independent of chelation. Efficacy and biochemical mechanistic studies in an FDA-approved preclinical animal model have not been reported. Therefore, in a swine model of cyanide poisoning, we evaluated the efficacy of intramuscular glyoxylate on clinical, metabolic, and biochemical endpoints. Animals were instrumented for continuous hemodynamic monitoring and infused with potassium cyanide. Following cyanide-induced apnea, saline control or glyoxylate was administered intramuscularly. Throughout the study, serial blood samples were collected for pharmacokinetic, metabolite, and biochemical studies, in addition, vital signs, hemodynamic parameters, and laboratory values were measured. Survival in glyoxylate-treated animals was 83% compared with 12% in saline-treated control animals (p < .01). Glyoxylate treatment improved physiological parameters including pulse oximetry, arterial oxygenation, respiration, and pH. In addition, levels of citric acid cycle metabolites returned to baseline levels by the end of the study. Moreover, glyoxylate exerted distinct effects on redox balance as compared with a cyanide-chelating countermeasure. In our preclinical swine model of lethal cyanide poisoning, intramuscular administration of the endogenous metabolite glyoxylate improved survival and clinical outcomes, and ameliorated the biochemical effects of cyanide.
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Affiliation(s)
- Vik S Bebarta
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado 80045, USA
| | - Xu Shi
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02115, USA
| | - Shunning Zheng
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02115, USA
| | - Tara B Hendry-Hofer
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado 80045, USA
| | - Carter C Severance
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado 80045, USA
| | - Matthew M Behymer
- Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, Indiana 47907, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, California 92093, USA
| | - Sari Mahon
- Department of Medicine, Beckman Laser Institute, University of California, Irvine, California 92697, USA
| | - Matthew Brenner
- Department of Medicine, Beckman Laser Institute, University of California, Irvine, California 92697, USA
| | - Gregory T Knipp
- Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, Indiana 47907, USA
| | - Vincent Jo Davisson
- Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, Indiana 47907, USA
| | - Randall T Peterson
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, Utah 84112, USA
| | - Calum A MacRae
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts 02115, USA
| | - Jared Rutter
- Department of Biochemistry, Howard Hughes Medical Institute, University of Utah, Salt Lake City, Utah 84112, USA
| | - Robert E Gerszten
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02115, USA
- Broad Institute, Cambridge, Massachusetts 02142, USA
- Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Anjali K Nath
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02115, USA
- Broad Institute, Cambridge, Massachusetts 02142, USA
- Harvard Medical School, Boston, Massachusetts 02115, USA
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7
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Mondal A, Chattopadhyay SK. Selective Turn-On Fluorescence Sensing of Cyanide Using the Pyridoxal Platform of a Ni(II) Complex. ACS OMEGA 2022; 7:40941-40949. [PMID: 36406569 PMCID: PMC9670700 DOI: 10.1021/acsomega.2c04063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Cyanide is a very toxic pollutant to aquatic life and the environment. Analytical methods for the quantitative assay of cyanide, which are rapid, sensitive (low limit of detection), and cost-effective, are in great demand. Colorimetric and fluorometric methods are ideally suited for this purpose. In this report, we describe a Ni(II) complex containing a pyridoxal platform for the rapid and sensitive fluorometric estimation of cyanide. The square-planar Ni(II) complex, [Ni(L)(N3)]·3H2O, where the ligand LH = 4-[(2-dimethylamino-ethylimino)-methyl]-5-hydroxymtheyl-2-methyl-pyridin-3-ol, a Schiff base formed between pyridoxal and (2-dimethylamino)ethyl amine, was synthesized and characterized by various spectroscopic techniques as well as by single-crystal X-ray structure determination. The complex was found to selectively bind CN- in the presence of other biologically important anions such as F-, Cl-, Br-, I-, OAc-, S2-, NO3 -, PO4 3-, SO4 2-, and H2PO4 - in tris-HCl/NaCl buffer [pH = 7.4], and it can be monitored by fluorescence turn-on or by UV-visible spectroscopy. The binding constant of the complex with CN- was estimated to be 2.046 × 1014 M-2 and the limit of detection (LOD) was 9 nM, the LOD being considerably lower than the maximum permissible level of cyanide ions (1.9 μM) in drinking water, as recognized by the World Health Organization (WHO). The effects of pH and temperature on the sensing are also investigated. The Ni(II) complex is also found to bind to calf-thymus DNA very strongly, and the apparent binding constant (K app) was determined to be 1.33 × 107 M-1 by the fluorescence quenching of the ethidium bromide-DNA adduct by the complex.
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Narayan S, Petersen TL. Uncommon Etiologies of Shock. Crit Care Clin 2022; 38:429-441. [DOI: 10.1016/j.ccc.2021.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Philipopoulos GP, Tat J, Chan A, Jiang J, Mukai D, Burney T, Doosty M, Mahon S, Patel HH, White CW, Brenner M, Lee J, Boss GR. Methyl mercaptan gas: mechanisms of toxicity and demonstration of the effectiveness of cobinamide as an antidote in mice and rabbits. Clin Toxicol (Phila) 2022; 60:615-622. [PMID: 34989638 PMCID: PMC9662850 DOI: 10.1080/15563650.2021.2017949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
CONTEXT Methyl mercaptan (CH3SH) is a colorless, toxic gas with potential for occupational exposure and used as a weapon of mass destruction. Inhalation at high concentrations can result in dyspnea, hypoventilation, seizures, and death. No specific methyl mercaptan antidote exists, highlighting a critical need for such an agent. Here, we investigated the mechanism of CH3SH toxicity, and rescue from CH3SH poisoning by the vitamin B12 analog cobinamide, in mammalian cells. We also developed lethal CH3SH inhalation models in mice and rabbits, and tested the efficacy of intramuscular injection of cobinamide as a CH3SH antidote. RESULTS We found that cobinamide binds to CH3SH (Kd = 84 µM), and improved growth of cells exposed to CH3SH. CH3SH reduced cellular oxygen consumption and intracellular ATP content and activated the stress protein c-Jun N-terminal kinase (JNK); cobinamide reversed these changes. A single intramuscular injection of cobinamide (20 mg/kg) rescued 6 of 6 mice exposed to a lethal dose of CH3SH gas, while all six saline-treated mice died (p = 0.0013). In rabbits exposed to CH3SH gas, 11 of 12 animals (92%) treated with two intramuscular injections of cobinamide (50 mg/kg each) survived, while only 2 of 12 animals (17%) treated with saline survived (p = 0.001). CONCLUSION We conclude that cobinamide could potentially serve as a CH3SH antidote.
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Affiliation(s)
| | - John Tat
- Department of Medicine, University of California, San Diego, CA, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, CA, USA
| | - Jingjing Jiang
- Department of Medicine, University of California, San Diego, CA, USA
| | - David Mukai
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Tanya Burney
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Melody Doosty
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Sari Mahon
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Hemal H Patel
- VA San Diego Healthcare System and Department of Anesthesiology, University of California, San Diego, CA, USA
| | - Carl W White
- Department of Pediatrics, University of Colorado, Aurora, CO, USA
| | - Matthew Brenner
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Jangwoen Lee
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, CA, USA
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de Jesus JPA, Assis LC, de Castro AA, da Cunha EFF, Nepovimova E, Kuca K, de Castro Ramalho T, de Almeida La Porta F. Effect of drug metabolism in the treatment of SARS-CoV-2 from an entirely computational perspective. Sci Rep 2021; 11:19998. [PMID: 34620963 PMCID: PMC8497625 DOI: 10.1038/s41598-021-99451-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/01/2021] [Indexed: 12/25/2022] Open
Abstract
Understanding the effects of metabolism on the rational design of novel and more effective drugs is still a considerable challenge. To the best of our knowledge, there are no entirely computational strategies that make it possible to predict these effects. From this perspective, the development of such methodologies could contribute to significantly reduce the side effects of medicines, leading to the emergence of more effective and safer drugs. Thereby, in this study, our strategy is based on simulating the electron ionization mass spectrometry (EI-MS) fragmentation of the drug molecules and combined with molecular docking and ADMET models in two different situations. In the first model, the drug is docked without considering the possible metabolic effects. In the second model, each of the intermediates from the EI-MS results is docked, and metabolism occurs before the drug accesses the biological target. As a proof of concept, in this work, we investigate the main antiviral drugs used in clinical research to treat COVID-19. As a result, our strategy made it possible to assess the biological activity and toxicity of all potential by-products. We believed that our findings provide new chemical insights that can benefit the rational development of novel drugs in the future.
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Affiliation(s)
- João Paulo Almirão de Jesus
- Laboratory of Nanotechnology and Computational Chemistry, Federal Technological University of Paraná, Avenida dos Pioneiros 3131, Londrina, Paraná, CEP 86036-370, Brazil
| | - Letícia Cristina Assis
- Department of Chemistry, Federal University of Lavras, Lavras, Minas Gerais, CEP 37200-000, Brazil
| | | | | | - Eugenie Nepovimova
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, 500 03, Hradec Králové, Czech Republic
| | - Kamil Kuca
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, 500 03, Hradec Králové, Czech Republic.
| | - Teodorico de Castro Ramalho
- Department of Chemistry, Federal University of Lavras, Lavras, Minas Gerais, CEP 37200-000, Brazil
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, 500 03, Hradec Králové, Czech Republic
| | - Felipe de Almeida La Porta
- Laboratory of Nanotechnology and Computational Chemistry, Federal Technological University of Paraná, Avenida dos Pioneiros 3131, Londrina, Paraná, CEP 86036-370, Brazil.
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11
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Hongprasit A, Okamoto Y, Toida T, Ogra Y. Comparison of quantification of selenocyanate and thiocyanate in cultured mammalian cells between HPLC-fluorescence detector and HPLC-inductively coupled plasma mass spectrometer. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1181:122924. [PMID: 34508979 DOI: 10.1016/j.jchromb.2021.122924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/03/2021] [Accepted: 09/01/2021] [Indexed: 11/28/2022]
Abstract
The simultaneous detection of cyanide (CN), thiocyanate (SCN), and selenocyanate (SeCN) by a HPLC-fluorescence detector (FLD) with the post-column König reaction was recently reported. SCN and SeCN are also detectable by HPLC-inductively coupled plasma mass spectrometry (HPLC-ICP-MS) because sulfur and selenium can be detected, respectively, without any pre- or post-treatment. ICP-MS has high sensitivity for selenium and sulfur detection and is robust to sample matrices. In this study, we compared HPLC-FLD with the post-column König reaction and HPLC-ICP-MS in terms of SCN and SeCN detection sensitivity and linearity. The limit of detection (LOD) for SCN indicated that HPLC-FLD with the post-column König reaction was 354 times more sensitive than HPLC-ICP-MS. Likewise, the LOD for SeCN indicated that HPLC-FLD was 51 times more sensitive than HPLC-ICP-MS. These results demonstrated that HPLC-FLD was a more suitable technique for SeCN and SCN detection than HPLC-ICP-MS. We previously reported that SeCN was generated in selenite-exposed mammalian cells to detoxify excess selenite. HPLC-FLD with the post-column König reaction enabled good separation and detection for quantifying SCN and SeCN in mammalian cell lines exposed to selenite. The intracellular SCN and SeCN concentrations determined by this technique suggested differences in the metabolic capacity for selenite to form SeCN among the cell lines. In addition, since the amount of intracellular SCN and SeCN were significantly decreased by pretreatment of myeloperoxidase (MPO) inhibitors, SCN and SeCN were resulted from the interaction of sulfur and selenium with endogenous CN, respectively, generated with MPO.
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Affiliation(s)
- Aphinan Hongprasit
- Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8675, Japan
| | - Yusuke Okamoto
- Division of Foods, National Institute of Health Sciences, 3-25-26 Tonomachi, Kawasaki-ku, Kawasaki-shi, Kanagawa 210-9501, Japan
| | - Toshihiko Toida
- Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8675, Japan
| | - Yasumitsu Ogra
- Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8675, Japan.
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Revalorization of Almond By-Products for the Design of Novel Functional Foods: An Updated Review. Foods 2021; 10:foods10081823. [PMID: 34441599 PMCID: PMC8391475 DOI: 10.3390/foods10081823] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/26/2021] [Accepted: 08/04/2021] [Indexed: 02/05/2023] Open
Abstract
The search for waste minimization and the valorization of by-products are key to good management and improved sustainability in the food industry. The great production of almonds, based on their high nutritional value as food, especially almond kernels, generates tons of waste yearly. The remaining parts (skin, shell, hulls, etc.) are still little explored, even though they have been used as fuel by burning or as livestock feed. The interest in these by-products has been increasing, as they possess beneficial properties, caused by the presence of different bioactive compounds, and can be used as promising sources of new ingredients for the food, cosmetic and pharmaceutical industry. Additionally, the use of almond by-products is being increasingly applied for the fortification of already-existing food products, but there are some limitations, including the presence of allergens and mycotoxins that harden their applicability. This review focuses on the extraction technologies applied to the valorization of almond by-products for the development of new value-added products that would contribute to the reduction of environmental impact and an improvement in the sustainability and competitiveness of the almond industry.
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Lippner DS, Hildenberger DM, Rhoomes MO, Winborn JN, Dixon H, McDonough J, Rockwood GA. A novel aqueous dimethyl trisulfide formulation is effective at low doses against cyanide toxicity in non-anesthetized mice and rats. Clin Toxicol (Phila) 2021; 60:83-94. [PMID: 34219566 DOI: 10.1080/15563650.2021.1935991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Cyanide (CN) is a metabolic poison that is capable of intoxicating individuals through accidental or intentional means. With high concentration exposures, death can occur in minutes. In cases of mass casualty exposures, there is a need for a rapid-acting countermeasure capable of being administered in a short period of time in a pre-hospital setting to treat victims. OBJECTIVE These studies evaluate the safety and efficacy of a novel aqueous formulation of dimethyl trisulfide (DMTS) as an intramuscular (IM) CN countermeasure using non-anesthetized rodent models. METHODS Non-anesthetized rodents (mice and rats) were exposed to hydrogen cyanide (HCN) or potassium cyanide (KCN) along with immediate IM 10% DMTS treatment or vehicle treatment. Survival and other parameters, such as the time to recovery and assessment of clinical toxic signs (e.g., gasping, loss of righting reflex, convulsions, etc.), were quantified to determine the effectiveness of 10% DMTS treatment (12.5, 25, 75 mg/kg IM) compared to vehicle control treatment. A rat KCN delayed-treatment model with a 15-minute treatment delay was also utilized to simulate a real-life exposure/treatment scenario with 10% DMTS treatment. The stability of the 10% DMTS formulation was also assessed. RESULTS A 25 mg/kg IM dose of 10% DMTS exhibits potent efficacy against subcutaneous (SC) KCN challenge in both mice and rats and inhalational HCN exposure in mice. 10% DMTS treatment also shortens the time to recovery in rats using a delayed-treatment model. CONCLUSION IM treatment with 10% DMTS improves survival and clinical outcomes in non-anesthetized rodent models of acute CN toxicity. Additionally, the use of an SC KCN delayed-treatment model in rats is advised to assess the performance of a candidate CN countermeasure in a more realistic exposure/treatment scenario.
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Affiliation(s)
- D S Lippner
- Medical Toxicology Research Division, Biochemistry and Physiology Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - D M Hildenberger
- Medical Toxicology Research Division, Biochemistry and Physiology Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - M O Rhoomes
- Medical Toxicology Research Division, Biochemistry and Physiology Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - J N Winborn
- Medical Toxicology Research Division, Biochemistry and Physiology Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - H Dixon
- Southwest Research Institute, San Antonio, TX, USA
| | - J McDonough
- Southwest Research Institute, San Antonio, TX, USA
| | - G A Rockwood
- Medical Toxicology Research Division, Biochemistry and Physiology Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
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15
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Ma KH, Lippner DS, Basi KA, DeLeon SM, Cappuccio WR, Rhoomes MO, Hildenberger DM, Hoard-Fruchey HM, Rockwood GA. Cyanide Poisoning Compromises Gene Pathways Modulating Cardiac Injury in Vivo. Chem Res Toxicol 2021; 34:1530-1541. [PMID: 33914522 DOI: 10.1021/acs.chemrestox.0c00467] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Smoke inhalation from a structure fire is a common route of cyanide poisoning in the U.S. Cyanide inhibits cellular respiration, often leading to death. Its rapid distribution throughout the body can result in injuries to multiple organs, and cyanide victims were reported to experience myocardial infarction and other cardiac complications. However, molecular mechanisms of such complications are yet to be elucidated. While FDA-approved CN antidotes such as sodium thiosulfate and hydroxocobalamin are clinically used, they have foreseeable limitations during mass casualty situations because they require intravenous administration. To facilitate the development of better antidotes and therapeutic treatments, a global view of molecular changes induced by cyanide exposure is necessary. As an exploratory pursuit, we performed oligonucleotide microarrays to establish cardiac transcriptomes of an animal model of nose-only inhalation exposure to hydrogen cyanide (HCN), which is relevant to smoke inhalation. We also profiled cardiac transcriptomes after subcutaneous injection of potassium cyanide (KCN). Although the KCN injection model has often been used to evaluate medical countermeasures, this study demonstrated that cardiac transcriptomes are largely different from that of the HCN inhalation model at multiple time points within 24 h after exposure. Pathway analysis identified that HCN-induced transcriptomes were enriched with genes encoding mediators of pathways critical in modulation of cardiac complications and that a large number of such genes were significantly decreased in expression. We utilized the upstream regulatory analysis to propose drugs that can be potentially employed to treat cyanide-induced cardiac complications.
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Affiliation(s)
- Ki H Ma
- Medical Toxicology Research Division, U.S. Army Medical Research Institute of Chemical Defense, 8350 Ricketts Point Road, Aberdeen Proving Ground, Maryland 21010, United States
| | - Dennean S Lippner
- Medical Toxicology Research Division, U.S. Army Medical Research Institute of Chemical Defense, 8350 Ricketts Point Road, Aberdeen Proving Ground, Maryland 21010, United States
| | - Kelly A Basi
- U.S. Army Combat Capabilities Development Command, Chemical Biological Center, 5183 Blackhawk Road, Aberdeen Proving Ground, Maryland 21010, United States
| | - Susan M DeLeon
- Medical Toxicology Research Division, U.S. Army Medical Research Institute of Chemical Defense, 8350 Ricketts Point Road, Aberdeen Proving Ground, Maryland 21010, United States
| | - William R Cappuccio
- Medical Toxicology Research Division, U.S. Army Medical Research Institute of Chemical Defense, 8350 Ricketts Point Road, Aberdeen Proving Ground, Maryland 21010, United States
| | - Melissa O Rhoomes
- Medical Toxicology Research Division, U.S. Army Medical Research Institute of Chemical Defense, 8350 Ricketts Point Road, Aberdeen Proving Ground, Maryland 21010, United States
| | - Diane M Hildenberger
- Medical Toxicology Research Division, U.S. Army Medical Research Institute of Chemical Defense, 8350 Ricketts Point Road, Aberdeen Proving Ground, Maryland 21010, United States
| | - Heidi M Hoard-Fruchey
- Medical Toxicology Research Division, U.S. Army Medical Research Institute of Chemical Defense, 8350 Ricketts Point Road, Aberdeen Proving Ground, Maryland 21010, United States
| | - Gary A Rockwood
- Medical Toxicology Research Division, U.S. Army Medical Research Institute of Chemical Defense, 8350 Ricketts Point Road, Aberdeen Proving Ground, Maryland 21010, United States
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Cyanobiphenyl-spiropyrane and -hemicyanine conjugates for cyanide detection in organic/aqueous media through reverse ICT direction: Their practical applications. Talanta 2021; 231:122385. [PMID: 33965047 DOI: 10.1016/j.talanta.2021.122385] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 11/21/2022]
Abstract
Cyanide is one of the most known toxic substances. It is used in many industries and threats human health and environment through releasing with wastewater. Therefore, it is very important to detect its accurate amount, rapidly. Herein, turn-on and turn-off fluorescence sensors of hybrid cyanobiphenyl-spiropyrane and -hemicyanine were developed for the detection of CN- ions on the basis of nuchleophilic addition to indolium moiety. Detection behavior of the both probes toward a series of anions was investigated by means of fluorescence, UV-vis, NMR and TOF-MS techniques. The results obviously indicate that both probes show remarkable spectral changes and high selectivity toward CN- with respect to other tested anions. Cyanide levels in water samples up to 0.208 μM could be quantitatively detected as practical application. A smartphone imaging application was successfully constructed for CN- detection. Noticeably, production of cotton kids and PSF capsules revealed that the probe could be conveniently used for on-site measurement of cyanide without complicated instruments.
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Role of Hemodialysis in the Management of Cyanide Intoxication From Apricot Kernels in a 3-Year-Old Child. Pediatr Emerg Care 2020; 36:e582-e584. [PMID: 30399062 DOI: 10.1097/pec.0000000000001644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cyanide (CN) is one among the most potent and rapidly acting lethal poisons, and it may cause death unless immediately diagnosed and treated. We report an unusual case of pediatric CN poisoning after ingestion of apricot kernels containing amygdalin, who survived with antidotal therapy and hemodialysis. A 3-year-old girl presented with respiratory distress and coma following tonic-clonic convulsions after ingestion of 3 apricot kernels. She had severe metabolic acidosis (pH 6.91, bicarbonate [HCO3] 5.6 mEq/L, base excess -26.0 mEq/L). Her blood CN level was measured 3.15 mg/L, 3 hours after ingestion. Hydroxocobalamin could not be administered immediately because it had to be brought from a medical center 4 hours apart. Therefore, a 3-hour hemodialysis session was carried out, following which she showed some clinical improvement. In addition, when hydroxocobalamin was obtained, it was then administered. During follow-up, she was completely asymptomatic with blood pressure, and other hemodynamic parameters normalized. This case presents hemodialysis as a way to correct metabolic derangements from CN poisoning and suggests that it may have a role in select cases of pediatric CN poisoning, especially when CN-scavenging antidotes may be unavailable.
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He XY, Wu LJ, Wang WX, Xie PJ, Chen YH, Wang F. Amygdalin - A pharmacological and toxicological review. JOURNAL OF ETHNOPHARMACOLOGY 2020; 254:112717. [PMID: 32114166 DOI: 10.1016/j.jep.2020.112717] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 02/20/2020] [Accepted: 02/23/2020] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Amygdalin is commonly distributed in plants of the Rosaceae, such as peach, plum, loquat, apple and bayberry, but most notably in the seeds (kernels) of apricot almonds. As a naturally aromatic cyanogenic compound, it has long been used in Asia, Europe and other regions for the treatment of various diseases including cough, asthma, nausea, leprosy and leukoderma. Importantly, in recent years, an increasing attention has been paid to its antitumor effect. AIM OF THE STUDY The paper aims to review the pharmacological activities and toxicological effects of amygdalin and provide a reference and perspective for its further investigation. METHODS Electronic databases including the Web of Science, Cochrane Library, PubMed, EMBASE, the Chinese Biological Medicine Database, China National Knowledge Infrastructure, Wanfang database and VIP information database were searched up to November 2019 to identify eligible studies. A meticulous review was performed, an in-depth analysis on the pharmacological activity and toxicology of amygdalin was conducted, and perspectives for future research were also discussed. RESULTS A total of 110 papers about in vitro/in vivo studies on amygdalin have been reviewed. Analysis on the data suggested that this compound presented pharmacological activities of anti-tumor, anti-fibrotic, anti-inflammatory, analgesic, immunomodulatory, anti-atherosclerosis, ameliorating digestive system and reproductive system, improving neurodegeneration and myocardial hypertrophy, as well as reducing blood glucose. In addition, studies revealed that amygdalin's toxicity was caused by its poisonous decomposite product of benzaldehyde and hydrogen cyanide after oral ingestion, toxicity of intravenous administration route was far less than the oral route, and it can be avoidable with an oral dose ranging from 0.6 to 1 g per day. CONCLUSION This paper has systematically reviewed the pharmacology and toxicology of amygdalin and provided comprehensive information on this compound. We hope this review highlights some perspectives for the future research and development of amygdalin.
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Affiliation(s)
- Xiao-Yan He
- College of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, PR China
| | - Li-Juan Wu
- College of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, PR China
| | - Wen-Xiang Wang
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, PR China
| | - Pei-Jun Xie
- College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610036, PR China
| | - Yun-Hui Chen
- College of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, PR China.
| | - Fei Wang
- College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610036, PR China.
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Panay AJ, Vargas-Serna CL, Carmona-Orozco ML. Biodegradation of cyanide using recombinant Escherichia coli expressing Bacillus pumilus cyanide dihydratase. REVISTA COLOMBIANA DE BIOTECNOLOGÍA 2020. [DOI: 10.15446/rev.colomb.biote.v22n1.79559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Despite its high toxicity, cyanide is used in several industrial processes, and as a result, large volumes of cyanide wastewater need to be treated prior to discharge. Enzymatic degradation of industrial cyanide wastewater by cyanide dihydratase, which is capable of converting cyanide to ammonia and formate, is an attractive alternative to conventional chemical methods of cyanide decontamination. However, the main impediment to the use of this enzyme for the biodegradation of cyanide is the intolerance to the alkaline pH at which cyanide waste is kept and its low thermoresistance. In the present study, the catalytic properties of whole E. coli cells overexpressing a cyanide dihydratase gene from B. pumilus were compared to those of the purified enzyme under conditions similar to those found in industrial cyanide wastewater. In addition, the capacity of whole cells to degrade free cyanide in contaminated wastewater resulting from the gold mining process was also determined. The characteristics of intracellular enzyme, relative to purified enzyme, included increased thermostability, as well as greater tolerance to heavy metals and to a lesser extent pH. On the other hand, significant enzymatic degradation (70%) of free cyanide in the industrial sample was achieved only after dilution. Nevertheless, the increased thermostability observed for intracellular CynD suggest that whole cells of E. coli overexpressing CynD are suited for process that operate at elevated temperatures, a limitation observed for the purified enzyme.
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Abstract
The internet has become a popular resource to learn about health and to investigate one's own health condition. However, given the large amount of inaccurate information online, people can easily become misinformed. Individuals have always obtained information from outside the formal health care system, so how has the internet changed people's engagement with health information? This review explores how individuals interact with health misinformation online, whether it be through search, user-generated content, or mobile apps. We discuss whether personal access to information is helping or hindering health outcomes and how the perceived trustworthiness of the institutions communicating health has changed over time. To conclude, we propose several constructive strategies for improving the online information ecosystem. Misinformation concerning health has particularly severe consequences with regard to people's quality of life and even their risk of mortality; therefore, understanding it within today's modern context is an extremely important task.
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Affiliation(s)
- Briony Swire-Thompson
- Network Science Institute, Northeastern University, Boston, Massachusetts 02115, USA; , .,Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts 02138, USA
| | - David Lazer
- Network Science Institute, Northeastern University, Boston, Massachusetts 02115, USA; , .,Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts 02138, USA
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21
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Harmon E, Lebin J, Murphy D, Watsjold B. Fatality from potassium gold cyanide poisoning. BMJ Case Rep 2019; 12:e229947. [PMID: 31350229 PMCID: PMC6663265 DOI: 10.1136/bcr-2019-229947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2019] [Indexed: 11/03/2022] Open
Abstract
While potassium cyanide poisoning has been well described, the toxicity of potassium gold cyanide is less well understood. This case describes an 84-year-old man who presented after an intentional ingestion of 0.5-1 teaspoons of potassium gold cyanide. Despite antidotal therapy, the patient rapidly developed severe lactic acidosis, multiorgan dysfunction and ultimately expired. While the patient's clinical findings were consistent with acute cyanide poisoning, a serum cyanide level was below the toxic threshold. Previous reports have suggested that gold toxicity may also contribute to the effects of potassium gold cyanide, and may have played a role in the patient's rapid decline. In addition to treatment of cyanide toxicity, management of acute gold toxicity should also be considered in potassium gold cyanide ingestion.
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Affiliation(s)
- Elizabeth Harmon
- Emergency Medicine, University of Washington, Seattle, Washington, USA
| | - Jacob Lebin
- Emergency Medicine, University of Washington, Seattle, Washington, USA
| | - David Murphy
- Emergency Medicine, University of Washington, Seattle, Washington, USA
| | - Bjorn Watsjold
- Emergency Medicine, University of Washington, Seattle, Washington, USA
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22
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Cheung JY, Merali S, Wang J, Zhang XQ, Song J, Merali C, Tomar D, You H, Judenherc-Haouzi A, Haouzi P. The central role of protein kinase C epsilon in cyanide cardiotoxicity and its treatment. Toxicol Sci 2019; 171:247-257. [PMID: 31173149 PMCID: PMC6735853 DOI: 10.1093/toxsci/kfz137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/28/2019] [Accepted: 05/28/2019] [Indexed: 01/02/2023] Open
Abstract
In adult mouse myocytes, brief exposure to sodium cyanide (CN) in the presence of glucose does not decrease ATP levels, yet produces profound reduction in contractility, intracellular Ca2+ concentration ([Ca2+]i) transient and L-type Ca2+ current (ICa) amplitudes. We analyzed proteomes from myocytes exposed to CN, focusing on ionic currents associated with excitation-contraction coupling. CN induced phosphorylation of α1c subunit of L-type Ca2+ channel and α2 subunit of Na+-K+-ATPase. Methylene blue (MB), a CN antidote that we previously reported to ameliorate CN-induced reduction in contraction, [Ca2+]i transient and ICa amplitudes, was able to reverse this phosphorylation. CN decreased Na+-K+-ATPase current contributed by α2 but not α1 subunit, an effect that was also counteracted by MB. Peptide consensus sequences suggested CN-induced phosphorylation was mediated by protein kinase C epsilon (PKCε). Indeed, CN stimulated PKC kinase activity and induced PKCε membrane translocation, effects that were prevented by MB. Pre-treatment with myristoylated PKCε translocation activator or inhibitor peptides mimicked and inhibited the effects of CN on ICa and myocyte contraction, respectively. We conclude that CN activates PKCε, which phosphorylates L-type Ca2+ channel and Na+-K+-ATPase, resulting in depressed cardiac contractility. We hypothesize that this inhibition of ion fluxes represents a novel mechanism by which the cardiomyocyte reduces its ATP demand (decreased ion fluxes and contractility), diminishes ATP turnover and preserves cell viability. However, this cellular protective effect translates into life-threatening cardiogenic shock in vivo, thereby creating a profound disconnect between survival mechanisms at the cardiomyocyte level from those at the level of the whole organism.
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Affiliation(s)
- Joseph Y Cheung
- Center for Translational Medicine and Lewis Katz School of Medicine of Temple University, Philadelphia, PA.,Department of Medicine, Lewis Katz School of Medicine of Temple University, Philadelphia, PA
| | - Salim Merali
- Moulder Center for Drug Discovery Research, Temple University School of Pharmacy, Philadelphia, PA
| | - JuFang Wang
- Center for Translational Medicine and Lewis Katz School of Medicine of Temple University, Philadelphia, PA
| | - Xue-Qian Zhang
- Center for Translational Medicine and Lewis Katz School of Medicine of Temple University, Philadelphia, PA
| | - Jianliang Song
- Center for Translational Medicine and Lewis Katz School of Medicine of Temple University, Philadelphia, PA
| | - Carmen Merali
- Moulder Center for Drug Discovery Research, Temple University School of Pharmacy, Philadelphia, PA
| | - Dhanendra Tomar
- Center for Translational Medicine and Lewis Katz School of Medicine of Temple University, Philadelphia, PA
| | - Hanning You
- Department of Medicine, Lewis Katz School of Medicine of Temple University, Philadelphia, PA
| | | | - Philippe Haouzi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA
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Petrikovics I, Kiss L, Chou CE, Ebrahimpour A, Kovács K, Kiss M, Logue B, Chan A, Manage ABW, Budai M, Boss GR, Rockwood GA. Antidotal efficacies of the cyanide antidote candidate dimethyl trisulfide alone and in combination with cobinamide derivatives. Toxicol Mech Methods 2019; 29:438-444. [DOI: 10.1080/15376516.2019.1585504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Ilona Petrikovics
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Lóránd Kiss
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Ching-En Chou
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Afshin Ebrahimpour
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Kristóf Kovács
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Márton Kiss
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Brian Logue
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, CA, USA
| | - Ananda B. W. Manage
- Department of Mathematics and Statistics, Sam Houston State University, Huntsville, TX, USA
| | - Marianna Budai
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, CA, USA
| | - Gary A. Rockwood
- US Army Medical Research Institute of Chemical Defense, APG, MD, USA
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Kobayashi K, Aramasa H, Nakai H, Nakajima M, Taguchi H. Colorimetric determination of β-1,2-glucooligosaccharides for an enzymatic assay using 3-methyl-2-benzothiazolinonehydrazone. Anal Biochem 2018; 560:1-6. [DOI: 10.1016/j.ab.2018.08.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/06/2018] [Accepted: 08/23/2018] [Indexed: 11/26/2022]
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Hendrix RJ, Martins PN, Stoff JS, Ahearn A, Bozorgzadeh A, Movahedi B. Successful Renal Transplantation after Presumed Cyanide Toxicity Treated with Hydroxocobalamin and Review of the Literature. Case Rep Transplant 2018; 2018:3753479. [PMID: 30271651 PMCID: PMC6151203 DOI: 10.1155/2018/3753479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/10/2018] [Accepted: 07/17/2018] [Indexed: 11/18/2022] Open
Abstract
We report two cases of successful renal transplantation with allografts from donors who suffered anoxic brain injury as the primary cause of death from house fires. Each was treated prophylactically with hydroxocobalamin (Cyanokit) for suspected cyanide toxicity. During organ procurement, gross examination was notable for deep discoloration of the parenchymal tissues. Approximately 6 and 18 months after transplantation, both recipients have excellent renal graft function and remain independent from hemodialysis (HD). Hydroxocobalamin is the antidote for suspected acute cyanide toxicity. While largely tolerated by the recipient, there is concern over the potential functional implications of the associated side effects of dramatic tissue discoloration and development of oxalate crystals. Furthermore, difficulties performing hemodialysis in patients treated with hydroxocobalamin have been reported due to discoloration of the effluent fluid impacting the colorimetric sensor, causing false alarms and repetitive interruptions. As such, many transplant centers in the United States (US) continue to reject these organs. We seek to highlight two cases of successful transplantation following donor administration of hydroxocobalamin (Cyanokit) and present the first documented case of successful perioperative intermittent hemodialysis following transplantation of an allograft exposed to hydroxocobalamin. Furthermore, we emphasize the importance of optimal organ utilization and caution against unnecessary refusal.
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Affiliation(s)
- Ryan J. Hendrix
- University of Massachusetts Medical School, Department of Surgery, Division of Organ Transplantation, USA
| | - Paulo N. Martins
- University of Massachusetts Medical School, Department of Surgery, Division of Organ Transplantation, USA
| | - Jeffrey S. Stoff
- University of Massachusetts Medical School, Department of Medicine, Division of Nephrology, USA
| | - Aaron Ahearn
- University of Massachusetts Medical School, Department of Surgery, Division of Organ Transplantation, USA
| | - Adel Bozorgzadeh
- University of Massachusetts Medical School, Department of Surgery, Division of Organ Transplantation, USA
| | - Babak Movahedi
- University of Massachusetts Medical School, Department of Surgery, Division of Organ Transplantation, USA
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Kiss L, Bocsik A, Walter FR, Ross J, Brown D, Mendenhall BA, Crews SR, Lowry J, Coronado V, Thompson DE, Sipos P, Szabó-Révész P, Deli MA, Petrikovics I. From the Cover: In Vitro and In Vivo Blood-Brain Barrier Penetration Studies with the Novel Cyanide Antidote Candidate Dimethyl Trisulfide in Mice. Toxicol Sci 2018; 160:398-407. [PMID: 28973547 DOI: 10.1093/toxsci/kfx190] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Recent in vitro and in vivo studies highlight the strong potential of dimethyl trisulfide (DMTS) as an antidote for cyanide (CN) intoxication. Due to its high oxygen demand, the brain is one of the main target organs of CN. The blood-brain barrier (BBB) regulates the uptake of molecules into the brain. In the literature, there is no data about the ability of DMTS to penetrate the BBB. Therefore, our aim was to test the in vitro BBB penetration of DMTS and its in vivo pharmacokinetics in blood and brain. The in vitro BBB penetration of DMTS was measured by using a parallel artificial membrane permeability assay (BBB-PAMPA), and a triple BBB co-culture model. The pharmacokinetics was investigated in a mouse model by following the DMTS concentration in blood and brain at regular time intervals following intramuscular administration. DMTS showed high penetrability in both in vitro systems (apparent permeability coefficients: BBB-PAMPA 11.8 × 10-6 cm/s; cell culture 158 × 10-6 cm/s) without causing cell toxicity and leaving the cellular barrier intact. DMTS immediately absorbed into the blood after the intramuscular injection (5 min), and rapidly penetrated the brain of mice (10 min). In addition to the observed passive diffusion in the in vitro studies, the contribution of facilitated and/or active transport to the measured high permeability of DMTS in the pharmacokinetic studies can be hypothesized. Earlier investigations demonstrating the antidotal efficacy of DMTS against CN together with the present results highlight the promise of DMTS as a brain-protective CN antidote.
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Affiliation(s)
- Lóránd Kiss
- Department of Chemistry, Sam Houston State University, Huntsville, Texas 77341
| | - Alexandra Bocsik
- Institute of Biophysics, Biological Research Centre, Hungarian Academy of Sciences, Szeged, Hungary
| | - Fruzsina R Walter
- Institute of Biophysics, Biological Research Centre, Hungarian Academy of Sciences, Szeged, Hungary
| | - James Ross
- Department of Chemistry, Sam Houston State University, Huntsville, Texas 77341
| | - Denise Brown
- Department of Chemistry, Sam Houston State University, Huntsville, Texas 77341
| | - Brooke A Mendenhall
- Department of Chemistry, Sam Houston State University, Huntsville, Texas 77341
| | - Sarah R Crews
- Department of Chemistry, Sam Houston State University, Huntsville, Texas 77341
| | - Jana Lowry
- Department of Chemistry, Sam Houston State University, Huntsville, Texas 77341
| | - Valerie Coronado
- Department of Chemistry, Sam Houston State University, Huntsville, Texas 77341
| | - David E Thompson
- Department of Chemistry, Sam Houston State University, Huntsville, Texas 77341
| | - Peter Sipos
- Department of Pharmaceutical Technology, University of Szeged, Szeged, Hungary
| | | | - Mária A Deli
- Institute of Biophysics, Biological Research Centre, Hungarian Academy of Sciences, Szeged, Hungary
| | - Ilona Petrikovics
- Department of Chemistry, Sam Houston State University, Huntsville, Texas 77341
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Anoxia-Hypoxia in Forensic Neuropsychological Assessment: Cognitive Impact of Pulmonary Injuries, Respiratory Distress, Cerebral Blood Hypoperfusion, and Major Surgeries. PSYCHOLOGICAL INJURY & LAW 2018. [DOI: 10.1007/s12207-018-9319-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Carbon monoxide poisoning in a young, healthy patient: A case study of heart failure recovery after Hyperbaric Oxygenation Treatment. Intensive Crit Care Nurs 2018; 47:85-88. [PMID: 29753599 DOI: 10.1016/j.iccn.2018.04.008] [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] [Received: 02/09/2018] [Revised: 04/10/2018] [Accepted: 04/17/2018] [Indexed: 11/20/2022]
Abstract
The effectiveness of hyperbaric oxygen treatment for acute cardiac diseases is unknown. Similarly, the effectiveness of hyperbaric oxygen treatment for carbon monoxide intoxication is also unknown, particularly for cases in which carboxyhemoglobin (COHb) levels return to normal. Our case study revolved around a healthy twenty-year-old male patient, who suffered from carbon monoxide intoxication. The patient presented to the Emergency Department unconscious. Blood workup revealed significant carbon monoxide intoxication and cardiac injury (COHb = 41%, troponin T = 0.38 ng/dl, ST depression). He was intubated and transferred to a specialist Centre for hyperbaric oxygenation treatment, whilst mechanically ventilated. COHb on arrival (5 hours later) was 4.3%. First echocardiography revealed estimated ejection fraction of 30%, moderate-severe left ventricular dysfunction and global hypokinesis. Patient received 3 rounds of HBOT; each round was 2.4 ATA, 100% O2 and 120 minutes long within the following 24 hours. Afterwards, the patient was successfully extubated. Three days later, a second echocardiography showed remarkable improvement with normal left ventricular size and function. The patient discharged the following day without complaints or the need for long-term medication. Hyperbaric treatment for carbon monoxide intoxication with compromised cardiac function should be considered even when carboxyhaemoglobin levels have returned to normal. This is due to mitochondrial impairment caused by carbon monoxide intoxication that eventually can lead to significant cardiac deterioration.
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Cheung JY, Wang J, Zhang XQ, Song J, Tomar D, Madesh M, Judenherc-Haouzi A, Haouzi P. Methylene blue counteracts cyanide cardiotoxicity: cellular mechanisms. J Appl Physiol (1985) 2018; 124:1164-1176. [PMID: 29420146 PMCID: PMC6050200 DOI: 10.1152/japplphysiol.00967.2017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/09/2018] [Accepted: 02/01/2018] [Indexed: 11/22/2022] Open
Abstract
In adult left ventricular mouse myocytes, exposure to sodium cyanide (NaCN) in the presence of glucose dose-dependently reduced contraction amplitude, with ~80% of maximal inhibitory effect attained at 100 µM. NaCN (100 µM) exposure for 10 min significantly decreased contraction and intracellular Ca2+ concentration ([Ca2+]i) transient amplitudes, systolic but not diastolic [Ca2+]i, and maximal L-type Ca2+ current ( ICa) amplitude, indicating acute alteration of [Ca2+]i homeostasis largely accounted for the observed excitation-contraction abnormalities. In addition, NaCN depolarized resting membrane potential ( Em), reduced action potential (AP) amplitude, prolonged AP duration at 50% (APD50) and 90% repolarization (APD90), and suppressed depolarization-activated K+ currents but had no effect on Na+-Ca2+ exchange current ( INaCa). NaCN did not affect cellular adenosine triphosphate levels but depolarized mitochondrial membrane potential (ΔΨm) and increased superoxide (O2·-) levels. Methylene blue (MB; 20 µg/ml) added 3 min after NaCN restored contraction and [Ca2+]i transient amplitudes, systolic [Ca2+]i, Em, AP amplitude, APD50, APD90, ICa, depolarization-activated K+ currents, ΔΨm, and O2·- levels toward normal. We conclude that MB reversed NaCN-induced cardiotoxicity by preserving intracellular Ca2+ homeostasis and excitation-contraction coupling ( ICa), minimizing risks of arrhythmias ( Em, AP configuration, and depolarization-activated K+ currents), and reducing O2·- levels. NEW & NOTEWORTHY Cyanide poisoning due to industrial exposure, smoke inhalation, and bioterrorism manifests as cardiogenic shock and requires rapidly effective antidote. In the early stage of cyanide exposure, adenosine triphosphate levels are normal but myocyte contractility is reduced, largely due to alterations in Ca2+ homeostasis because of changes in oxidation-reduction environment of ion channels. Methylene blue, a drug approved by the U.S. Food and Drug Administration, ameliorates cyanide toxicity by normalizing oxidation-reduction state and Ca2+ channel function.
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Affiliation(s)
- Joseph Y Cheung
- Center of Translational Medicine, Lewis Katz School of Medicine, Temple University , Philadelphia, Pennsylvania
- Department of Medicine, Lewis Katz School of Medicine, Temple University , Philadelphia, Pennsylvania
| | - JuFang Wang
- Center of Translational Medicine, Lewis Katz School of Medicine, Temple University , Philadelphia, Pennsylvania
| | - Xue-Qian Zhang
- Center of Translational Medicine, Lewis Katz School of Medicine, Temple University , Philadelphia, Pennsylvania
| | - Jianliang Song
- Center of Translational Medicine, Lewis Katz School of Medicine, Temple University , Philadelphia, Pennsylvania
| | - Dhanendra Tomar
- Center of Translational Medicine, Lewis Katz School of Medicine, Temple University , Philadelphia, Pennsylvania
| | - Muniswamy Madesh
- Center of Translational Medicine, Lewis Katz School of Medicine, Temple University , Philadelphia, Pennsylvania
| | - Annick Judenherc-Haouzi
- Heart and Vascular Institute, Pennsylvania State University College of Medicine , Hershey, Pennsylvania
| | - Philippe Haouzi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University College of Medicine , Hershey, Pennsylvania
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Gonzales J, Sabatini S. Cyanide Poisoning: Pathophysiology and Current Approaches to Therapy. Int J Artif Organs 2018. [DOI: 10.1177/039139888901200601] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- J. Gonzales
- Texas Tech University Health Sciences Center Dep. of Internal Medicine, Lubbock, Texas - USA
| | - S. Sabatini
- Texas Tech University Health Sciences Center Dep. of Internal Medicine, Lubbock, Texas - USA
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Foncerrada G, Culnan DM, Capek KD, González-Trejo S, Cambiaso-Daniel J, Woodson LC, Herndon DN, Finnerty CC, Lee JO. Inhalation Injury in the Burned Patient. Ann Plast Surg 2018; 80:S98-S105. [PMID: 29461292 PMCID: PMC5825291 DOI: 10.1097/sap.0000000000001377] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Inhalation injury causes a heterogeneous cascade of insults that increase morbidity and mortality among the burn population. Despite major advancements in burn care for the past several decades, there remains a significant burden of disease attributable to inhalation injury. For this reason, effort has been devoted to finding new therapeutic approaches to improve outcomes for patients who sustain inhalation injuries.The three major injury classes are the following: supraglottic, subglottic, and systemic. Treatment options for these three subtypes differ based on the pathophysiologic changes that each one elicits.Currently, no consensus exists for diagnosis or grading of the injury, and there are large variations in treatment worldwide, ranging from observation and conservative management to advanced therapies with nebulization of different pharmacologic agents.The main pathophysiologic change after a subglottic inhalation injury is an increase in the bronchial blood flow. An induced mucosal hyperemia leads to edema, increases mucus secretion and plasma transudation into the airways, disables the mucociliary escalator, and inactivates hypoxic vasocontriction. Collectively, these insults potentiate airway obstruction with casts formed from epithelial debris, fibrin clots, and inspissated mucus, resulting in impaired ventilation. Prompt bronchoscopic diagnosis and multimodal treatment improve outcomes. Despite the lack of globally accepted standard treatments, data exist to support the use of bronchoscopy and suctioning to remove debris, nebulized heparin for fibrin casts, nebulized N-acetylcysteine for mucus casts, and bronchodilators.Systemic effects of inhalation injury occur both indirectly from hypoxia or hypercapnia resulting from loss of pulmonary function and systemic effects of proinflammatory cytokines, as well as directly from metabolic poisons such as carbon monoxide and cyanide. Both present with nonspecific clinical symptoms including cardiovascular collapse. Carbon monoxide intoxication should be treated with oxygen and cyanide with hydroxocobalamin.Inhalation injury remains a great challenge for clinicians and an area of opportunity for scientists. Management of this concomitant injury lags behind other aspects of burn care. More clinical research is required to improve the outcome of inhalation injury.The goal of this review is to comprehensively summarize the diagnoses, treatment options, and current research.
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Affiliation(s)
- Guillermo Foncerrada
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
- Shriners Hospitals for Children - Galveston, Galveston, Texas, USA
| | - Derek M. Culnan
- JMS Burn and Reconstructive Center at Merit Health Central, Jackson, MS, USA
| | - Karel D. Capek
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
- Shriners Hospitals for Children - Galveston, Galveston, Texas, USA
| | - Sagrario González-Trejo
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
- Shriners Hospitals for Children - Galveston, Galveston, Texas, USA
| | - Janos Cambiaso-Daniel
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
- Shriners Hospitals for Children - Galveston, Galveston, Texas, USA
| | - Lee C. Woodson
- Shriners Hospitals for Children - Galveston, Galveston, Texas, USA
- Department of Anesthesiology, University of Texas Medical Branch Galveston, Texas, USA
| | - David N. Herndon
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
- Shriners Hospitals for Children - Galveston, Galveston, Texas, USA
| | - Celeste C. Finnerty
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
- Shriners Hospitals for Children - Galveston, Galveston, Texas, USA
| | - Jong O. Lee
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
- Shriners Hospitals for Children - Galveston, Galveston, Texas, USA
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DeLeon SM, Downey JD, Hildenberger DM, Rhoomes MO, Booker L, Rockwood GA, Basi KA. DMTS is an effective treatment in both inhalation and injection models for cyanide poisoning using unanesthetized mice. Clin Toxicol (Phila) 2017; 56:332-341. [PMID: 28922956 DOI: 10.1080/15563650.2017.1376749] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
CONTEXT Cyanide (CN) is a metabolic poison, halting ATP synthesis by inhibiting complex IV of the electron transport chain. If exposed at high enough concentrations, humans and most animals can die within minutes. Because time is a crucial factor in survival of CN poisoning, a rapidly bioavailable, nontoxic, easy to administer CN medical countermeasure could improve morbidity/mortality in a mass CN exposure scenario. The most likely route of exposure to CN is via inhalation. OBJECTIVE This study examined the efficacy of a new formulation for dimethyl trisulfide (DMTS), a countermeasure which has shown promise as a treatment for CN poisoning, using both inhalation and injection models of CN exposure. METHODS We developed a model of acute CN inhalation intoxication, using the highly toxic agent system from CH Technologies for nose-only exposure. Both continuous and discontinuous HCN exposure paradigms were implemented. For comparison, we also utilized a potassium cyanide (KCN) injection model. In all experiments, DMTS was administered as a cyanide countermeasure via intramuscular injection in unanesthetized mice. RESULTS We found DMTS administration to be highly protective against both subcutaneous KCN and HCN inhalation toxicity. In the KCN injection model, DMTS afforded protection against 3.73 times the LD50 dose of KCN. In our HCN inhalation exposure model, mice challenged with LC50 HCN doses for the duration of either 10- or 40-minute exposure paradigms demonstrated improved survival in the presence of DMTS treatment (87.5% and 90.0% survival, respectively). Animals in the DMTS treatment groups of both lethal exposure models similarly exhibited improvement in observed toxic signs. CONCLUSION We show that a newly developed formulation of DMTS is efficacious within two lethal CN exposure mouse models (inhalation and injection) and is highly effective by intramuscular injection. Within these HCN studies, we demonstrate efficacy of DMTS in both continuous and discontinuous inhalation exposure models.
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Affiliation(s)
- Susan M DeLeon
- a Medical Toxicology Division, Biochemistry and Physiology Branch , US Army Medical Research Institute of Chemical Defense , Aberdeen Proving Ground , MD , USA
| | - Jason D Downey
- a Medical Toxicology Division, Biochemistry and Physiology Branch , US Army Medical Research Institute of Chemical Defense , Aberdeen Proving Ground , MD , USA
| | - Diane M Hildenberger
- a Medical Toxicology Division, Biochemistry and Physiology Branch , US Army Medical Research Institute of Chemical Defense , Aberdeen Proving Ground , MD , USA
| | - Melissa O Rhoomes
- a Medical Toxicology Division, Biochemistry and Physiology Branch , US Army Medical Research Institute of Chemical Defense , Aberdeen Proving Ground , MD , USA
| | - Lamont Booker
- a Medical Toxicology Division, Biochemistry and Physiology Branch , US Army Medical Research Institute of Chemical Defense , Aberdeen Proving Ground , MD , USA
| | - Gary A Rockwood
- a Medical Toxicology Division, Biochemistry and Physiology Branch , US Army Medical Research Institute of Chemical Defense , Aberdeen Proving Ground , MD , USA
| | - Kelly A Basi
- a Medical Toxicology Division, Biochemistry and Physiology Branch , US Army Medical Research Institute of Chemical Defense , Aberdeen Proving Ground , MD , USA
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33
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De Capitani EM, Borrasca-Fernandes CF, Branco Pimenta M, Prado CC, Soubhia PC, Lanaro R, Mello Moreira S, Linden R, Nóbrega HV, Bucaretchi F, Costa JL. Suicide attempt with acetonitrile ingestion in a nursing mother. Clin Toxicol (Phila) 2017; 55:929-933. [DOI: 10.1080/15563650.2017.1324977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Eduardo Mello De Capitani
- Campinas Poison Control Center, University of Campinas, São Paulo, Brazil
- School of Medicine, University of Campinas, São Paulo, Brazil
| | | | | | | | | | - Rafael Lanaro
- Campinas Poison Control Center, University of Campinas, São Paulo, Brazil
| | | | - Rafael Linden
- Feevale University, Novo Hamburgo, Rio Grande do Sul, Brazil
| | | | - Fábio Bucaretchi
- Campinas Poison Control Center, University of Campinas, São Paulo, Brazil
- School of Medicine, University of Campinas, São Paulo, Brazil
| | - José Luiz Costa
- Campinas Poison Control Center, University of Campinas, São Paulo, Brazil
- Faculty of Pharmaceutical Sciences, University of Campinas, São Paulo, Brazil
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Lavon O, Avrahami A, Eisenkraft A. Effectiveness of isosorbide dinitrate in cyanide poisoning as a function of the administration timing. BMC Pharmacol Toxicol 2017; 18:13. [PMID: 28288687 PMCID: PMC5348846 DOI: 10.1186/s40360-017-0122-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 02/04/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Better and safer antidotes against cyanide poisoning are needed. Prior study has shown a favorable effect of isosorbide dinitrate (ISDN) on the survival of cyanide-poisoned rabbits when administered as early as 1 min after poisoning. The aim of the current study was to further evaluate the efficacy of intravenous ISDN administered in clinically relevant timing for first responders. METHODS A comparative animal study using 24 rabbits in 4 randomized study groups was performed. Animals were poisoned with intravenous potassium cyanide (1 mg/kg). Animals in Group 1 served as controls and received no treatment. Groups 2-4 animals were treated intravenously with ISDN (50 μg/kg) after poisoning; one group after 3 min, another group after 5 min and the last after 7 min. Animals were observed for 30 min after poisoning. The study endpoints included survival rate, clinical status, blood pressure, pulse per minute, blood lactate and pH. RESULTS Five of 6 animals (83.3%) from every treatment group survived the whole observation period while all control untreated animals died. All the rabbits collapsed immediately after exposure, showing rapidly deteriorated vital signs with lactic metabolic acidosis (peak blood lactate levels of 18.1 to 19.0 mmol/L on average at 10 min post exposure). Vital signs, clinical scores, and blood gases of treated rabbits gradually improved. CONCLUSION Poisoned rabbits showed improved short-term survival following the administration of ISDN up to 7 min after lethal cyanide poisoning of. We see a potential for ISDN as an antidote against cyanide poisoning.
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Affiliation(s)
- Ophir Lavon
- Clinical Pharmacology and Toxicology Unit, Carmel Medical Center, 7 Michal St., Haifa, 3436212 Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Amit Avrahami
- Pre Clinical Research Authority, Technion-Israel Institute of Technology, Haifa, Israel
| | - Arik Eisenkraft
- Institute for Research in Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem, Israel
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Park JM, Trevor Sewell B, Benedik MJ. Cyanide bioremediation: the potential of engineered nitrilases. Appl Microbiol Biotechnol 2017; 101:3029-3042. [PMID: 28265723 DOI: 10.1007/s00253-017-8204-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 02/13/2017] [Accepted: 02/15/2017] [Indexed: 11/29/2022]
Abstract
The cyanide-degrading nitrilases are of notable interest for their potential to remediate cyanide contaminated waste streams, especially as generated in the gold mining, pharmaceutical, and electroplating industries. This review provides a brief overview of cyanide remediation in general but with a particular focus on the cyanide-degrading nitrilases. These are of special interest as the hydrolysis reaction does not require secondary substrates or cofactors, making these enzymes particularly good candidates for industrial remediation processes. The genetic approaches that have been used to date for engineering improved enzymes are described; however, recent structural insights provide a promising new approach.
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Affiliation(s)
- Jason M Park
- Department of Biology, Texas A&M University, College Station, TX, 77843-3258, USA
| | - B Trevor Sewell
- Structural Biology Research Unit, Institute for Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, 7925, South Africa
| | - Michael J Benedik
- Department of Biology, Texas A&M University, College Station, TX, 77843-3258, USA.
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Enkhbaatar P, Pruitt BA, Suman O, Mlcak R, Wolf SE, Sakurai H, Herndon DN. Pathophysiology, research challenges, and clinical management of smoke inhalation injury. Lancet 2016; 388:1437-1446. [PMID: 27707500 PMCID: PMC5241273 DOI: 10.1016/s0140-6736(16)31458-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 08/11/2016] [Accepted: 08/16/2016] [Indexed: 01/02/2023]
Abstract
Smoke inhalation injury is a serious medical problem that increases morbidity and mortality after severe burns. However, relatively little attention has been paid to this devastating condition, and the bulk of research is limited to preclinical basic science studies. Moreover, no worldwide consensus criteria exist for its diagnosis, severity grading, and prognosis. Therapeutic approaches are highly variable depending on the country and burn centre or hospital. In this Series paper, we discuss understanding of the pathophysiology of smoke inhalation injury, the best evidence-based treatments, and challenges and future directions in diagnostics and management.
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Affiliation(s)
- Perenlei Enkhbaatar
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA.
| | - Basil A Pruitt
- Department of Surgery, Division of Trauma, University of Texas Health Science Center, San Antonio, TX, USA
| | - Oscar Suman
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospitals for Children, Galveston, TX, USA
| | - Ronald Mlcak
- Shriners Hospitals for Children, Galveston, TX, USA; Department of Respiratory Care, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Steven E Wolf
- Department of Surgery, University of Texas, Southwestern Medical Center, Dallas, TX, USA
| | - Hiroyuki Sakurai
- Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - David N Herndon
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospitals for Children, Galveston, TX, USA
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Case Files from the University of California San Diego Health System Fellowship Coma and Severe Acidosis: Remember to Consider Acetaminophen. J Med Toxicol 2016; 11:368-76. [PMID: 26153488 DOI: 10.1007/s13181-015-0492-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Rockwood GA, Thompson DE, Petrikovics I. Dimethyl trisulfide: A novel cyanide countermeasure. Toxicol Ind Health 2016; 32:2009-2016. [PMID: 26939832 DOI: 10.1177/0748233715622713] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the present studies, the in vitro and in vivo efficacies of a novel cyanide countermeasure, dimethyl trisulfide (DMTS), were evaluated. DMTS is a sulfur-based molecule found in garlic, onion, broccoli, and similar plants. DMTS was studied for effectiveness as a sulfur donor-type cyanide countermeasure. The sulfur donor reactivity of DMTS was determined by measuring the rate of the formation of the cyanide metabolite thiocyanate. In experiments carried out in vitro in the presence of the sulfurtransferase rhodanese (Rh) and at the experimental pH of 7.4, DMTS was observed to convert cyanide to thiocyanate with greater than 40 times higher efficacy than does thiosulfate, the sulfur donor component of the US Food and Drug Administration-approved cyanide countermeasure Nithiodote® In the absence of Rh, DMTS was observed to be almost 80 times more efficient than sodium thiosulfate in vitro The fact that DMTS converts cyanide to thiocyanate more efficiently than does thiosulfate both with and without Rh makes it a promising sulfur donor-type cyanide antidote (scavenger) with reduced enzyme dependence in vitro The therapeutic cyanide antidotal efficacies for DMTS versus sodium thiosulfate were measured following intramuscular administration in a mouse model and expressed as antidotal potency ratios (APR = LD50 of cyanide with antidote/LD50 of cyanide without antidote). A dose of 100 mg/kg sodium thiosulfate given intramuscularly showed only slight therapeutic protection (APR = 1.1), whereas the antidotal protection from DMTS given intramuscularly at the same dose was substantial (APR = 3.3). Based on these data, DMTS will be studied further as a promising next-generation countermeasure for cyanide intoxication.
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Affiliation(s)
- Gary A Rockwood
- Analytical Toxicology Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - David E Thompson
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Ilona Petrikovics
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
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Hsiao PJ, Chang CF, Chiu CC, Chan JS, Chiang WF, Wu CC, Lin SH, Chen JS. High Anion Gap Metabolic Acidosis after a Suicide Attempt with Cyanide: The Rebirth of Cyanide Poisoning. Intern Med 2015; 54:1901-4. [PMID: 26234233 DOI: 10.2169/internalmedicine.54.4272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 33-year-old woman was admitted to our emergency department in a state of unconsciousness after attempting suicide with unknown substances. Severe metabolic acidosis (pH: 6.81), with a high anion gap (36.2) and high lactate level (20.2 mmol/L), was observed. After four hours of intensive medical treatment, the patient regained consciousness, with a return of the arterial pH to 7.42. Finally, cyanide intoxication was diagnosed based on the detection of a serum cyanide level of 3.5 mg/L. The presence of a high anion gap associated with severe lactic acidosis is a clue for making a rapid differential diagnosis of acute cyanide intoxication. Providing intensive and immediate supportive management is also crucial, even in cases without obtainable specific antidotes.
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Affiliation(s)
- Po-Jen Hsiao
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taiwan
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Lavon O. Early administration of isosorbide dinitrate improves survival of cyanide-poisoned rabbits. Clin Toxicol (Phila) 2014; 53:22-7. [PMID: 25519879 DOI: 10.3109/15563650.2014.990564] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT More effective, rapidly delivered, safer antidotes are needed for cyanide poisoning. Previous study has demonstrated a beneficial effect of isosorbide dinitrate on the survival of cyanide-poisoned mice. OBJECTIVE To evaluate the effectiveness of isosorbide dinitrate compared with that of sodium nitrite in cyanide poisoning. MATERIALS AND METHODS A comparative animal study was performed using 18 rabbits, randomized into 3 study groups. Animals were poisoned intravenously with potassium cyanide (1 mg/kg). The first group was not given any further treatment. The second and third groups were treated intravenously 1 min after poisoning with sodium nitrite (6 mg/kg) and isosorbide dinitrate (50 μg/kg), respectively. The primary outcome was short-term survival of up to 30 min. Secondary outcomes included time to death, a clinical score, mean blood pressure, pulse, blood pH, and lactate and methemoglobin levels. RESULTS Rabbits treated with isosorbide dinitrate or sodium nitrite survived while only one untreated rabbit survived. Median time to death of the 5 poisoned and untreated animals was 10 min. All the animals collapsed soon after poisoning, exhibiting rapidly disturbed vital signs and developed lactic metabolic acidosis; average peak blood lactate levels were 15.5-19.1 mmol/L at 10 min after poisoning. The treated animals improved gradually with practically full recovery of the clinical scores, vital signs, and blood gas levels. Sodium nitrite administration raised methemoglobin to an average peak of 7.9%, while isosorbide dinitrate did not change methemoglobin levels. CONCLUSION Early administration of isosorbide dinitrate improved the short-term survival of cyanide-poisoned rabbits. Isosorbide dinitrate shows potential as an antidote for cyanide poisoning and may exert its effect using a nitric-oxide-dependent mechanism.
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Affiliation(s)
- Ophir Lavon
- Clinical Pharmacology and Toxicology Unit, Carmel Medical Center , Haifa , Israel
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Use of Cyanide Antidotes in Burn Patients With Suspected Inhalation Injuries in North America. J Burn Care Res 2014; 35:e112-7. [DOI: 10.1097/bcr.0b013e31829b3868] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Belani KG, Singh H, Beebe DS, George P, Patterson SE, Nagasawa HT, Vince R. Cyanide toxicity in juvenile pigs and its reversal by a new prodrug, sulfanegen sodium. Anesth Analg 2012; 114:956-61. [PMID: 22392971 DOI: 10.1213/ane.0b013e31824c4eb5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Cyanide (CN) toxicity is a serious clinical problem and can occur with sodium nitroprusside (SNP) administration, accidental smoke inhalation, industrial mishaps, and bio-terrorism. In this study, we induced severe CN toxicity independently with SNP or sodium cyanide (NaCN) in a juvenile pig model to demonstrate reversal of severe CN toxicity with a new antidote, sulfanegen sodium, a prodrug of 3-mercaptopyruvate. METHODS SNP study: A pilot study in 11 anesthetized, mechanically ventilated juvenile pigs allowed us to determine the dose of SNP to induce CN toxicity. Blood CN, serum lactates, and blood gases were monitored. CN toxicity was defined as the occurrence of severe lactic acidosis accompanied by significant elevation in blood CN levels. Based on this pilot study, 8 anesthetized pigs received a high-dose i.v. infusion of SNP (100 mg/h) for 2 hours to induce CN toxicity. They were then randomized to receive either sulfanegen sodium or placebo. Four pigs received 3 doses of sulfanegen sodium (2.5 g i.v.) every hour after induction of severe CN toxicity, and 4 pigs received placebo. NaCN study: A pilot study was conducted in 4 spontaneously ventilating pigs sedated with propofol plus ketamine to demonstrate hemodynamic and metabolic stability for several hours. After this, 6 pigs were similarly sedated and given NaCN in bolus aliquots to produce CN toxicity ultimately resulting in death. Hemodynamics and metabolic variables were followed to define peak CN toxicity. In another group of 6 pigs, severe CN toxicity was induced by this method, and at peak toxicity, the animals were given sulfanegen sodium (2.5 g i.v.) followed by a repeat dose 60 minutes later in surviving animals. RESULTS SNP study: The pilot study demonstrated the occurrence of a significant increase in blood CN levels (P < 0.05) accompanied by severe lactic acidemia (P < 0.05) in all pigs receiving a high dose of SNP. Administration of the sulfanegen antidote resulted in progressive significant reduction in blood lactate and CN levels with 100% survival (P < 0.05), whereas the placebo-treated pigs deteriorated and did not survive (P < 0.05). NaCN study: NaCN injection resulted in CN toxicity accompanied by severe lactic acidosis and mortality in all the pigs. Sulfanegen sodium reversed this toxicity and prevented mortality in all the pigs treated with this antidote. CONCLUSIONS CN toxicity can be successfully induced in a juvenile pig model with SNP or NaCN. The prodrug, sulfanegen sodium, is effective in reversing CN toxicity induced by SNP or NaCN.
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Affiliation(s)
- Kumar G Belani
- Department of Anesthesiology, University of Minnesota, Minneapolis, Minnesota 55455, USA.
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Cigolini D, Ricci G, Zannoni M, Codogni R, De Luca M, Perfetti P, Rocca G. Hydroxocobalamin treatment of acute cyanide poisoning from apricot kernels. BMJ Case Rep 2011; 2011:bcr.03.2011.3932. [PMID: 22694886 DOI: 10.1136/bcr.03.2011.3932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Clinical experience with hydroxocobalamin in acute cyanide poisoning via ingestion remains limited. This case concerns a 35-year-old mentally ill woman who consumed more than 20 apricot kernels. Published literature suggests each kernel would have contained cyanide concentrations ranging from 0.122 to 4.09 mg/g (average 2.92 mg/g). On arrival, the woman appeared asymptomatic with a raised pulse rate and slight metabolic acidosis. Forty minutes after admission (approximately 70 min postingestion), the patient experienced headache, nausea and dyspnoea, and was hypotensive, hypoxic and tachypnoeic. Following treatment with amyl nitrite and sodium thiosulphate, her methaemoglobin level was 10%. This prompted the administration of oxygen, which evoked a slight improvement in her vital signs. Hydroxocobalamin was then administered. After 24 h, she was completely asymptomatic with normalised blood pressure and other haemodynamic parameters. This case reinforces the safety and effectiveness of hydroxocobalamin in acute cyanide poisoning by ingestion.
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Affiliation(s)
- Davide Cigolini
- UOS di Tossicologia Clinica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
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Lavon O, Bentur Y. Does amyl nitrite have a role in the management of pre-hospital mass casualty cyanide poisoning? Clin Toxicol (Phila) 2010; 48:477-84. [PMID: 20653465 DOI: 10.3109/15563650.2010.505573] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Amyl nitrite has been recommended as a cyanide antidote for several decades. Its antidotal properties were initially attributed to induction of methemoglobin and later to a nitric oxide mediated hemodynamic effect. The ease of administration and alleged rapid clinical effect would recommend its wide use in the pre-hospital management of mass casualty cyanide poisoning; yet there are concerns regarding the use of amyl nitrite for this indication. OBJECTIVE Review the data on amyl nitrite in cyanide poisoning and evaluate its efficacy and safety in mass casualty cyanide poisoning. METHODS A literature search utilizing PubMed, Toxnet, textbooks in toxicology and pharmacology, and the bibliographies of the articles retrieved identified 17 experimental studies and human reports on the use of amyl nitrite in cyanide poisoning, and 40 additional articles on amyl nitrite's properties and adverse effects. One paper was excluded as it was a conference abstract with limited data. MECHANISMS OF ACTION The antidotal properties of amyl nitrite were attributed initially to induction of methemoglobinemia and later to nitric oxide mediated vasodilation. EFFICACY EXPERIMENTAL STUDIES Animal studies on the use of amyl nitrite in cyanide poisoning are limited, and their results are inconsistent, which makes their extrapolation to humans questionable. EFFICACY HUMAN STUDIES Clinical reports are limited in number and the part played by amyl nitrite relative to the other treatments administered (e.g. life support, sodium nitrite, and sodium thiosulfate) is unclear. ADVERSE EFFECTS Amyl nitrite can be associated with potentially serious adverse reactions such as hypotension, syncope, excessive methemoglobinemia, and hemolysis in G6PD deficient patients. These effects are more pronounced in young children, in the elderly, and in patients with cardiac and pulmonary disorders. Dose regimen. The method of administration of amyl nitrite (breaking pearls into gauze or a handkerchief and applying it intermittently to the victim's nose and mouth for a few minutes) is not easily controlled, might result in under- or over-dosing, can prevent the caregiver from administering life support, and possibly expose him/her to amyl nitrite's adverse effects. CONCLUSIONS Administration of amyl nitrite in mass casualty cyanide poisoning can result in unnecessary morbidity and may interfere with the proper management of the incident and the required supportive treatment and rapid evacuation. In the authors' opinion these drawbacks make the use of amyl nitrite in pre-hospital mass casualty cyanide poisoning unwarranted.
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Affiliation(s)
- Ophir Lavon
- Rambam Health Care Campus, Israel Poison Information Center, Haifa, Israel
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Baskin SI, Rockwood GA. Neurotoxicological and Behavioral Effects of Cyanide and Its Potential Therapies. MILITARY PSYCHOLOGY 2009. [DOI: 10.1207/s15327876mp1402_6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Steven I. Baskin
- Pharmacology Division, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
| | - Gary A. Rockwood
- Drug Assessment Division, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland
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Bhattacharya R, Satpute R, Hariharakrishnan J, Tripathi H, Saxena P. Acute toxicity of some synthetic cyanogens in rats and their response to oral treatment with alpha-ketoglutarate. Food Chem Toxicol 2009; 47:2314-20. [DOI: 10.1016/j.fct.2009.06.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 05/21/2009] [Accepted: 06/10/2009] [Indexed: 11/16/2022]
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Toxic Gas, Fume, and Smoke Inhalation. Crit Care Med 2008. [DOI: 10.1016/b978-032304841-5.50051-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Milazzo S, Lejeune S, Ernst E. Laetrile for cancer: a systematic review of the clinical evidence. Support Care Cancer 2006; 15:583-595. [PMID: 17106659 DOI: 10.1007/s00520-006-0168-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Accepted: 09/20/2006] [Indexed: 11/25/2022]
Abstract
BACKGROUND Many cancer patients treated with conventional therapies also try 'alternative' cancer treatments. Laetrile is one such 'alternative' that is claimed to be effective by many alternative therapists. Laetrile is also sometimes referred to as amygdalin, although the two are not the same. OBJECTIVE The aim of this review is to summarize all types of clinical data related to the effectiveness or safety of laetrile interventions as a treatment of any type of cancer. MATERIALS AND METHODS All types of clinical studies containing original clinical data of laetrile interventions were included. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (from 1951), EMBASE (from 1980), Allied and Complementary Medicine (AMED), Scirus, CancerLit, Cumulative Index to Nursing and Allied Health (CINAHL; all from 1982), CAMbase (from 1998), the MetaRegister, the National Research Register, and our own files. For reports on the safety of laetrile, we also searched the Uppsala database. No language restrictions were imposed. RESULTS Thirty six reports met our inclusion criteria. No controlled clinical trials were found. Three articles were nonconsecutive case series, 2 were consecutive case series, 6 were best case series, and 25 were case reports. None of these publications proved the effectiveness of laetrile. CONCLUSION Therefore, the claim that laetrile has beneficial effects for cancer patients is not supported by sound clinical data.
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Affiliation(s)
- Stefania Milazzo
- Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Institute of Health and Social Care, 25 Victoria Park Road, Exeter, EX2 4NT, UK
| | - Stephane Lejeune
- EORTC Data Centre, Avenue E. Mounier 83, bte 11, 1200, Brussels, Belgium
| | - Edzard Ernst
- Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Institute of Health and Social Care, 25 Victoria Park Road, Exeter, EX2 4NT, UK.
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Lin CC, Wong BK, Burgey CS, Gibson CR, Singh R. In vitro metabolism of a thrombin inhibitor and quantitation of metabolically generated cyanide. J Pharm Biomed Anal 2005; 39:1014-20. [PMID: 16023819 DOI: 10.1016/j.jpba.2005.05.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2005] [Revised: 05/27/2005] [Accepted: 05/27/2005] [Indexed: 10/25/2022]
Abstract
During the metabolic characterization of compound I, 2-{6-cyano-3-[(2,2-difluoro-2-pyridin-2-ylethyl)amino]-2-oxopyrazin-1(2H)-yl]-N-[(3-fluoropyridin-2-yl)methyl]acetamide, evidence was obtained for extensive oxidative bioactivation of the pyrazinone ring system and some of the resulting metabolites were apparently devoid of the cyano moiety. Two assays, a spectrophotometric and a high-pressure liquid chromatography (HPLC) pre-column derivatization method, were evaluated for their ability to detect and quantify cyanide that is metabolically generated from liver microsomal incubations. When I was incubated (45 microM) in the presence of NADPH-fortified human liver microsomes for 2h, 7.5 microM of cyanide was detected using the spectrophotometric assay and 8.9 microM was measured using the HPLC methodology. Overall, the results from the two assays appeared to agree reasonably well with each other. However, the HPLC assay was the preferred method for the evaluation of cyanide formation in vitro due to its sensitivity, reliability, and ease of use.
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Affiliation(s)
- C Charles Lin
- Department of Drug Metabolism, Merck Research Laboratories, Merck and Co. Inc., Merck Research Labs, BLA-33, P.O. Box 4, PA 19486, USA
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