1
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Alruhaimi RS, Ahmeda AF, Hussein OE, Alotaibi MF, Germoush MO, Elgebaly HA, Hassanein EHM, Mahmoud AM. Galangin attenuates chlorpyrifos-induced kidney injury by mitigating oxidative stress and inflammation and upregulating Nrf2 and farnesoid-X-receptor in rats. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2024; 110:104542. [PMID: 39179192 DOI: 10.1016/j.etap.2024.104542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 08/06/2024] [Accepted: 08/20/2024] [Indexed: 08/26/2024]
Abstract
Chlorpyrifos (CPF) is a highly toxic commonly used pesticide and can seriously harm human health. This study assessed the potential of galangin (GAL), an antioxidant flavonoid, to attenuate oxidative stress, inflammation and kidney injury caused by CPF, emphasizing the role of farnesoid-x-receptor (FXR) and Nrf2. Rats were supplemented with CPF and GAL for 28 days. CPF increased serum creatinine, urea and Kim-1, provoked several tissue alterations, and increased kidney ROS, malondialdehyde (MDA), NF-κB p65, TNF-α, iNOS, and caspase-3. GAL effectively ameliorated serum kidney injury markers, ROS, MDA, and TNF-α, suppressed NF-κB p65, iNOS, and caspase-3, and enhanced antioxidants. GAL suppressed Keap1 and upregulated FXR, Nrf2, HO-1 and NQO-1 in CPF-administered rats. GAL exhibited binding affinity with Keap1, FXR, caspase-3, iNOS, HO-1, and NF-κB. In conclusion, GAL is effective in preventing CPF nephrotoxicity by attenuating oxidative stress and inflammation. This protection is linked to upregulation of antioxidants, Nrf2/HO-1 signaling and FXR.
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Affiliation(s)
- Reem S Alruhaimi
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Ahmad F Ahmeda
- Department of Basic Medical Sciences, College of Medicine, Ajman University, Ajman 346, United Arab Emirates; Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
| | - Omnia E Hussein
- Higher Technological Institute for Applied Health Sciences, Beni-Suef, Egypt
| | - Mohammed F Alotaibi
- Physiology Department, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
| | - Mousa O Germoush
- Biology Department, College of Science, Jouf University, Sakakah, Saudi Arabia
| | - Hassan A Elgebaly
- Biology Department, College of Science, Jouf University, Sakakah, Saudi Arabia
| | - Emad H M Hassanein
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Al-Azhar University-Assiut Branch, Egypt
| | - Ayman M Mahmoud
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M1 5GD, UK; Molecular Physiology Division, Zoology Department, Faculty of Science, Beni-Suef University, Beni-Suef 62514, Egypt.
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2
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Kaulgud RS, H B N, Kurjogi MM, S V, Vanti GL. Serum Organophosphorus compound levels as a surrogate marker for severity assessment and management in Acute Organophosphorus Poisoning - A novel approach. J Pharm Biomed Anal 2024; 247:116237. [PMID: 38838441 DOI: 10.1016/j.jpba.2024.116237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/30/2024] [Accepted: 05/17/2024] [Indexed: 06/07/2024]
Abstract
Organophosphorus (OP) compounds are the most extensively used pesticides' class worldwide; cause most self‑poisoning deaths especially in India. Thus, it is utmost important for early identification and aggressive management of OP poisoning from the clinical perspective to prevent serious complications by using sophisticated LC-MS/MS approach. This was a prospective study involving 103 patients of OP cases admitted to Karnataka Institute of Medical Sciences from June 2022 to May 2023, based on the inclusion and exclusion criteria patients were subjected to study. On admission, venous blood was collected from patient with Malathion and Profenofos OP poisoning history and subjected to serum biomarker and to LC-MS/MS analysis. Out of the 103 patients, 68 patients consumed Profenofos (66%) and 35 patients consumed Malathion (34%). Pseudocholinesterase levels among the of OP cases revealed that the 33 patients had mild toxicity, 40 patients had moderate toxicity and 30 patients had severe toxicity of OP poisoning. Subsequently LC-MS/MS analysis showed that the results obtained are not in correlation with indirect serum marker pseudocholinesterase levels. On the other side, LC-MS/MS results are in correlation with the clinical outcome of the patients with respect to morbidity and mortality. Thus, LC-MS/MS approach to assess the OP levels in patients could be used as potential diagnostic and prognostic marker for the absolute quantification of OP compounds compared to indirect OP levels estimation.
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Affiliation(s)
- Ram S Kaulgud
- Multi-Disciplinary Research Unit, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India; Department of Internal Medicine, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India
| | - Nidish H B
- Multi-Disciplinary Research Unit, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India
| | - Mahantesh M Kurjogi
- Multi-Disciplinary Research Unit, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India
| | - Veeresh S
- Multi-Disciplinary Research Unit, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India
| | - Gulamnabi L Vanti
- Multi-Disciplinary Research Unit, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India.
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3
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Alruhaimi RS, Alotaibi MF, Alnasser SM, Alzoghaibi MA, Germoush MO, Alotaibi M, Hassanein EHM, Mahmoud AM. Farnesol prevents chlorpyrifos nephrotoxicity by modulating inflammatory mediators, Nrf2 and FXR and attenuating oxidative stress. Food Chem Toxicol 2024; 190:114788. [PMID: 38849050 DOI: 10.1016/j.fct.2024.114788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/28/2024] [Accepted: 06/03/2024] [Indexed: 06/09/2024]
Abstract
Chlorpyrifos (CPF) is a broad-spectrum insecticide widely employed in agricultural field for pest control. Exposure to CPF is associated with serious effects to the main organs, including kidneys. Significant evidence denotes that oxidative stress (OS) and inflammation are implicated in CPF toxicity. This study aimed to evaluate the potential of farnesol (FAR) to modulate inflammatory mediators and farnesoid-X-receptor (FXR) and Nrf2 in a rat model of CPF nephrotoxicity. CPF and FAR were orally supplemented for 28 days and blood and kidney samples were collected for investigations. CPF administration elevated blood creatinine and urea, kidney MDA and NO, and upregulated NF-κB p65, IL-1β, TNF-α, iNOS, and caspase-3. In addition, CPF upregulated kidney Keap1, and decreased GSH, antioxidant enzymes, and Nrf2, FXR, HO-1 and NQO-1. FAR ameliorated creatinine and urea, prevented histopathological alterations, decreased MDA and NO, and enhanced antioxidants in CPF-administered rats. FAR modulated NF-κB p65, iNOS, TNF-α, IL-1β, caspase-3, Keap1, HO-1, NQO-1, Nrf2 and FXR. In silico investigations revealed the binding affinity of FAR towards Keap1 and FXR, as well as NF-κB, caspase-3, iNOS, and HO-1. In conclusion, FAR prevents CPF-induced kidney injury by attenuating OS, inflammation, and apoptosis, effects associated with modulation of FXR, Nrf2/HO-1 signaling and antioxidants.
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Affiliation(s)
- Reem S Alruhaimi
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Mohammed F Alotaibi
- Physiology Department, College of Medicine, King Saud University, Riyadh, 11461, Saudi Arabia
| | - Sulaiman M Alnasser
- Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Qassim, 51452, Saudi Arabia
| | - Mohammed A Alzoghaibi
- Physiology Department, College of Medicine, King Saud University, Riyadh, 11461, Saudi Arabia
| | - Mousa O Germoush
- Biology Department, College of Science, Jouf University, Sakakah, 72388, Saudi Arabia
| | - Meshal Alotaibi
- Department of Pharmacy Practice, College of Pharmacy, University of Hafr Albatin, Hafar Al Batin, 39524, Saudi Arabia
| | - Emad H M Hassanein
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Al-Azhar University-Assiut Branch, Egypt
| | - Ayman M Mahmoud
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, M1 5GD, UK; Molecular Physiology Division, Department of Zoology, Faculty of Science, Beni-Suef University, Beni-Suef 62514, Egypt.
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4
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Vikhe CS, Yadav V, Brahmane NA. A Comprehensive Physiotherapy Approach to Regain Functional Independence in Intermediate Syndrome Secondary to Organophosphate Poisoning: A Case Report. Cureus 2024; 16:e63929. [PMID: 39105001 PMCID: PMC11299130 DOI: 10.7759/cureus.63929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 07/05/2024] [Indexed: 08/07/2024] Open
Abstract
Organophosphate poisoning (OPP) remains a significant public health issue globally, particularly in middle- and low-income countries. This study aimed to assess the effectiveness of physiotherapy interventions in managing patients with OPP, focusing on reducing the severity of intermediate syndrome symptoms and associated complications such as respiratory muscle weakness and bilateral loculated pleural effusions. A 48-year-old male with a history of alcohol consumption was transferred to the medicine intensive care unit due to poison ingestion. The patient exhibited symptoms of respiratory distress and decreased consciousness, necessitating intubation and mechanical ventilation. Physiotherapy interventions included patient education, secretion mobilization, vital capacity improvement, secondary complication prevention, chest expansion exercises, dyspnea-relieving positions, and mobilization. The patient's progress was monitored using various scales, including the Functional Independence Measure Scale, ICU Mobility Scale, and Chelsea Critical Care Physical Assessment Tool. Significant improvements in functional independence, mobility, and psychological well-being were observed throughout the intervention period. This study highlights the importance of physiotherapy in the comprehensive management of OPP, emphasizing its role in mitigating respiratory complications and improving overall functional outcomes.
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Affiliation(s)
- Chaitali S Vikhe
- Department of Sports Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vaishnavi Yadav
- Department of Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Neha A Brahmane
- Department of Pediatric Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Jaiswal S, Singh B, Dhingra I, Joshi A, Kodgire P. Bioremediation and bioscavenging for elimination of organophosphorus threats: An approach using enzymatic advancements. ENVIRONMENTAL RESEARCH 2024; 252:118888. [PMID: 38599448 DOI: 10.1016/j.envres.2024.118888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/06/2024] [Accepted: 04/05/2024] [Indexed: 04/12/2024]
Abstract
Organophosphorus compounds (OP) are highly toxic pesticides and nerve agents widely used in agriculture and chemical warfare. The extensive use of these chemicals has severe environmental implications, such as contamination of soil, water bodies, and food chains, thus endangering ecosystems and biodiversity. Plants absorb pesticide residues, which then enter the food chain and accumulate in the body fat of both humans and animals. Numerous human cases of OP poisoning have been linked to both acute and long-term exposure to these toxic OP compounds. These compounds inhibit the action of the acetylcholinesterase enzyme (AChE) by phosphorylation, which prevents the breakdown of acetylcholine (ACh) neurotransmitter into choline and acetate. Thus, it becomes vital to cleanse the environment from these chemicals utilizing various physical, chemical, and biological methods. Biological methods encompassing bioremediation using immobilized microbes and enzymes have emerged as environment-friendly and cost-effective approaches for pesticide removal. Cell/enzyme immobilized systems offer higher stability, reusability, and ease of product recovery, making them ideal tools for OP bioremediation. Interestingly, enzymatic bioscavengers (stoichiometric, pseudo-catalytic, and catalytic) play a vital role in detoxifying pesticides from the human body. Catalytic bioscavenging enzymes such as Organophosphate Hydrolase, Organophosphorus acid anhydrolase, and Paraoxonase 1 show high degradation efficiency within the animal body as well as in the environment. Moreover, these enzymes can also be employed to decontaminate pesticides from food, ensuring food safety and thus minimizing human exposure. This review aims to provide insights to potential collaborators in research organizations, government bodies, and industries to bring advancements in the field of bioremediation and bioscavenging technologies for the mitigation of OP-induced health hazards.
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Affiliation(s)
- Surbhi Jaiswal
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology, Indore, Simrol, Khandwa Road, Indore, 453552, India
| | - Brijeshwar Singh
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology, Indore, Simrol, Khandwa Road, Indore, 453552, India
| | - Isha Dhingra
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology, Indore, Simrol, Khandwa Road, Indore, 453552, India
| | - Abhijeet Joshi
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology, Indore, Simrol, Khandwa Road, Indore, 453552, India.
| | - Prashant Kodgire
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology, Indore, Simrol, Khandwa Road, Indore, 453552, India.
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Nelakuditi M, Kumar S, Shaikh SM, Parepalli A, Kumar MJ. A Narrative Review on Magnesium Sulfate as a Game Changer in Reducing ICU Stays in Organophosphate Poisoning Cases. Cureus 2024; 16:e65481. [PMID: 39188488 PMCID: PMC11345587 DOI: 10.7759/cureus.65481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Accepted: 07/26/2024] [Indexed: 08/28/2024] Open
Abstract
Organophosphate (OP) poisoning is a critical public health issue, particularly in agricultural regions where these compounds are extensively used as pesticides. The toxic effects of OP compounds arise from their inhibition of acetylcholinesterase, leading to an accumulation of acetylcholine and a subsequent cholinergic crisis, which can be fatal if not promptly treated. Traditional management of OP poisoning includes the administration of atropine and pralidoxime; however, these treatments often fall short of reducing the high morbidity and mortality associated with severe cases. Recent research has highlighted the potential of magnesium sulfate as an adjunctive treatment for OP poisoning. Magnesium sulfate exerts its beneficial effects through mechanisms such as calcium channel blockade and stabilization of neuromuscular junctions, which help mitigate the cholinergic hyperactivity induced by OP compounds. Clinical studies have shown that magnesium sulfate can significantly reduce the duration of intensive care unit (ICU) stays and improve overall patient outcomes. This narrative review aims to comprehensively analyze current insights into using magnesium sulfate to manage OP poisoning. It discusses the pathophysiology of OP poisoning, the pharmacological action of magnesium sulfate, and the clinical evidence supporting its use. Furthermore, the review will address the safety profile of magnesium sulfate and its potential role in current treatment guidelines. By synthesizing available evidence, this review seeks to establish magnesium sulfate as a game-changer in the management of OP poisoning, ultimately contributing to better clinical practices and patient outcomes.
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Affiliation(s)
- Manikanta Nelakuditi
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sunil Kumar
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Suhail M Shaikh
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Avinash Parepalli
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - M Jayanth Kumar
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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7
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Boggs K, Madhok M, Ahluwalia T. Development and Design of a Pediatric Case-Based Virtual Escape Room on Organophosphate Toxicity. JOURNAL OF EDUCATION & TEACHING IN EMERGENCY MEDICINE 2024; 9:SG36-SG62. [PMID: 39129722 PMCID: PMC11312879 DOI: 10.21980/j8dh1v] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 06/14/2024] [Indexed: 08/13/2024]
Abstract
Audience This case-based virtual escape room (VER) serves as a didactic activity suitable for learners who require an understanding of organophosphate toxicity. Educators may use this VER for distance-based learning in settings with adequate internet access. Introduction India faces a concerning escalation in suicide rates, particularly among teenagers and young adults, often involving intentional pesticide ingestion, notably organophosphates.1-3 Our project addresses organophosphate ingestion by using a VER, a virtual learning platform adapted from in-person escape rooms to engage participants for educational purposes.4,5 Demonstrating success in medical, pharmacy, and nursing education, VERs increased satisfaction and competency among healthcare trainees compared to traditional learning platforms while fostering teamwork and communication in a virtual learning environment.6,7. Educational Objectives By the end of the activity, learners should be able to: 1) recognize risk factors, symptoms, and presentation for organophosphate poisoning; 2) understand the radiologic and laboratory findings in organophosphate poisoning; 3) distinguish and differentiate electrocardiogram findings in common toxic ingestions; 4) explain the pathophysiology of organophosphate poisoning; 5) understand the importance of decontamination of the patient and personal protective equipment for staff for organophosphate poisoning; 6) describe the airway management of organophosphate poisoning; 7) describe the medical management of organophosphate poisoning, including antidotes and the correct dosing and 8) demonstrate teamwork through communication and collaboration. Educational Methods The development process involved a seven-step approach, beginning with topic selection. The process involved creating a scenario, defining learning objectives, and designing an appropriate room. Clues and puzzles were tailored to align with the learning objectives and promote interactivity. The VER was hosted on Google Sites (Google LLC), accompanied by a facilitator guide offering content and technical support. Research Methods This VER leverages technology for distance learning, using Zoom (Zoom Video Communications Inc.) for online sessions with EM trainees. Participants were organized into small groups in breakout rooms on Zoom, following a structured format that included a pre-briefing, a timed escape room scenario, debriefing, and evaluation. Afterward, an evaluation in the format of a survey was distributed to participants. This study was Institutional Review Board exempt. Results Out of 120 participants in the VER, 50% responded to a survey. The majority found the activity interactive, engaging, and exciting. This feedback indicated a positive reaction to the VER, consistent with the Kirkpatrick model's first level of assessment.8 The VER effectively promoted learning and reinforced clinical knowledge, contributing to the second level of the Kirkpatrick model. In this case, 84.7% of respondents were able to identify knowledge gaps, and 84.2% of respondents found this to be a feasible model to reinforce medical knowledge. Discussion This innovative VER addresses the value of distance-based learning in any setting with an internet connection. It has successfully enhanced collaboration and communication among participants in small groups, making it a valuable resource for medical education. This study has several limitations worth noting including a relatively low survey response rate. Baseline data was not collected prior to the VER. Additionally, the VER was not designed to be an open-book assessment; however, the absence of an in-person moderator makes it challenging to ascertain whether participants used external resources. Furthermore, the exclusive focus of this VER on a single topic may diminish its overall use compared to more traditional didactic sessions. This study is also limited by lack of long-term outcome data. Future studies could further assess knowledge improvement and clinical application. The authors plan to develop additional case-based VERs to advance EM trainees' knowledge, skills, and communication. Overall, the VER offers a promising and free educational tool for distance learning with potential benefits for various settings with internet access. Topics Escape room, gamification, global health, organophosphate poisoning, simulation, virtual escape rooms.
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Affiliation(s)
- Kaitlyn Boggs
- Medical University of South Carolina, Department of Emergency Medicine, Charleston, SC
| | - Manu Madhok
- Children’s Minnesota, Department of Emergency Medicine, Minneapolis, MN
| | - Tania Ahluwalia
- Children’s National Hospital, Department of Emergency Medicine, Washington, DC
- George Washington University, Washington, DC
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8
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Azman AA, Muhd Noor ND, Leow ATC, Mohd Noor SA, Mohamad Ali MS. Identification and characterization of a promiscuous metallohydrolase in metallo-β-lactamase superfamily from a locally isolated organophosphate-degrading Bacillus sp. strain S3wahi. Int J Biol Macromol 2024; 271:132395. [PMID: 38761915 DOI: 10.1016/j.ijbiomac.2024.132395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/23/2024] [Accepted: 05/13/2024] [Indexed: 05/20/2024]
Abstract
In this present study, characteristics and structure-function relationship of an organophosphate-degrading enzyme from Bacillus sp. S3wahi were described. S3wahi metallohydrolase, designated as S3wahi-MH (probable metallohydrolase YqjP), featured the conserved αβ/βα metallo-β-lactamase-fold (MBL-fold) domain and a zinc bimetal at its catalytic site. The metal binding site of S3wahi-MH also preserves the H-X-H-X-D-H motif, consisting of specific amino acids at Zn1 (Asp69, His70, Asp182, and His230) and Zn2 (His65, His67, and His137). The multifunctionality of S3wahi-MH was demonstrated through a steady-state kinetic study, revealing its highest binding affinity (KM) and catalytic efficiency (kcat/KM) for OP compound, paraoxon, with values of 8.09 × 10-6 M and 4.94 × 105 M-1 s-1, respectively. Using OP compound, paraoxon, as S3wahi-MH native substrate, S3wahi-MH exhibited remarkable stability over a broad temperature range, 20 °C - 60 °C and a broad pH tolerance, pH 6-10. Corresponded to S3wahi-MH thermal stability characterization, the estimated melting temperature (Tm) was found to be 72.12 °C. S3wahi-MH was also characterized with optimum catalytic activity at 30 °C and pH 8. Additionally, the activity of purified S3wahi-MH was greatly enhanced in the presence of 1 mM and 5 mM of manganese (Mn2+), showing relative activities of 1323.68 % and 2073.68 %, respectively. The activity of S3wahi-MH was also enhanced in the presence of DMSO and DMF, showing relative activities of 270.37 % and 307.41 %, respectively. The purified S3wahi-MH retained >60 % residual activity after exposure to non-ionic Tween series surfactants. Nevertheless, the catalytic activity of S3wahi-MH was severely impacted by the treatment of SDS, even at low concentrations. Considering its enzymatic properties and promiscuity, S3wahi-MH emerges as a promising candidate as a bioremediation tool in wide industrial applications, including agriculture industry.
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Affiliation(s)
- Ameera Aisyah Azman
- Enzyme and Microbial Technology Research Center, Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; Department of Biochemistry, Faculty of Biotechnology and Biomolecular Science, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
| | - Noor Dina Muhd Noor
- Enzyme and Microbial Technology Research Center, Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; Department of Biochemistry, Faculty of Biotechnology and Biomolecular Science, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
| | - Adam Thean Chor Leow
- Enzyme and Microbial Technology Research Center, Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; Department of Cell and Molecular Biology, Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
| | - Siti Aminah Mohd Noor
- Center for Defence Foundation Studies, National Defence University of Malaysia, Kem Perdana Sungai Besi, Kuala Lumpur 57000, Malaysia
| | - Mohd Shukuri Mohamad Ali
- Enzyme and Microbial Technology Research Center, Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia; Department of Biochemistry, Faculty of Biotechnology and Biomolecular Science, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia.
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9
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Goulay R, Fémy F, Nervo A, Valentino S, Madi M, Joly AL, Servonnet A, Nachon F, Reymond C, Jaffré N. Baseline physiological data from anesthetized pigs in a VX intoxication model. Toxicol Lett 2024; 397:117-128. [PMID: 38768837 DOI: 10.1016/j.toxlet.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 05/10/2024] [Accepted: 05/17/2024] [Indexed: 05/22/2024]
Abstract
Over the past fifty years, swine models have been used for organophosphorus intoxication studies. Among these studies and others on the swine model in general, some physiological data, especially cholinesterase activity highly impacted by organophosphorus compounds like nerve agent VX, still need to be completed. To support and compare our model to others, we have published the experimental protocol, the physiological values of 31 juvenile anesthetized pigs, and the 6 h-follow-up of six supplementary anesthetized control animals and 7 VX-intoxicated pigs. We reported hemodynamics and respiratory parameters, blood levels in several biochemical parameters, blood gas, and complete blood count and compared them to the literature. We also focused on tissue and blood cholinesterase activities and detailed them for acetylcholinesterase and butyrylcholinesterase. After establishing a broad physiological data set consistent with the literature, we reported several cardio-respiratory parameters that seem more affected by an organophosphate intoxication, like heart rate, arterial blood pressure, cardiac output, and respiratory rate. Within the blood, oxygen saturation (SpO2), lactatemia, base excess, and glycemia can also be measured and associated with the other parameters to evaluate the life-threatening status. This swine model is currently used to develop and evaluate medical countermeasures against organophosphate nerve agent intoxications.
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Affiliation(s)
- R Goulay
- Department of Toxicology and Chemical Risks, French Armed Forces Biomedical Research Institute, Brétigny Sur Orge, France
| | - F Fémy
- Department of Toxicology and Chemical Risks, French Armed Forces Biomedical Research Institute, Brétigny Sur Orge, France; Departments of Emergency, Georges Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, France
| | - A Nervo
- Department of Toxicology and Chemical Risks, French Armed Forces Biomedical Research Institute, Brétigny Sur Orge, France
| | - S Valentino
- Department of Toxicology and Chemical Risks, French Armed Forces Biomedical Research Institute, Brétigny Sur Orge, France
| | - M Madi
- Department of Toxicology and Chemical Risks, French Armed Forces Biomedical Research Institute, Brétigny Sur Orge, France
| | - A-L Joly
- Department of Toxicology and Chemical Risks, French Armed Forces Biomedical Research Institute, Brétigny Sur Orge, France
| | - A Servonnet
- Department of Toxicology and Chemical Risks, French Armed Forces Biomedical Research Institute, Brétigny Sur Orge, France
| | - F Nachon
- Department of Toxicology and Chemical Risks, French Armed Forces Biomedical Research Institute, Brétigny Sur Orge, France
| | - C Reymond
- Department of Toxicology and Chemical Risks, French Armed Forces Biomedical Research Institute, Brétigny Sur Orge, France
| | - N Jaffré
- Department of Toxicology and Chemical Risks, French Armed Forces Biomedical Research Institute, Brétigny Sur Orge, France.
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10
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Cornelissen AS, van den Berg RM, Langenberg JP, van Grol M, Bross R, Pittman J, Cochrane L, Savransky V. Effective skin decontamination with RSDL® (reactive skin decontamination lotion kit) following dermal exposure to a Novichok class nerve agent. Chem Biol Interact 2024; 395:111001. [PMID: 38641146 DOI: 10.1016/j.cbi.2024.111001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/30/2024] [Accepted: 04/07/2024] [Indexed: 04/21/2024]
Abstract
In recent years, various poisoning incidents have been reported, involving the alleged use of the so-called Novichok agents, resulting in their addition to the Schedule I list of the Organisation for the Prohibition of Chemical Warfare (OPCW). As the physicochemical properties of these agents are different from the 'classical' nerve agents, such as VX, research is needed to evaluate whether and to what extent existing countermeasures are effective. Here, we evaluated the therapeutic potential of RSDL® (Reactive Skin Decontamination Lotion Kit) for the neutralization of percutaneous toxicity caused by Novichok agents, both in vitro and in vivo. Experiments showed the three selected Novichok agents (A230, A232, A234) could be degraded by RSDL lotion, but at a different rate. The half-life of A234, in the presence of an excess of RSDL lotion, was 36 min, as compared to A230 (<5 min) and A232 (18 min). Following dermal exposure of guinea pigs to A234, application of the RSDL kit was highly effective in preventing intoxication, even when applied up until 30 min following exposure. Delayed use of the RSDL kit until the appearance of clinical signs of intoxication (3-4 h) was not able to prevent intoxication progression and deaths. This study determines RSDL decontamination as an effective treatment strategy for dermal exposure to the Novichok agent A234 and underscores the importance of early, forward use of skin decontamination, as rapidly as possible.
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Affiliation(s)
- Alex S Cornelissen
- TNO Defence, Safety and Security, CBRN Protection, Rijswijk, the Netherlands
| | | | - Jan P Langenberg
- TNO Defence, Safety and Security, CBRN Protection, Rijswijk, the Netherlands
| | - Marco van Grol
- TNO Defence, Safety and Security, CBRN Protection, Rijswijk, the Netherlands
| | - Rowdy Bross
- TNO Defence, Safety and Security, CBRN Protection, Rijswijk, the Netherlands
| | - John Pittman
- Emergent BioSolutions Inc., Gaithersburg, MD, USA
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11
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Gupta T, Ratandeep, Dutt M, Kaur B, Punia S, Sharma S, Sahu PK, Pooja, Saya L. Graphene-based nanomaterials as potential candidates for environmental mitigation of pesticides. Talanta 2024; 272:125748. [PMID: 38364558 DOI: 10.1016/j.talanta.2024.125748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/30/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
Over the years, bioaccumulation of hazardous chemicals in the food chain has become a critical issue, resulting in numerous health risks. Environmental mitigation aims to clean up contaminated sites and eliminate hazardous materials from the air, water, or soil to restore the site to its original and safe condition. Pesticides constitute one of the most dangerous environmental pollutants which are generally used to increase crop production. Addressing the removal or treatment of pesticides has become pivotal in mitigating environmental threats. Diverse remediation methods are employed to protect the environment and public health. Graphene-based materials have emerged as promising candidates with exceptional properties, including excellent adsorption capacity due to their high surface area, strong hydrophilicity, and tunable properties. Owing to these properties, they have been attracting major research attention in the field of design and fabrication of materials for the mitigation of pesticides from the environment such as from contaminated food, water and other samples. Various physical, chemical and biological extraction techniques are adopted to remove pesticides. This review article provides an insight into the potential role of graphene-based materials in the environmental remediation of pesticides. We have focused on the removal of Organophosphates, Organochlorines, Carbamates and Pyrethroids present in water, fruit, vegetable and other samples, highlighting the urgent need for environmental remediation. While graphene-based materials hold potential for pesticide remediation, addressing challenges in scalable production, assessing long-term sustainability, and mitigating potential environmental impacts are critical steps for successful large-scale applications.
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Affiliation(s)
- Tarisha Gupta
- Department of Chemistry, IIT Gandhinagar, Palaj, Gandhinagar, 382355, Gujarat, India
| | - Ratandeep
- Department of Chemistry, University of Delhi, Delhi, 110007, India
| | - Madhav Dutt
- Department of Chemistry, Sri Venkateswara College (University of Delhi), Dhaula Kuan, New Delhi, 110021, India
| | - Bikaramjeet Kaur
- Department of Chemistry, Sri Venkateswara College (University of Delhi), Dhaula Kuan, New Delhi, 110021, India
| | - Srishti Punia
- Department of Chemistry, Sri Venkateswara College (University of Delhi), Dhaula Kuan, New Delhi, 110021, India
| | - Suhani Sharma
- Department of Chemistry, Sri Venkateswara College (University of Delhi), Dhaula Kuan, New Delhi, 110021, India
| | - Prasanta Kumar Sahu
- Department of Chemistry, Shivaji College, (University of Delhi), Raja Garden, New Delhi, 110027, India
| | - Pooja
- Department of Chemistry, Sri Venkateswara College (University of Delhi), Dhaula Kuan, New Delhi, 110021, India.
| | - Laishram Saya
- Department of Chemistry, Sri Venkateswara College (University of Delhi), Dhaula Kuan, New Delhi, 110021, India.
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12
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Hirayama I, Kamijo Y, Nonaka M, Yano T, Ishii M, Tominaga Y. Sublingual administration of atropine eye drops for treating organophosphorus poisoning. Clin Case Rep 2024; 12:e8762. [PMID: 38681030 PMCID: PMC11052684 DOI: 10.1002/ccr3.8762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/08/2024] [Accepted: 03/16/2024] [Indexed: 05/01/2024] Open
Abstract
An 89-year-old patient with fenitrothion toxicity received sublingual atropine eye drops, reducing the intravenous atropine requirement. This alternative method enabled rapid rehabilitation, and he walked unaided, leading to discharge.
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Affiliation(s)
- Ichiro Hirayama
- Department of Clinical Toxicology, Faculty of MedicineSaitama Medical UniversitySaitamaJapan
- Department of Emergency MedicineNational Hospital Organization Saitama HospitalSaitamaJapan
| | - Yoshito Kamijo
- Department of Clinical Toxicology, Faculty of MedicineSaitama Medical UniversitySaitamaJapan
| | - Minaho Nonaka
- Department of Emergency MedicineNational Hospital Organization Saitama HospitalSaitamaJapan
| | - Tetsuhiro Yano
- Department of Emergency MedicineNational Hospital Organization Saitama HospitalSaitamaJapan
| | - Mitsuru Ishii
- Department of Emergency MedicineNational Hospital Organization Saitama HospitalSaitamaJapan
| | - Yoshiteru Tominaga
- Department of Emergency MedicineNational Hospital Organization Saitama HospitalSaitamaJapan
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13
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Pradeep U, Chiwhane A, Acharya S, Kumar S, Daiya V, Kasat PR, Gupta A, Bedi GN. The Role of Neutrophil-to-Lymphocyte Ratio in Predicting Outcomes of Acute Organophosphorus Poisoning: A Comprehensive Review. Cureus 2024; 16:e60854. [PMID: 38910647 PMCID: PMC11191379 DOI: 10.7759/cureus.60854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
Organophosphorus poisoning (OPP) poses a significant threat to human health, necessitating accurate prognostic markers for timely intervention and improved outcomes. This review evaluates the potential of the neutrophil-to-lymphocyte ratio (NLR) as a prognostic indicator in acute organophosphorus poisoning (AOPP). A comprehensive analysis of existing literature reveals that elevated NLR values correlate with increased severity of poisoning and adverse clinical outcomes, including mortality and morbidity. NLR assessment offers valuable prognostic information beyond traditional markers, aiding risk stratification and guiding clinical decision-making. Integration of NLR into clinical practice holds promise for optimizing patient care through the early identification of high-risk individuals and tailored therapeutic interventions. Further research is needed to validate the utility of NLR in larger patient cohorts and standardize its incorporation into clinical guidelines. Leveraging NLR as a prognostic tool can enhance risk stratification, optimize treatment strategies, and ultimately improve outcomes in AOPP.
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Affiliation(s)
- Utkarsh Pradeep
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anjalee Chiwhane
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sourya Acharya
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sunil Kumar
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Varun Daiya
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Paschyanti R Kasat
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aman Gupta
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Gautam N Bedi
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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14
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Tomioka T, Shimoyama K, Tanino Y, Hirayama M, Homma H. Utility of Automated Infrared Pupillometry in Assessing the Prolonged Course of Organophosphate Poisoning: A Case Report. Cureus 2024; 16:e58872. [PMID: 38800312 PMCID: PMC11116839 DOI: 10.7759/cureus.58872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
Central and autonomic nervous system signs of organophosphate poisoning (OP), such as altered consciousness, noticeable lacrimation, and salivation, can be influenced by medications used in intensive care settings, such as atropine and pralidoxime methyl (PAM). Because of this, there are no established methods for assessing the duration of OP while receiving antidotal treatment. In the present case, we used the Neurological Pupil Index (NPi) to evaluate the duration of OP in an 82-year-old woman who attempted suicide by ingesting up to 100 mL of fenitrothion. Until hospitalization day (HD) 20, discontinuation of atropine led to the recurrence of altered consciousness, while its reinstatement resulted in improvement; this made it difficult to assess the prolongation of OP based on signs and symptoms. Until HD 20, the NPi remained at 0/0, and subsequently, it increased. Additionally, even after discontinuing atropine, consciousness, tearing, and salivation did not worsen, indicating recovery from OP. On HD 26, serum acetylcholinesterase (AChE) levels were elevated above the measurable level for the first time, following an increase in the NPi. In this case, assessing the persistence of OP based on signs was challenging because these signs improved with atropine and PAM treatment. The improvement in NPi levels coincided with an improvement in poisoning, suggesting that NPi is useful for evaluating the duration of OP. NPi is noninvasive and sensitive compared to AChE, which is used to gauge the persistence of OP and could be used to allow earlier cessation of medication and guide appropriate treatment durations.
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Affiliation(s)
- Takuya Tomioka
- Department of Emergency and Critical Care Medicine, Tokyo Medical University, Tokyo, JPN
| | - Keiichiro Shimoyama
- Department of Emergency and Critical Care Medicine, Tokyo Medical University, Tokyo, JPN
| | - Yusuke Tanino
- Department of Emergency and Critical Care Medicine, Tokyo Medical University, Tokyo, JPN
| | - Masaru Hirayama
- Department of Emergency and Critical Care Medicine, Tokyo Medical University, Tokyo, JPN
| | - Hiroshi Homma
- Department of Emergency and Critical Care Medicine, Tokyo Medical University, Tokyo, JPN
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15
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Pan S, Bruun DA, Lein PJ, Chen CY. Cardiovascular responses of adult male Sprague-Dawley rats following acute organophosphate intoxication and post-exposure treatment with midazolam with or without allopregnanolone. Arch Toxicol 2024; 98:1177-1189. [PMID: 38305864 PMCID: PMC10944447 DOI: 10.1007/s00204-023-03679-x] [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: 09/11/2023] [Accepted: 12/20/2023] [Indexed: 02/03/2024]
Abstract
Recent experimental evidence suggests combined treatment with midazolam and allopregnanolone is more effective than midazolam alone in terminating seizures triggered by acute organophosphate (OP) intoxication. However, there are concerns that combined midazolam and allopregnanolone increases risk of adverse cardiovascular events. To address this, we used telemetry devices to record cardiovascular responses in adult male Sprague-Dawley rats acutely intoxicated with diisopropylfluorophosphate (DFP). Animals were administered DFP (4 mg/kg, sc), followed immediately by atropine (2 mg/kg, i.m.) and 2-PAM (25 mg/kg, i.m.). At 40 min post-exposure, a subset of animals received midazolam (0.65 mg/kg, im); at 50 min, these rats received a second dose of midazolam or allopregnanolone (12 mg/kg, im). DFP significantly increased blood pressure by ~ 80 mmHg and pulse pressure by ~ 34 mmHg that peaked within 12 min. DFP also increased core temperature by ~ 3.5 °C and heart rate by ~ 250 bpm that peaked at ~ 2 h. Heart rate variability (HRV), an index of autonomic function, was reduced by ~ 80%. All acute (within 15 min of exposure) and two-thirds of delayed (hours after exposure) mortalities were associated with non-ventricular cardiac events within 10 min of cardiovascular collapse, suggesting that non-ventricular events should be closely monitored in OP-poisoned patients. Compared to rats that survived DFP intoxication without treatment, midazolam significantly improved recovery of cardiovascular parameters and HRV, an effect enhanced by allopregnanolone. These data demonstrate that midazolam improved recovery of cardiovascular and autonomic function and that the combination of midazolam and allopregnanolone may be a better therapeutic strategy than midazolam alone.
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Affiliation(s)
- Shiyue Pan
- Department of Pharmacology, Davis, School of Medicine, University of California, Davis, CA, USA
| | - Donald A Bruun
- Department of Molecular Biosciences, Davis, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Pamela J Lein
- Department of Molecular Biosciences, Davis, School of Veterinary Medicine, University of California, Davis, CA, USA
- Davis, School of Medicine, MIND Institute, University of California, Sacramento, CA, USA
| | - Chao-Yin Chen
- Department of Pharmacology, Davis, School of Medicine, University of California, Davis, CA, USA.
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16
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Sezigen S, Kaya SI, Bakirhan NK, Ozkan SA. Development of a molecularly imprinted polymer-based electrochemical sensor for the selective detection of nerve agent VX metabolite ethyl methylphosphonic acid in human plasma and urine samples. Anal Bioanal Chem 2024; 416:1505-1515. [PMID: 38267586 PMCID: PMC10861733 DOI: 10.1007/s00216-024-05155-6] [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: 11/06/2023] [Revised: 12/29/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024]
Abstract
This study focuses on the detection of ethyl methyl phosphonic acid (EMPA), a metabolite of the banned organophosphorus nerve agent VX. We developed an electrochemical sensor utilizing the molecularly imprinted polymer (MIP) based on 4-aminobenzoic acid (4-ABA) and tetraethyl orthosilicate for the selective detection of EMPA in human plasma and urine samples. The 4-ABA@EMPA/MIP/GCE sensor was constructed by a thermal polymerization process on a glassy carbon electrode and sensor characterization was performed by cyclic voltammetry and electrochemical impedance spectroscopy. The 4-ABA@EMPA/MIP/GCE sensor demonstrated impressive linear ranges 1.0 × 10-10 M-2.5 × 10-9 M for the standard solution, 1.0 × 10-10 M-2.5 × 10-9 M for the urine sample, and 1.0 × 10-10 M-1 × 10-9 M of EMPA for the plasma sample with outstanding detection limits of 2.75 × 10-11 M (standard solution), 2.11 × 10-11 M (urine), and 2.36 × 10-11 M (plasma). The sensor exhibited excellent recovery percentages ranging from 99.86 to 101.30% in urine samples and 100.62 to 101.08% in plasma samples. These findings underscore the effectiveness of the 4-ABA@EMPA/MIP/GCE as a straightforward, highly sensitive, and selective interface capable of detecting the target analyte EMPA in human plasma and urine samples.
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Affiliation(s)
- Sermet Sezigen
- Department of Medical CBRN Defense, University of Health Sciences, Ankara, Türkiye.
| | - S Irem Kaya
- Department of Analytical Chemistry, Gulhane Faculty of Pharmacy, University of Health Sciences, Ankara, Türkiye
| | - Nurgul K Bakirhan
- Department of Analytical Chemistry, Gulhane Faculty of Pharmacy, University of Health Sciences, Ankara, Türkiye
| | - Sibel A Ozkan
- Department of Analytical Chemistry, Faculty of Pharmacy, Ankara University, Ankara, Türkiye
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17
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Xia JD, Wang H, Hua LW, Xu M, Zheng X, Zhang K. Comparative analysis of organophosphorus versus carbamate pesticide poisoning: a case study. Arh Hig Rada Toksikol 2024; 75:81-84. [PMID: 38548379 PMCID: PMC10978098 DOI: 10.2478/aiht-2024-75-3781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/01/2023] [Accepted: 02/01/2024] [Indexed: 04/01/2024] Open
Abstract
Organophosphorus poisoning is a critical condition that can cause central nervous system depression, respiratory failure, and death early on. As its clinical manifestations closely resemble those of carbamate pesticide poisoning, the aim of this case study is to present a case of misdiagnosis, initially identifying carbofuran poisoning as organophosphate in a patient suspect of a heatstroke. We also present a case of intentional self-poisoning with organophosphate dichlorvos to underline the likelihood of pesticide poisoning in patients exhibiting acute cholinergic symptoms when the ingested substance is not known. In such cases, empirical treatment with atropine and oxime can be started pending timely differential diagnosis to adjust treatment as necessary.
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Affiliation(s)
- Jia-ding Xia
- Affiliated Hospital of Chengde Medical University, Intensive Care Unit, Chengde, China
| | - Hui Wang
- Affiliated Hospital of Chengde Medical University, Intensive Care Unit, Chengde, China
| | - Li-wei Hua
- Affiliated Hospital of Chengde Medical University, Intensive Care Unit, Chengde, China
| | - Min Xu
- Affiliated Hospital of Chengde Medical University, Intensive Care Unit, Chengde, China
| | - Xin Zheng
- Affiliated Hospital of Chengde Medical University, Intensive Care Unit, Chengde, China
| | - Kun Zhang
- Affiliated Hospital of Chengde Medical University, Intensive Care Unit, Chengde, China
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18
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Suwannachat J, Saenchoopa A, Tun WST, Patramanon R, Daduang S, Daduang J, Kulchat S. An electrochemical AChE-based biosensor for organophosphate pesticides using a modified CuNWs/rGO nanocomposite on a screen-printed carbon electrode. Food Chem 2024; 434:137431. [PMID: 37738810 DOI: 10.1016/j.foodchem.2023.137431] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/24/2023] [Accepted: 09/06/2023] [Indexed: 09/24/2023]
Abstract
An enzymatic electrochemical biosensor was built for the indirect detection of organophosphates (OPs), based on acetylcholinesterase inhibition. The biosensor was fabricated for enhanced performance on a screen-printed carbon electrode (SPCE), modified with copper nanowires (CuNWs) composited with reduced graphene oxide (rGO). The oxidation current was measured using the cyclic voltammogram (CV) method, as generated by the enzymatic interaction between acetylcholinesterase (AChE) and its substrate, acetylthiocholine (ATCh). The biosensing response is the reduction in signal caused by the inhibition of acetylcholinesterase in the presence of an organophosphate inhibitor. Benchmarking shows that the CuNWs/rGO nanocomposite enhanced the signal current considerably and decreased the oxidation potential for electrochemical detection of the OP chlorpyrifos, exhibiting a wide linear detection rangefrom 10 µg/L-200 µg/L, with a limit of detection of 3.1 µg/L and limit of quantification of 12.5 µg/L. This sensor is useful for the analysis of chlorpyrifosin drinking water and orange juice, with high recovery rates and no interference effects.
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Affiliation(s)
- Jakkrit Suwannachat
- Materials Chemistry Research Center, Department of Chemistry and Center of Excellence for Innovation in Chemistry, Faculty of Science, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Apichart Saenchoopa
- Materials Chemistry Research Center, Department of Chemistry and Center of Excellence for Innovation in Chemistry, Faculty of Science, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Wonn Shweyi Thet Tun
- Department of Biochemistry, Faculty of Science, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Rina Patramanon
- Department of Biochemistry, Faculty of Science, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Sakda Daduang
- Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Jureerat Daduang
- Department of Clinical Chemistry, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Sirinan Kulchat
- Materials Chemistry Research Center, Department of Chemistry and Center of Excellence for Innovation in Chemistry, Faculty of Science, Khon Kaen University, Khon Kaen 40002, Thailand.
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19
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Patel A, Chavan G, Nagpal AK. Navigating the Neurological Abyss: A Comprehensive Review of Organophosphate Poisoning Complications. Cureus 2024; 16:e54422. [PMID: 38510851 PMCID: PMC10951431 DOI: 10.7759/cureus.54422] [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: 11/29/2023] [Accepted: 02/18/2024] [Indexed: 03/22/2024] Open
Abstract
Organophosphate poisoning is a significant global health concern with implications for both occupational and environmental settings. This comprehensive review thoroughly explores the biochemical basis, clinical presentation, diagnostic methods, treatment strategies, and long-term effects of organophosphate exposure. The acute phase is characterized by cholinergic crisis, respiratory distress, and neurological manifestations, while delayed complications include the intermediate syndrome and organophosphate-induced delayed neuropathy. Diagnostic approaches involve clinical evaluation, cholinesterase-level assessments, and imaging studies. Treatment strategies encompass decontamination, antidotes such as atropine and pralidoxime, and supportive care. Long-term effects may include cognitive and neurological sequelae, necessitating rehabilitation approaches such as physical and occupational therapy. Prevention strategies include stringent occupational safety guidelines, sustainable agricultural practices, and public awareness initiatives. The implications for clinical practice underscore the importance of a multidisciplinary approach. At the same time, the call to action emphasizes the need for collaborative efforts in prevention and awareness to mitigate the impact of organophosphate poisoning on public health and the environment.
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Affiliation(s)
- Aniket Patel
- Emergency Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Gajanan Chavan
- Emergency Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Anmol K Nagpal
- Emergency Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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20
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Jha A, Hazra D, Yadav B, Zachariah A, Alex R. Prognostication and Prediction of Outcomes in Patients with Organophosphorus and Carbamate Poisoning: A Prospective Cohort Study. Indian J Crit Care Med 2024; 28:141-147. [PMID: 38323266 PMCID: PMC10839923 DOI: 10.5005/jp-journals-10071-24617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/18/2023] [Indexed: 02/08/2024] Open
Abstract
Background Organophosphorus (OP) and carbamate poisoning are significant concerns in developing nations. This study evaluates the effectiveness of the ChE check mobile, a cholinesterase-rapid bedside diagnostic test, in the diagnosis and management of OP and carbamate poisoning. Materials and methods We conducted this prospective observational study, involving patients with OP and carbamate poisoning over 1 year (June 2016 to June 2017) at a single tertiary care center. Levels of RBC cholinesterase (E-AChE), butyl cholinesterase (BChE), and various other determinants were systematically coded and analyzed. Results The study population (n = 60) consisted primarily of males (n = 43; 71.7%), with a mean age of 30.6 (SD: 13.7) years. Monocrotophos (n = 10; 20.4%) and carbofuran (n = 4; 8.1%) were the commonest OP and carbamate compounds, respectively. The median initial atropinization dose was 10 (IQR: 0, 61.5) mg, with a median total administered atropine dose of 116 (IQR: 32, 320) mg. A significant negative correlation was found between E-AChE levels and both the initial atropinization dose (ρ: -0.653, p-value < 0.001) and total atropine requirement (ρ: -0.659, p-value < 0.001) during admission. An E-AChE cut-off of 4 units/g hemoglobin provided an area under the curve of 0.73 (sensitivity: 80.0%, specificity: 68.6%, p-value < 0.001) for predicting moderate to severe peradeniya organophosphorus poisoning. Conclusion The check mobile device can be a valuable tool for prognosticating patients. There was a significant correlation between low E-AChE levels and the atropine requirement and severity. How to cite this article Jha A, Hazra D, Yadav B, Zachariah A, Alex R. Prognostication and Prediction of Outcomes in Patients with Organophosphorus and Carbamate Poisoning: A Prospective Cohort Study. Indian J Crit Care Med 2024;28(2):141-147.
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Affiliation(s)
- Avanish Jha
- Department of General Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Darpanarayan Hazra
- Department of Emergency Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Bijesh Yadav
- Department of Biostatistics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Anand Zachariah
- Department of General Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Reginald Alex
- Department of Emergency Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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21
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Abdel-Karim RI, Hashish RK, Badran DI, Mohammed SS, Salem NA. The ameliorative effect of cerium oxide nanoparticles on chlorpyrifos induced hepatotoxicity in a rat model: Biochemical, molecular and immunohistochemical study. J Trace Elem Med Biol 2024; 81:127346. [PMID: 38000167 DOI: 10.1016/j.jtemb.2023.127346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Chlorpyrifos (CPF) is a widely used insecticide that causes toxicity to living organisms through the production of free radicals. Cerium oxide nanoparticles (CeO2NPs) are a new antioxidant agent that has proved therapeutic effects. We evaluated the effect of CeO2NPs on CPF hepatotoxicity. METHODS Forty rats were randomized into four groups. Group I: rats received 1 ml corn oil by gastric tube once daily and 0.5 ml PBS by intra-peritoneal injection twice a week for 4 weeks. Group II: received CeO2NPs 0.5 mg/kg in PBS by i.p. injection, twice weekly for four weeks. Group III: were treated with oral administration of CPF 13.5 mg/kg in corn oil daily for 4 weeks. Group IV: received CPF as in group III, then each animal received CeO2NPs twice weekly for four weeks as in group II. Twenty-four hours after the last dose, rats were anesthetized and sera were collected for liver enzymes assessment. Afterwards, rats were sacrificed, livers were excised, the right lobe of each liver was fixed for immunohistochemical studies, and the left lobe was homogenized for oxidative profile assessment and molecular analysis. RESULTS CPF group showed significant increase in liver transaminases, disturbance of the oxidative profile with up-regulation of BAX expression and down-regulation in the Bcl-2, Gadd45 and NFE2L2. CPF caused severe histopathological liver damage as well as significant increase in anti-Caspase 3 and TNF immunostaining. The CeO2NPs treated group revealed significant improvement of all previous parameters. CONCLUSION CeO2NPs could alleviate CPF hepatoxicity through decreasing expression of the inflammatory and apoptotic proteins and increasing the activity of antioxidant enzymes.
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Affiliation(s)
- Rehab I Abdel-Karim
- Forensic Medicine and Clinical Toxicology department, Faculty of Medicine, Suez Canal University, Egypt
| | - Rania K Hashish
- Forensic Medicine and Clinical Toxicology department, Faculty of Medicine, Suez Canal University, Egypt
| | - Dahlia I Badran
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Suez Canal University, Egypt; Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Badr University in Cairo, Cairo, Egypt.
| | - Sally S Mohammed
- Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Egypt
| | - Noha A Salem
- Department of Human Anatomy and Embryology, Faculty of Medicine, Suez Canal University, Egypt
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22
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Islam A, Chowdhury D, Palit PK, Sohel M, Mozibullah M, Islam MJ, Al Mamun A, Datta J, Dev A, Nath PK, Chowdhury MFF, Nath SK, Mujib ASM. Serum creatinine phosphokinase: A potential prognostic marker in assessing clinical severity with organophosphorus poisoning. J Clin Lab Anal 2023; 37:e24980. [PMID: 37908063 PMCID: PMC10749490 DOI: 10.1002/jcla.24980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 09/14/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION Organophosphorus compound (OPC) poisoning undoubtedly being a major concern in cultivation sites of the developing world, including Bangladesh. Two potential biomarkers, for example, serum creatine phosphokinase (CPK) and lactate dehydrogenase (LDH), are widely used in OPC poisoning severity indicators in patients. In this study, we sought to correlate the severity score of acute OPC poisoning with CPK or LDH level and subsequently explore their prognostic value. METHODS This study was performed on a total of 70 patients with OPC poisoning admitted to the inpatient care unit at a territory-based hospital in Bangladesh. Sociodemographics and poison types were recorded, and severity was assessed according to Peradeniya Organophosphorus Poisoning (POP) scale. Serum CPK and LDH levels were measured and recorded. RESULTS A total of seventy OPC patients were included with male to female ratio of 1.33:1, respectively, with a mean age of 28.7 ± 12.8 years. Chlorpyrifos and methylparathion were the most commonly utilized OP compounds, accounting for 42.9% and 28.6%, respectively. Among the OPC patients, the majority were married homemakers from rural areas. According to POP score, 55.7% and 37.1% of patients were categorized as mild and moderate, whereas very few were found to be severe. The mean serum CPK and LDH of OPC-patients at admission time were 235.6 ± 79.8 IU/L and 348.3 ± 154.1 IU/L, respectively. Serum CPK, atropine dose and hospital stay strongly correlated with clinical severity. CONCLUSION We conclude that the serum CPK level strongly correlates with the degree of OPC poisoning and can be used as a predictor of the clinical intervention approaches.
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Affiliation(s)
- Ashekul Islam
- Department of Biochemistry and Molecular BiologyMawlana Bhashani Science and Technology UniversityTangailBangladesh
| | - Dhiman Chowdhury
- Department of Medicine, Chittagong Medical College HospitalChattogramBangladesh
| | - Pulak Kanti Palit
- Department of Medicine, Chittagong Medical College HospitalChattogramBangladesh
| | - Md Sohel
- Department of Biochemistry and Molecular BiologyMawlana Bhashani Science and Technology UniversityTangailBangladesh
- Department of Biochemistry and Molecular BiologyPrimeasia UniversityDhakaBangladesh
| | - Md. Mozibullah
- Department of Biochemistry and Molecular BiologyMawlana Bhashani Science and Technology UniversityTangailBangladesh
| | - Mohammod Johirul Islam
- Department of Biochemistry and Molecular BiologyMawlana Bhashani Science and Technology UniversityTangailBangladesh
| | - Abdullah Al Mamun
- Department of Biochemistry and Molecular BiologyMawlana Bhashani Science and Technology UniversityTangailBangladesh
| | - Joyonti Datta
- Department of Medicine, Chittagong Medical College HospitalChattogramBangladesh
| | - Annanya Dev
- Department of Medicine, Chittagong Medical College HospitalChattogramBangladesh
| | - Pradip Kumar Nath
- Department of Medicine, Chittagong Medical College HospitalChattogramBangladesh
| | | | - Sabuj Kanti Nath
- Department of Medicine, Chittagong Medical College HospitalChattogramBangladesh
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Bhakaney PR, Yadav VD, Nagore AA, Kulkarni CA. Resurgence to Life: A Case Report on Inpatient Rehabilitation in Organophosphate Poisoning Followed by Intermediate Syndrome. Cureus 2023; 15:e49069. [PMID: 38125255 PMCID: PMC10731128 DOI: 10.7759/cureus.49069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
Organophosphate poisoning (OPP) results from the occupational, accidental, or suicidal intake of organophosphate pesticides (OPs). There is a huge limitation in the available literature on OPP cases and the role of physiotherapy in such cases. We report a case of a 33-year-old farmer, found in a state of ingested insecticide and admitted to the emergency department. The patient had two to three episodes of vomiting, associated with continuous tremors in his hands and legs. Immediately infused with atropine, the patient's general condition deteriorated, and he was intubated with an endotracheal tube. With the signs of long-term intubation, a tracheostomy was done. A respiratory therapy consult was taken for indications of intermediate syndrome and to achieve early weaning. The patient's referral was received in view of the long-term requirement of bronchial hygiene and the need for early ambulation as well as psychological support. Informed consent was taken from the family prior to the commencement of the treatment. Respiratory therapy interventions included body positioning, bronchial hygiene techniques, chest proprioceptive neuromuscular facilitation (PNF) techniques, and mobility exercises to achieve early ambulation. Physiotherapists have the appropriate training, knowledge, and skills to deliver the exercise components and help patients return to their activities of daily living. Significant levels of improvement have been seen in the general condition of the patient. The overall functioning of the patient's health was seen as improved on the scales of consciousness, early mobility in the step-down unit, and quality of life.
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Affiliation(s)
- Pallavi R Bhakaney
- Cardiorespiratory Physiotherapy, Dr. D. Y. Patil College of Physiotherapy, Pune, IND
| | - Vaishnavi D Yadav
- Cardiorespiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditi A Nagore
- Cardiorespiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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24
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Al Amrani F, Wali Y, Mittal A, Al Futaisi A. Delayed myelopathy in a child following organic phosphate poisoning. BMJ Case Rep 2023; 16:e253456. [PMID: 37879708 PMCID: PMC10603530 DOI: 10.1136/bcr-2022-253456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023] Open
Abstract
We report a rare manifestation of delayed organophosphate (OP) poisoning in a male patient in his early childhood. After initially presenting with a cholinergic crisis after OP exposure, the patient returned 3 weeks later with paraparesis and difficulty with bladder control. The results of the MRI of the spine and brain as well as the nerve conduction studies were normal. Myelopathy induced by OP poisoning should be considered in any patient with a history of OP exposure and a presentation of paraparesis. At most recent follow-up, the patient had full bladder control and could walk without assistance. However, he demonstrated circumduction while walking with upper motor neuron signs. Furthermore, he had mild Achilles tendon contractures on both sides. To enable early detection, neurologists and paediatricians should be aware of this uncommon complication of OP poisoning which may influence neurological outcome.
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Affiliation(s)
- Fatma Al Amrani
- Department of Child Health, Sultan Qaboos University, Muscat, Oman
| | - Yasser Wali
- Department of Child Health, Sultan Qaboos University, Muscat, Oman
| | - Alok Mittal
- Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Seeb, Muscat, Oman
| | - Amna Al Futaisi
- Department of Child Health, Sultan Qaboos University, Muscat, Oman
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25
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Abdollahi Aghdam A, Chamanara M, Laripour R, Ebrahimi M. Micro-extraction, pre-concentration, and microfluidic-based separation of organophosphate insecticides followed by the miniaturized electrochemical detection system. BIOIMPACTS : BI 2023; 14:25288. [PMID: 38938753 PMCID: PMC11199932 DOI: 10.34172/bi.2023.25288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/20/2022] [Accepted: 07/02/2022] [Indexed: 06/29/2024]
Abstract
Introduction A new analytical method based on the coupling of microextraction and microfluidics was developed and investigated for the pre-concentration, separation, and electrochemical detection of fenitrothion (FT) and parathion (PA) at the sub-ppm concentrations. Methods In the first step, the microchip capillary electrophoresis technique was used to serve as a separation and detection system. Analytes were injected in the 40 mm long microchannel with 10 mm sidearms. Then, they were separated by applying a direct electrical field (+1800 V) between the buffer and detection reservoirs. 2-(n-morpholino)ethanesulfonic acid (MES) buffer (20 mM, pH 5) was used as a running buffer. The electrochemical detection was performed using three Pt microelectrodes with the width of working, counter, and reference electrodes (50, 250, and 250 µm, respectively) in the out-channel approach. Results The system was devised to have the optimum detection potential equal to -1.2 V vs. pseudo-reference electrode. The dimensions of the SU-8 channel have 20 µm depth and 50 µm width. In the second step, an air-assisted liquid-liquid microextraction technique was used to extract and preconcentration of analytes from human blood plasma. Then, 1, 2 di-bromoethan was used as extractant solvent, the analytes were preconcentrated, and the sedimented solvent (50 µL) was evaporated in a 60 ˚C water bath followed by substitution of running buffer containing 10% ethanol. The optimal extraction cycles were found to be 8 with adding 1% NaCl to the aqueous phase. Analyzing time of the mentioned analytes was less than 100s, the precision range was 3.3 - 8.2 with a linear range of 0.8-100 ppm and 1.2-100 ppm for FT and PA, respectively. The extraction recoveries were about 91% and 87% for FT and PA, respectively. The detection limits for FT and PA were 240 and 360 ppb, respectively. Finally, the reliability of the method was investigated by GC-FID. Conclusion The proposed method and device were validated and can be used as in situ and portable detection systems for detecting fenitrothion and parathion insecticides.
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Affiliation(s)
- Abdollah Abdollahi Aghdam
- Department of Toxicology and Pharmacology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
- Research Center for Pharmaceutical Nanotechnology, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohsen Chamanara
- Department of Toxicology and Pharmacology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
- Toxicology Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Reza Laripour
- Department of Social and Preventive Medicine, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Mohsen Ebrahimi
- Department of Toxicology and Pharmacology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
- Toxicology Research Center, AJA University of Medical Sciences, Tehran, Iran
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26
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Bashyal B, Yadav A, Deo AK, Kharel KK, Kharel D, Panthi B. Severe acute organophosphate poisoning managed with 2-month prolonged atropine therapy: a case report. Ann Med Surg (Lond) 2023; 85:5179-5182. [PMID: 37811057 PMCID: PMC10553172 DOI: 10.1097/ms9.0000000000001207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/08/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction and Importance Organophosphate (OP) poisoning is a common and potentially fatal condition that requires prompt and aggressive treatment with atropine, oximes, and supportive care. We report a rare case of OP poisoning that needed high doses of atropine and intensive care for 60 days. Case Presentation A 39-year-old male ingested 200 ml of chlorpyrifos, an OP compound, and presented with vomiting and epigastric pain. He received an initial dose of atropine of 60 ml (36 mg, 1 ml=0.6 mg), followed by an infusion of 16 ml/h (9.6 mg/h). He developed hypoxia, cardiac arrest, delirium, fever, and persistent bronchorrhea. He was intubated, resuscitated, and transferred to ICU, where he continued showing signs of OP excess and therefore, he received up to 170 ml/h (102 mg/h) of atropine infusion, along with triple inotropes and sedation. He underwent tracheostomy and gradual weaning of atropine. He recovered completely and was discharged in stable condition. Clinical Discussion This case demonstrates the need for prolonged monitoring of patients with OP poisoning wherein the patient can develop signs of OP excess even after initial atropinization, the effectiveness of multiple doses of atropine in OP poisoning, and the importance of monitoring for complications associated with a prolonged hospital stay. It also shows the potential need for prolonged atropine therapy and intensive care in OP poisoning. Conclusion OP poisoning can be life-threatening and requires early and aggressive treatment with atropine, oximes, and supportive care. Clinicians should be aware of the potential need for prolonged atropine therapy in OP poisoning cases to improve the chances of survival.
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Affiliation(s)
- Bibhav Bashyal
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu
| | - Alisha Yadav
- Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj
| | - Anand K. Deo
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu
| | | | | | - Bishal Panthi
- Manipal College of Medical Sciences, Biratnagar, Nepal
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27
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Silwal P, Adhikari R, Yadav B, Sah SK, Bhatt A, Basnet S. Lambda-cyhalothrin ingestion: an infrequent yet concerning presentation of pyrethroid poisoning. Ann Med Surg (Lond) 2023; 85:5250-5254. [PMID: 37811048 PMCID: PMC10553105 DOI: 10.1097/ms9.0000000000001246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/21/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction and importance Lambda-cyhalothrin is a type II pyrethroid compound commonly used as a pesticide, with the potential to cause life-threatening toxicity in humans. Furthermore, among cases of pesticide poisoning in Nepal, organophosphates are most frequently implicated. Case presentation A 40-year-old female presented to our hospital after ingesting a pesticide compound with suicidal intent. She also admitted to alcohol intoxication and exhibited symptoms of confusion, abdominal pain, nausea, and vomiting. An atropine challenge test yielded negative results. Therefore, conservative management was continued. It was discovered later that the ingested pesticide was lambda-cyhalothrin. The patient's condition eventually improved with supportive treatment. Clinical discussion Several reports have highlighted the overlapping clinical features between organophosphorus and pyrethroid poisoning. In some cases of pyrethroid poisoning, misdiagnosis as organophosphorus poisoning has occurred, leading to the inappropriate administration of atropine. In our case, initial management was challenging owing to the lack of accurate information about the ingested compound. On further evaluation, cholinergic clinical features were absent and the atropine challenge test was negative. This was suggestive of nonorganophosphorus compound poisoning. Conclusion This case illustrates that managing pesticide poisoning becomes challenging when the nature of the pesticide is unknown. Patients suffering from poisoning caused by pyrethroid compounds like lambda-cyhalothrin can present with features resembling organophosphorus poisoning. In such circumstances, a comprehensive clinical evaluation should guide the management. Clinical features and an atropine challenge test can aid in differentiating organophosphorus from nonorganophosphorus compound poisoning. This distinction facilitates therapeutic decision-making, including the consideration of atropine administration.
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Affiliation(s)
| | | | | | | | - Ajay Bhatt
- Department of Emergency Medicine, John A. Burns School of Medicine, University of Hawaii, Hawaii, USA
| | - Samjhana Basnet
- Department of General Practice and Emergency Medicine, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchowk, Nepal
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28
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Hsu SS, Lin YS, Chen HC, Liang WZ. Involvement of oxidative stress-related apoptosis in chlorpyrifos-induced cytotoxicity and the ameliorating potential of the antioxidant vitamin E in human glioblastoma cells. ENVIRONMENTAL TOXICOLOGY 2023; 38:2143-2154. [PMID: 37283489 DOI: 10.1002/tox.23850] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/18/2023] [Accepted: 05/28/2023] [Indexed: 06/08/2023]
Abstract
Organophosphate pesticides (OPs), which are among the most widely used synthetic chemicals for the control of a wide variety of pests, are however associated with various adverse reactions in animals and humans. Chlorpyrifos, an OP, has been shown to cause various health complications due to ingestion, inhalation, or skin absorption. The mechanisms underlying the adverse effect of chlorpyrifos on neurotoxicity have not been elucidated. Therefore, we aimed to determine the mechanism of chlorpyrifos-induced cytotoxicity and to examine whether the antioxidant vitamin E (VE) ameliorated these cytotoxic effects using DBTRG-05MG, a human glioblastoma cell line. The DBTRG-05MG cells were treated with chlorpyrifos, VE, or chlorpyrifos plus VE and compared with the untreated control cells. Chlorpyrifos induced a significant decrease in cell viability and caused morphological changes in treated cultures. Furthermore, chlorpyrifos led to the increased production of reactive oxygen species (ROS) accompanied by a decrease in the level of reduced glutathione. Additionally, chlorpyrifos induced apoptosis by upregulating the protein levels of Bax and cleaved caspase-9/caspase-3 and by downregulating the protein levels of Bcl-2. Moreover, chlorpyrifos modulated the antioxidant response by increasing the protein levels of Nrf2, HO-1, and NQO1. However, VE reversed the cytotoxicity and oxidative stress induced by chlorpyrifos treatment in DBTRG-05MG cells. Overall, these findings suggest that chlorpyrifos causes cytotoxicity through oxidative stress, a process that may play an important role in the development of chlorpyrifos-associated glioblastoma.
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Affiliation(s)
- Shu-Shong Hsu
- Department of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Neurosurgery, National Defense Medical Center, Taipei, Taiwan
- College of Health and Nursing, Meiho University, Pingtung, Taiwan
| | - Yung-Shang Lin
- Department of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Neurosurgery, Pingtung Veterans General Hospital, Pingtung, Taiwan
| | - Hui-Ching Chen
- Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wei-Zhe Liang
- Department of Pharmacy and Master Program, College of Pharmacy and Health Care, Tajen University, Pingtung, Taiwan
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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29
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Aishwarya KM, Zanzmera P, Patel J, Mendpara V, Lapsiwala B, Jain S, Porwal V, Modi N, Shah K. Organophosphate Compound Poisoning - An Unusual Presentation as Guillain Barre Syndrome. Ann Indian Acad Neurol 2023; 26:845-847. [PMID: 38022453 PMCID: PMC10666853 DOI: 10.4103/aian.aian_459_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/26/2023] [Accepted: 09/02/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- K M Aishwarya
- Department of Medicine, Government Medical College, Surat, Gujarat, India
| | - Paresh Zanzmera
- Department of Neurology, Government Medical College, Surat, Gujarat, India
| | - Jay Patel
- Department of Neurology, Government Medical College, Surat, Gujarat, India
| | - Vaidehi Mendpara
- Department of Medicine, Government Medical College, Surat, Gujarat, India
| | - Boney Lapsiwala
- Department of Medicine, Government Medical College, Surat, Gujarat, India
| | - Shruti Jain
- Department of Medicine, Government Medical College, Surat, Gujarat, India
| | - Vishma Porwal
- Department of Medicine, Government Medical College, Surat, Gujarat, India
| | - Nishi Modi
- Department of Medicine, Government Medical College, Surat, Gujarat, India
| | - Kinjal Shah
- Department of Neurology, Government Medical College, Surat, Gujarat, India
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30
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Fouad MM, Zawilla NH, Moubarez DA. Successful treatment of intermediate syndrome in a COVID-19 patient with severe organophosphate toxicity. Int J Crit Illn Inj Sci 2023; 13:145-147. [PMID: 38023580 PMCID: PMC10664041 DOI: 10.4103/ijciis.ijciis_84_22] [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: 12/14/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 12/01/2023] Open
Abstract
Organophosphate (OP) poisoning is one of the most common causes of poisoning in the world, due to its easy availability, low cost, and wide occupational exposure. It has a significant death and morbidity rate. Cholinergic syndrome, intermediate syndrome (IMS), and syndrome of delayed polyneuropathy are the three primary syndromes that define OP poisoning. We report the case of a 44-year-old male patient who had a history of OP poisoning by inhalation and later developed altered mental status (AMS). The patient transiently improved and regained consciousness following treatment with atropine and obidoxime. He deteriorated the following day with AMS and generalized muscle weakness consistent with IMS and was intubated for airway protection. Despite further complication by Klebsiella and COVID-19 infections, he recovered to hospital discharge on day 14.
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Affiliation(s)
- Marwa Mohammed Fouad
- Department of Occupational and Environmental Medicine, Cairo University, Cairo, Egypt
| | - Nermin Hamdy Zawilla
- Department of Occupational and Environmental Medicine, Cairo University, Cairo, Egypt
- Department of National Environmental and Clinical Toxicology Research Center, Cairo University, Cairo, Egypt
| | - Doaa Atef Moubarez
- Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
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31
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Alruhaimi RS. Betulinic acid protects against cardiotoxicity of the organophosphorus pesticide chlorpyrifos by suppressing oxidative stress, inflammation, and apoptosis in rats. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:51180-51190. [PMID: 36808036 DOI: 10.1007/s11356-023-25917-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/09/2023] [Indexed: 04/16/2023]
Abstract
The widespread application of organophosphorus (OP) pesticides can affect the environment as well as the animal and human health. Chlorpyrifos (CPF) is a broad-spectrum OP pesticide used in agriculture and can cause several toxic effects in which oxidative stresses and inflammation play a key role. This study aimed to evaluate the protective activity of betulinic acid (BA), an antioxidant and anti-inflammatory pentacyclic triterpene, against CPF cardiotoxicity in rats. The rats were divided into four groups. CPF (10 mg/kg) and BA (25 mg/kg) were orally administered for 28 days, and blood and heart samples were collected. CPF-administered rats showed an increase in serum cardiac troponin I (cTnI), creatine kinase (CK)-MB, and lactate dehydrogenase (LDH), accompanied with multiple myocardial tissue alterations. Lipid peroxidation (LPO), nitric oxide (NO), nuclear factor-kappaB (NF-κB), interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α were increased, and antioxidant were decrease in CPF-administered rats. BA ameliorated cardiac function markers and tissue injury, decreased LPO, NO, NF-κB, and proinflammatory cytokines, and increased antioxidants. In addition, BA decreased proapoptosis markers, and increased B-cell lymphoma (Bcl)-2, IL-10, Nrf2, and HO-1 in the heart of CPF-treated rats. In conclusion, BA protected against cardiotoxicity in CPF-administered rats by mitigating oxidative stress, inflammation, and apoptosis, and enhanced Nrf2 and antioxidants.
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Affiliation(s)
- Reem S Alruhaimi
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia.
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32
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Sepahi S, Gerayli S, Delirrad M, Taghavizadeh Yazdi ME, Zare-Zardini H, Bushehri B, Ghorani-Azam A. Biochemical responses as early and reliable biomarkers of organophosphate and carbamate pesticides intoxication: A systematic literature review. J Biochem Mol Toxicol 2023; 37:e23285. [PMID: 36524544 DOI: 10.1002/jbt.23285] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/03/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
Inhibition of cholinesterase (ChE) activity has been long considered as the main diagnostic method of organophosphate (OP) and carbamate pesticides poisoning; however, it has been shown that ChE activity may also be altered due to exposure to other non-organophosphorus toxicants and variety of different medical conditions. Hence, to avoid misdiagnosis, we aimed to systematically review available documents to look for additional biomarkers of OP and carbamate poisoning. The electronic databases in addition to Google scholar were searched for eligible articles on March 2022 using "organophosphate," "carbamate," and "biomarker" including all their similar terms. After collecting the relevant documents, the data were extracted and described qualitatively. In total, data of 66 articles from 51 human and 15 animal studies were extracted. Findings demonstrated that enzymes such as β-glucuronidase, neuropathy target esterase, amylase, and lipase, in addition to hematological indicators such as CBC, CRP, lactate dehydrogenase, and CPK have high sensitivity and accuracy in the diagnosis of OP poisoning. Findings suggest that using various markers for diagnosis of OP intoxication is helpful for appropriate management, and early identifying the patients at risk of death. The suggested biomarkers also help to avoid misdiagnosis of OP poisoning with other similar conditions.
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Affiliation(s)
- Samaneh Sepahi
- Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Sina Gerayli
- Division of Inflammation and inflammatory Diseases, Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Delirrad
- Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran.,Department of Forensic Medicine and Toxicology, Urmia University of Medical Sciences, Urmia, Iran
| | | | - Hadi Zare-Zardini
- Hematology and Oncology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Sciences, Farhangian University, Isfahan, Iran
| | - Behzad Bushehri
- Department of Forensic Medicine and Toxicology, Urmia University of Medical Sciences, Urmia, Iran
| | - Adel Ghorani-Azam
- Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran.,Department of Forensic Medicine and Toxicology, Urmia University of Medical Sciences, Urmia, Iran
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Uys F, O'Neill M, Farina Z, Belford J. Case Report. S Afr Med J 2023; 113:57-60. [PMID: 36757073 DOI: 10.7196/samj.2023.v113i2.16832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Indexed: 02/10/2023] Open
Abstract
The illegal practice of combining organophosphates (OPs) with other compounds such as carbamates and pyrethroids, creating 'streetpesticides', is common in South Africa. These agents contain mostly unknown quantities of unregulated toxins and contribute to atypicaland unpredictable clinical presentations following human ingestion. We present such a case in a patient with intentional rodenticideingestion. The initial presentation in the emergency department was a classic cholinergic toxidrome, and clinical resolution was achievedafter provision of atropine. This was followed 12 hours later by an acute decompensation resulting from an apparent sympatheticallydriven episode of autonomic instability and acute pulmonary oedema requiring immediate respiratory and haemodynamic support. In ourdiscussion, we explore this secondary decompensation and suggest various pathophysiological explanations for this atypical clinical coursefollowing what had appeared to be OP poisoning. The patient was discharged home after a total of 6 days in hospital.
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Affiliation(s)
- F Uys
- Department of Anaesthesia and Critical Care, Harry Gwala Regional Hospital, Pietermaritzburg, South Africa.
| | - M O'Neill
- Department of Anaesthesia and Critical Care, Harry Gwala Regional Hospital, Pietermaritzburg, South Africa.
| | - Z Farina
- Head, Clinical Department: Anaesthesia and Critical Care, Greys Hospital, Pietermaritzburg, South Africa; Honorary lecturer, Department of Anaesthesia and Critical Care, University of KwaZulu-Natal, Pietermarizburg, South Africa.
| | - J Belford
- Department of Anaesthesia and Critical Care, Harry Gwala Regional Hospital, Pietermaritzburg, South Africa.
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Wu Y, Weng X, Liu S, Tan Y, Liang H, Li Y, Wen L, Chen Q, Jing C. Associations of single and multiple organophosphate pesticide exposure with female infertility in the USA: data from the 2015-2018 National Health and Nutrition Examination Survey. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:23411-23421. [PMID: 36322354 DOI: 10.1007/s11356-022-23624-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
Substantial evidence has shown that organophosphate pesticide (OPP) exposure altered the reproductive system functions, such as prolonged menstrual cycles, sexual hormone imbalance, and changes in ovarian weight. However, the association of OPP exposure with female infertility is unclear. We explored the relationships of four single OPP metabolites and their mixed exposure with self-reported infertility among women aged 20-50 in the USA using the data from two cycles (2015-2016 and 2017-2018) of the National Health and Nutrition Examination Survey (NHANES) by multiple logistic regression, Bayesian kernel machine regression (BKMR), and quantile g-computation (QGC). Eventually, 659 females were included in our study. Among these females, 77 participants were ever infertile. Multiple logistic regression showed that the odds ratios (ORs) in the second and third tertiles of dimethylphosphate (DMP) for female infertility were 2.53 (95% confidence interval (95%CI): 1.20-5.32, P value = 0.016) and 2.96 (95%CI: 1.18-7.47, P value = 0.023) compared to the lowest tertile after adjusting for all covariates (P for trend = 0.022). A significantly positive association between the mixed OPP metabolites and infertility was observed in the BKMR model, in which DMP had the highest posterior inclusion probability (PIP = 0.741). The QGC model showed similar results, in which OPP metabolite mixtures increased the risk of female infertility, with DMP as a significantly positive contributor to the outcome. This study revealed the potential harm of OPP mixtures for female infertility in the USA, and DMP played the most critical role in female infertility risk among all OPP metabolites.
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Affiliation(s)
- Yingying Wu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Xueqiong Weng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Shan Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Yuxuan Tan
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Huanzhu Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Yexin Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Lin Wen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Qian Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Chunxia Jing
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China.
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, 510632, Guangdong, China.
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Abduh MS, Alruhaimi RS, Alqhtani HA, Hussein OE, Abukhalil MH, Kamel EM, Mahmoud AM. Rosmarinic acid mitigates chlorpyrifos-induced oxidative stress, inflammation, and kidney injury in rats by modulating SIRT1 and Nrf2/HO-1 signaling. Life Sci 2023; 313:121281. [PMID: 36521549 DOI: 10.1016/j.lfs.2022.121281] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/30/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
Chlorpyrifos (CPF) is a widely used broad-spectrum pesticide with multi-organ toxic effects. Oxidative stress was found to play a role in the deleterious effects of CPF, including nephrotoxicity. This study investigated the protective effect of the antioxidant polyphenol rosmarinic acid (RA) against CPF-induced kidney injury, with an emphasis on oxidative injury, inflammation, SIRT1, and Nrf2/HO-1 signaling. Rats received 10 mg/kg CPF and 25, 50, and 100 mg/kg RA orally for 28 days, and the samples were collected for analysis. CPF increased serum urea and creatinine and kidney Kim-1 and caused several histopathological alterations. ROS, MDA, NO, NF-κB p65, TNF-α, and IL-1β were elevated in the kidney of CPF-intoxicated rats. RA ameliorated kidney function markers, prevented tissue injury, suppressed ROS, MDA, and NO, and downregulated NF-κB p65, TNF-α, and IL-1β in CPF-intoxicated rats in a dose-dependent manner. RA decreased Bax, caspase-3, oxidative DNA damage, and Keap1, boosted antioxidant enzymes and Bcl-2, and upregulated Nrf2, HO-1, and SIRT1 in CPF-administered rats. Molecular docking simulation revealed the binding affinity of RA toward NF-κB, Keap1, HO-1, and SIRT1. In conclusion, RA prevented CPF nephrotoxicity by attenuating oxidative stress, inflammation, and apoptosis and upregulating SIRT1 and Nrf2/HO-1 signaling.
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Affiliation(s)
- Maisa Siddiq Abduh
- Immune Responses in Different Diseases Research Group, Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia; Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Reem S Alruhaimi
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Haifa A Alqhtani
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Omnia E Hussein
- Higher Technological Institute of Applied Health Sciences, Beni-Suef, Egypt
| | - Mohammad H Abukhalil
- Department of Medical Analysis, Princess Aisha Bint Al-Hussein College of Nursing and Health Sciences, Al-Hussein Bin Talal University, Ma'an, Jordan; Department of Biology, College of Science, Al-Hussein Bin Talal University, Ma'an, Jordan
| | - Emadeldin M Kamel
- Department of Chemistry, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt
| | - Ayman M Mahmoud
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK; Physiology Division, Zoology Department, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt.
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Xu B, Zeng W, Chen F, Lin G, Wang M, Ding J, Hong Y, Ke J, Wang X, Shang X. Clinical characteristics and early prediction of mortality risk in patients with acute organophosphate poisoning-induced shock. Front Med (Lausanne) 2023; 9:990934. [PMID: 36714143 PMCID: PMC9874994 DOI: 10.3389/fmed.2022.990934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/07/2022] [Indexed: 01/12/2023] Open
Abstract
Objective To further get insights of clinical characteristics of acute organophosphate poisoning-induced shock, investigate the relationship between shock and prognosis, and screen risk indicators for prognosis. Methods A total of 73 patients with acute organophosphate poisoning admitted to our hospital between January 2014 and December 2021 were enrolled in this retrospective study. Patients were divided into the shock group and the non-shock group. The pH value of blood, arterial blood carbon dioxide partial pressure (PaCO2), arterial partial pressure of oxygen (PaO2), base excess (BE), lactic acid (Lac), serum albumin (ALB), total bilirubin (TBIL), alanine aminotransferase (ALT), serum creatinine (Cr), serum potassium (K), serum calcium (Ca), serum sodium (Na), blood chloride (Cl), serum troponin I (cTNI), brain natriuretic peptide (BNP), white blood cell count (WBC), hemoglobin (HGB), platelet count (PLT), and other clinical indicators of patients were recorded. Incidence of shock, time of shock onset, and outcomes of patients were also recorded. Cox proportional hazards regression models were performed for analysis. Results The incidence of organophosphate poisoning-induced shock was 30.1% (22/73), and 72.7% of shock patients developed shock blood pressure within 6 h. The levels of blood lactate, ALT, Cr, cTNI, BNP, and Cl in the shock group were significantly higher than those in the non-shock group, while the level of Ca and pH value was significantly lower than that in the non-shock group (all p < 0.05). Moreover, compared with patients without shock (2.0%), the mortality rate was significantly increased in patients with shock (36.4%), which was supported by the results from adjusted Cox proportional hazards regression model. We found that shock and elevated serum creatinine were associated with increased risk of death in patients with organophosphate poisoning (shock: HR, 10.9; 95% CI 1.2-96.3; elevated serum creatinine: HR, 1.0, 95% CI 1.0-1.0). Conclusion This study indicated the association between elevated serum creatinine and increased mortality rates in patients with organophosphate poisoning, highlighting the importance of the comprehensive management of shock, especially the control of renal function, in these poisoning patients.
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Affiliation(s)
- Bing Xu
- Department of Emergency, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Emergency Medical Center, Fujian Provincial Key Laboratory of Emergency Medicine, Fuzhou, China
| | - Weijia Zeng
- Department of Emergency, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Emergency Medical Center, Fujian Provincial Key Laboratory of Emergency Medicine, Fuzhou, China
| | - Feng Chen
- Department of Emergency, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Emergency Medical Center, Fujian Provincial Key Laboratory of Emergency Medicine, Fuzhou, China
| | - Gui Lin
- Department of Emergency, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Emergency Medical Center, Fujian Provincial Key Laboratory of Emergency Medicine, Fuzhou, China
| | - Mengjie Wang
- Department of Emergency, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Emergency Medical Center, Fujian Provincial Key Laboratory of Emergency Medicine, Fuzhou, China
| | - Jie Ding
- Department of Emergency, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Emergency Medical Center, Fujian Provincial Key Laboratory of Emergency Medicine, Fuzhou, China
| | - Ye Hong
- Department of Emergency, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Emergency Medical Center, Fujian Provincial Key Laboratory of Emergency Medicine, Fuzhou, China
| | - Jun Ke
- Department of Emergency, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Emergency Medical Center, Fujian Provincial Key Laboratory of Emergency Medicine, Fuzhou, China
| | - Xiaoping Wang
- Department of Emergency, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Emergency Medical Center, Fujian Provincial Key Laboratory of Emergency Medicine, Fuzhou, China,Xiaoping Wang,
| | - Xiuling Shang
- The Third Department of Critical Care Medicine, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Provincial Center for Critical Care Medicine, Fujian Provincial Key Laboratory of Critical Care Medicine, Fuzhou, China,*Correspondence: Xiuling Shang,
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Haridas A, Ravi P. Opsoclonus-myoclonus syndrome caused by organophosphate poisoning. Pract Neurol 2023; 23:243-245. [PMID: 36609395 DOI: 10.1136/pn-2022-003612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 01/09/2023]
Abstract
Opsoclonus-myoclonus syndrome is a combination of involuntary, arrhythmic, conjugate saccadic eye movements with myoclonus. The most common cause in adults is paraneoplastic encephalitis. Rarer causes include infections such as scrub typhus, and toxins such as organophosphates and cocaine. Organophosphates are one of the common poisonings in tropical countries such as India, causing both central and peripheral nervous system manifestations. We describe a middle-aged male farmer with unexplained altered consciousness and respiratory depression. After 2 days, he developed opsoclonus-myoclonus, and then bronchorrhoea and bradycardia, raising suspicion of organophosphate poisoning. After we had identified a very low serum cholinesterase concentration, he disclosed having consumed organophosphates.
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Affiliation(s)
- Aalaya Haridas
- General Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
| | - Pradeep Ravi
- General Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
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Miftahussurur M, Nabilah N, Rezkitha YA, Yamaoka Y. Current management of corrosive, alcohol, and organophosphate poisoning: Pearls and pitfalls. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2023; 28:20. [DOI: 10.4103/jrms.jrms_635_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 04/03/2023]
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Wu Y, Song J, Zhang Q, Yan S, Sun X, Yi W, Pan R, Cheng J, Xu Z, Su H. Association between organophosphorus pesticide exposure and depression risk in adults: A cross-sectional study with NHANES data. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 316:120445. [PMID: 36265728 DOI: 10.1016/j.envpol.2022.120445] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Organophosphorus pesticides (OPPs) are widely used pesticides, and previous studies showed that OPPs can increase the risk of central nervous system disorders (e.g., Parkinson's and Alzheimer's disease). However, few studies have comprehensively explored their association with depression in general adults. We analyzed data from 5206 participants aged 20 years or more based on four National Health and Nutrition Examination Survey (NHANES) cycles. OPPs exposure was estimated using measures of urinary concentrations for six OPPs metabolites. Survey-weighted generalized linear regression model (SWGLM) was used to explore the association of OPPs metabolites with depression. Subgroup analyses were performed by age (≦60 years and >60 years) and gender. The weighted quantile sum (WQS) regression model was used to explore the overall association of six OPPs metabolites with depression. In addition, The Bayesian kernel machine regression (BKMR) model was applied to investigate the interaction and joint effects of multiple OPPs metabolites with depression. The SWGLM showed that dimethyl phosphate (DMP) and dimethyl thiophosphate (DMTP), whether taken as continuous or quartile variables, had a positive correlation with depression. Diethyl phosphate (DEP) and dimethyl dithiophosphate (DMDTP) in the highest quartile were positively associated with depression compared to the lowest quartile. In subgroup analysis, we found that the effects of the above chemicals on depression existed in the male and young middle-aged population, while DMP was present in the female. There was a significant combined overall effect of six OPPs metabolites with depression [OR = 1.232, 95%CI: (1.011, 1.504)] in WQS. Furthermore, the BKMR model also showed a positive trend in the overall effect of six OPPs metabolites with depression. In conclusion, our results suggest that exposure to OPPs may increase the risk of depression in US adults. Men and young and middle-aged populations are more vulnerable to OPPs and the mixture of OPPs metabolites may induce depression.
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Affiliation(s)
- Yudong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Qin Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Shuangshuang Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Xiaoni Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, 288 Herston Road, Herston, QLD, 4006, Australia
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China.
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Organophosphate Insecticide Toxicity in Neural Development, Cognition, Behaviour and Degeneration: Insights from Zebrafish. J Dev Biol 2022; 10:jdb10040049. [PMID: 36412643 PMCID: PMC9680476 DOI: 10.3390/jdb10040049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/24/2022] Open
Abstract
Organophosphate (OP) insecticides are used to eliminate agricultural threats posed by insects, through inhibition of the neurotransmitter acetylcholinesterase (AChE). These potent neurotoxins are extremely efficacious in insect elimination, and as such, are the preferred agricultural insecticides worldwide. Despite their efficacy, however, estimates indicate that only 0.1% of organophosphates reach their desired target. Moreover, multiple studies have shown that OP exposure in both humans and animals can lead to aberrations in embryonic development, defects in childhood neurocognition, and substantial contribution to neurodegenerative diseases such as Alzheimer's and Motor Neurone Disease. Here, we review the current state of knowledge pertaining to organophosphate exposure on both embryonic development and/or subsequent neurological consequences on behaviour, paying particular attention to data gleaned using an excellent animal model, the zebrafish (Danio rerio).
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Ireland D, Zhang S, Bochenek V, Hsieh JH, Rabeler C, Meyer Z, Collins EMS. Differences in neurotoxic outcomes of organophosphorus pesticides revealed via multi-dimensional screening in adult and regenerating planarians. FRONTIERS IN TOXICOLOGY 2022; 4:948455. [PMID: 36267428 PMCID: PMC9578561 DOI: 10.3389/ftox.2022.948455] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/25/2022] [Indexed: 11/07/2022] Open
Abstract
Organophosphorus pesticides (OPs) are a chemically diverse class of commonly used insecticides. Epidemiological studies suggest that low dose chronic prenatal and infant exposures can lead to life-long neurological damage and behavioral disorders. While inhibition of acetylcholinesterase (AChE) is the shared mechanism of acute OP neurotoxicity, OP-induced developmental neurotoxicity (DNT) can occur independently and/or in the absence of significant AChE inhibition, implying that OPs affect alternative targets. Moreover, different OPs can cause different adverse outcomes, suggesting that different OPs act through different mechanisms. These findings emphasize the importance of comparative studies of OP toxicity. Freshwater planarians are an invertebrate system that uniquely allows for automated, rapid and inexpensive testing of adult and developing organisms in parallel to differentiate neurotoxicity from DNT. Effects found only in regenerating planarians would be indicative of DNT, whereas shared effects may represent neurotoxicity. We leverage this unique feature of planarians to investigate potential differential effects of OPs on the adult and developing brain by performing a comparative screen to test 7 OPs (acephate, chlorpyrifos, dichlorvos, diazinon, malathion, parathion and profenofos) across 10 concentrations in quarter-log steps. Neurotoxicity was evaluated using a wide range of quantitative morphological and behavioral readouts. AChE activity was measured using an Ellman assay. The toxicological profiles of the 7 OPs differed across the OPs and between adult and regenerating planarians. Toxicological profiles were not correlated with levels of AChE inhibition. Twenty-two "mechanistic control compounds" known to target pathways suggested in the literature to be affected by OPs (cholinergic neurotransmission, serotonin neurotransmission, endocannabinoid system, cytoskeleton, adenyl cyclase and oxidative stress) and 2 negative controls were also screened. When compared with the mechanistic control compounds, the phenotypic profiles of the different OPs separated into distinct clusters. The phenotypic profiles of adult vs. regenerating planarians exposed to the OPs clustered differently, suggesting some developmental-specific mechanisms. These results further support findings in other systems that OPs cause different adverse outcomes in the (developing) brain and build the foundation for future comparative studies focused on delineating the mechanisms of OP neurotoxicity in planarians.
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Affiliation(s)
- Danielle Ireland
- Department of Biology, Swarthmore College, Swarthmore, PA, United States
| | - Siqi Zhang
- Department of Bioengineering, University of California San Diego, La Jolla, CA, United States
| | - Veronica Bochenek
- Department of Biology, Swarthmore College, Swarthmore, PA, United States
| | - Jui-Hua Hsieh
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, Durham, NC, United States
| | - Christina Rabeler
- Department of Biology, Swarthmore College, Swarthmore, PA, United States
| | - Zane Meyer
- Department of Engineering, Swarthmore College, Swarthmore, PA, United States
- Department of Computer Science, Swarthmore College, Swarthmore, PA, United States
| | - Eva-Maria S. Collins
- Department of Biology, Swarthmore College, Swarthmore, PA, United States
- Department of Physics and Astronomy, Swarthmore College, Swarthmore, PA, United States
- Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center of Excellence in Environmental Toxicology, University of Pennsylvania, Philadelphia, PA, United States
- Department of Physics, University of California San Diego, La Jolla, CA, United States
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Lageju N, Neupane D, Jaiswal LS, Chapagain S, Uprety P, Regmi S, Bhandari S. Intermediate syndrome following organophosphate poisoning: A case report in a low resource and poor socio-economic setting. Clin Case Rep 2022; 10:e6448. [PMID: 36245455 PMCID: PMC9547344 DOI: 10.1002/ccr3.6448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/18/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022] Open
Abstract
Intermediate syndrome with respiratory failure is a serious complication that can be fatal as in our case of a 24-year-old-man who developed intermediate syndrome requiring intubation and respiratory support. Furthermore, the patient's socio-economic situation significantly impacts the illness's progress and prognosis.
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Affiliation(s)
- Nimesh Lageju
- B. P. Koirala Institute of Health SciencesDharanNepal
| | - Durga Neupane
- B. P. Koirala Institute of Health SciencesDharanNepal
| | - Lokesh Shekher Jaiswal
- Department of Surgery (Division of CTVS)B.P. Koirala Institute of Health SciencesDharanNepal
| | | | - Pratik Uprety
- B. P. Koirala Institute of Health SciencesDharanNepal
| | - Swapnil Regmi
- B. P. Koirala Institute of Health SciencesDharanNepal
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Muacevic A, Adler JR. Poisoning by Organophosphate Pesticides: A Case Report. Cureus 2022; 14:e29842. [PMID: 36348844 PMCID: PMC9630056 DOI: 10.7759/cureus.29842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2022] [Indexed: 01/12/2023] Open
Abstract
In many parts of the world, particularly in impoverished nations like Ethiopia, organophosphate compounds operate as suicide agents, are frequently employed as pesticides, and are strong inhibitors of the acetylcholinesterase enzyme. A 21-year-old Ethiopian female, a university student, was admitted to an emergency department on June 22, 2022, with a two-hour history of nausea and elevated secretions of salivation via the mouth. She had no previous history of psychiatric or neurological disorders, but three days before her admission, she quarreled with her boyfriend, became extremely depressed, and decided to commit suicide. She had a two-hour history of nausea and intermittent vomiting and a one-hour history of persistent vomiting, increased salivation secretions through the mouth, chills, progressive sweating, difficulty breathing, and dizziness. Upon admission, her neurological examination in the emergency department revealed a Glasgow Coma Scale score of 9/15. On admission, she was placed on two liters per minute of intranasal oxygen via the nasal cannula. On the same day, she was given atropine 0.15 mg intravenously, and the dose was doubled every 10 minutes until atropinization was achieved, and a bolus dose of 500ml of 0.9% of normal saline was initiated immediately.
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Sarailoo M, Afshari S, Asghariazar V, Safarzadeh E, Dadkhah M. Cognitive Impairment and Neurodegenerative Diseases Development Associated with Organophosphate Pesticides Exposure: a Review Study. Neurotox Res 2022; 40:1624-1643. [PMID: 36066747 DOI: 10.1007/s12640-022-00552-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/22/2022] [Accepted: 07/27/2022] [Indexed: 10/14/2022]
Abstract
A significant body of literature emphasizes the role of insecticide, particularly organophosphates (OPs), as the major environmental factor in the etiology of neurodegenerative diseases. This review aims to study the relationship between OP insecticide exposure, cognitive impairment, and neurodegenerative disease development. Human populations, especially in developing countries, are frequently exposed to OPs due to their extensive applications. The involvement of various signaling pathways in OP neurotoxicity are reported, but the OP-induced cognitive impairment and link between OP exposure and the pathophysiology of neurodegenerative diseases are not clearly understood. In the present review, we have therefore aimed to come to new conclusions which may help to find protective and preventive strategies against OP neurotoxicity and may establish a possible link between organophosphate exposure, cognitive impairment, and OP-induced neurotoxicity. Moreover, we discuss the findings obtained from animal and human research providing some support for OP-induced cognitive impairment and neurodegenerative disorders.
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Affiliation(s)
- Mehdi Sarailoo
- Students Research Committee, School of Public Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Salva Afshari
- Students Research Committee, Pharmacy School, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Vahid Asghariazar
- Deputy of Research & Technology, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Elham Safarzadeh
- Department of Microbiology, Parasitology, and Immunology, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Masoomeh Dadkhah
- Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Sciences, Ardabil, Iran.
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Wongta A, Sawang N, Tongjai P, Jatiket M, Hongsibsong S. The Assessment of Organophosphate Pesticide Exposure among School Children in Four Regions of Thailand: Analysis of Dialkyl Phosphate Metabolites in Students' Urine and Organophosphate Pesticide Residues in Vegetables for School Lunch. TOXICS 2022; 10:toxics10080434. [PMID: 36006115 PMCID: PMC9416577 DOI: 10.3390/toxics10080434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 06/05/2023]
Abstract
In Thailand, pesticides containing organophosphates (OP) are frequently applied to crops to suppress insects. School children can be exposed to OPs on a daily basis, from food consumption to breathing and touching pesticides drifted near classrooms. Living in an agricultural area can also be one of the causes. As a result, it is important to monitor OPs residues in the food chain and biomarkers of exposure. The Gas Chromatography-Flame Photometric Detector method was employed to examine the relationship between OPs residue and DAPs (Diakly phosphate) in four targeted locations in Thailand, as well as to examine the residues of OPs in vegetable samples and DAPs in 395 school children's urine samples. Vegetables were found to contain at least one OP, with chlorpyrifos being the most prevalent. The OPs detected frequencies for Sakon Nakhon, Chiang Mai, Phang Nga, and Pathum Thani are 96.1%, 94%, 91.7%, and 83.3%, respectively. The overall centration level of OPs showed 0.3261 mg/kg, 0.0636 mg/kg, 0.0023 mg/kg, 0.0150 mg/kg, 0.2003 mg/kg, 0.0295 mg/kg, and 0.0034 mg/kg for diazinon, dimethoate, pirimiphos-methyl, chlorpyrifos, profenofos, ethion, and triazophos, respectively. Nearly 98% of school children were detected with at least one DAP. The overall level of dimethyl phosphate metabolites (5.258 µmole/mole creatinine) in urine samples is higher than diethyl phosphate metabolites (2.884 µmole/mole creatinine), especially in the case of Pathum Thani. Our findings show a consistent relationship between OPs in vegetables from wet markets and DAPs in urine samples of school children in various parts of Thailand.
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Affiliation(s)
- Anurak Wongta
- Environmental, Occupational and NCD Center of Excellent, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.W.); (N.S.); (P.T.)
| | - Nootchakarn Sawang
- Environmental, Occupational and NCD Center of Excellent, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.W.); (N.S.); (P.T.)
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Phanika Tongjai
- Environmental, Occupational and NCD Center of Excellent, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.W.); (N.S.); (P.T.)
- School of Health Science Research, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | | | - Surat Hongsibsong
- Environmental, Occupational and NCD Center of Excellent, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (A.W.); (N.S.); (P.T.)
- School of Health Science Research, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
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Demissie Z, Bekele A, Bane A. A Case of Severe 2,4-Dichlorophenoxyacetic Acid Poisoning Causing Diagnostic and Treatment Challenges. Int Med Case Rep J 2022; 15:389-392. [PMID: 35935177 PMCID: PMC9346413 DOI: 10.2147/imcrj.s375882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
2,4-Dichlorophenoxyacetic acid is a poisonous herbicide. Though poisoning reports from this compound are rare, there is a tendency toward increased use of it in the agrarian society of Ethiopia. We herein report a case of a young female farmer from rural Ethiopia who was admitted to a local hospital after presenting with loss of consciousness and excess oral secretions 2 hours after a suicidal ingestion of an unknown toxic agent. She was originally treated for organophosphate poisoning, and then transferred to Saint Peter’s Hospital in Addis Ababa for more intensive care. There, ingestion of 2,4-D was confirmed, and she received supportive care, mechanical ventilation, and forced alkaline diuresis. Despite these interventions, she died several days later. Due to the similarity of some clinical signs with organophosphate poisoning in acute settings, there are possible missed cases of 2,4-D acid herbicide poisoning. No specific treatment is known, so a high index of suspicion for early detection, decontamination, and initiation of supportive care is crucial to improve survival after exposure. In addition, local policies on proper and controlled use of these herbicides are needed to improve awareness among users and prevent accidental and intentional exposures.
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Affiliation(s)
- Zekewos Demissie
- Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Correspondence: Zekewos Demissie, Email
| | - Amsalu Bekele
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abate Bane
- Department of Internal Medicine, Division of Gastroenterology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Fghihi-Zarandi A, Dabaghzadeh F, Vaziri A, Karami-Mohajeri S, Ghorbaninejad B, Zamani A, Rahimi-Sadegh K. Occupational risk assessment of organophosphates with an emphasis on psychological and oxidative stress factors. Toxicol Ind Health 2022; 38:342-350. [PMID: 35513771 DOI: 10.1177/07482337221096315] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Organophosphate pesticides (OPPs) are widely used all over the world in domestic and industrial settings, but these chemicals affect the nervous system, induce suicidal thoughts, depression and anxiety, and impair sleep quality. The purpose of this study was to investigate the relationship between the main toxicity mechanisms of OPPs, oxidative stress and cholinesterase inhibition, and psychological parameters in chronic exposure to OPPs. This cross-sectional study was conducted on 56 male OPPs factory workers as the worker group and 47 unexposed individuals within the same age range as the control group. Psychological factors were assessed using validated questionnaires. The activity of plasma cholinesterase and oxidative stress biomarkers, total antioxidant capacity of plasma, lipid peroxidation (LPO), and protein carbonylation were determined in blood samples by spectrophotometer. Sleep quality score in the factory workers was lower, and depression and suicidal ideation scores were higher than those in the control group. These factory workers showed 35% lower levels of plasma cholinesterase activity than did the controls. Compared to the control group, a significant impairment in oxidative stress biomarkers was also observed in the workers. Meanwhile, there was a significant relationship between the duration of employment and the level of LPO as well as a significant correlation between the quality of sleep and plasma cholinesterase in the workers. In conclusion, long-term exposure to OPPs could cause oxidative damages and neurobehavioral effects. The close monitoring of workplace exposure to organophosphates pesticides and also their respective solvents along with the reduction of working hours are of the necessities to avoid the adverse impacts of exposure to these pesticides.
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Affiliation(s)
- Ali Fghihi-Zarandi
- Department of Occupational Health Engineering, School of Public Health, 48463Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Dabaghzadeh
- Pharmaceutics Research Center, Institute of Neuropharmacology, 48463Kerman University of Medical Sciences, Kerman, Iran.,Departments of Toxicology and Pharmacology, School of Pharmacy, 48463Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Vaziri
- Department of Chemical and Petroleum Engineering, 68106Science and Research Branch of Islamic Azad, Tehran, Iran
| | - Somayyeh Karami-Mohajeri
- Departments of Toxicology and Pharmacology, School of Pharmacy, 48463Kerman University of Medical Sciences, Kerman, Iran.,Department of Chemical and Petroleum Engineering, 68106Science and Research Branch of Islamic Azad, Tehran, Iran
| | - Behnam Ghorbaninejad
- Departments of Toxicology and Pharmacology, School of Pharmacy, 48463Kerman University of Medical Sciences, Kerman, Iran
| | - Ahmadreza Zamani
- Vice_chancellery of Health, 48463Kerman University of Medical Sciences, Kerman, Iran
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Bugay V, Gregory SR, Belanger-Coast MG, Zhao R, Brenner R. Effects of Sublethal Organophosphate Toxicity and Anti-cholinergics on Electroencephalogram and Respiratory Mechanics in Mice. Front Neurosci 2022; 16:866899. [PMID: 35585917 PMCID: PMC9108673 DOI: 10.3389/fnins.2022.866899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/12/2022] [Indexed: 11/13/2022] Open
Abstract
Organophosphates are used in agriculture as insecticides but are potentially toxic to humans when exposed at high concentrations. The mechanism of toxicity is through antagonism of acetylcholinesterase, which secondarily causes excess activation of cholinergic receptors leading to seizures, tremors, respiratory depression, and other physiological consequences. Here we investigated two of the major pathophysiological effects, seizures and respiratory depression, using subcutaneous injection into mice of the organophosphate diisopropylfluorophosphate (DFP) at sublethal concentrations (2.1 mg/Kg) alone and co-injected with current therapeutics atropine (50 mg/Kg) or acetylcholinesterase reactivator HI6 (3 mg/Kg). We also tested a non-specific cholinergic antagonist dequalinium chloride (2 mg/Kg) as a novel treatment for organophosphate toxicity. Electroencephalogram (EEG) recordings revealed that DFP causes focal delta frequency (average 1.4 Hz) tonic spikes in the parietal region that occur transiently (lasting an average of 171 ± 33 min) and a more sustained generalized theta frequency depression in both parietal and frontal electrode that did not recover the following 24 h. DFP also caused behavioral tremors that partially recovered the following 24 h. Using whole body plethysmography, DFP revealed acute respiratory depression, including reduced breathing rates and tidal volumes, that partially recover the following day. Among therapeutic treatments, dequalinium chloride had the most potent effect on all physiological parameters by reducing acute EEG abnormalities and promoting a full recovery after 24 h from tremors and respiratory depression. Atropine and HI6 had distinct effects on EEGs. Co-treatment with atropine converted the acute 1.4 Hz tonic spikes to 3 Hz tonic spikes in the parietal electrode and promoted a partial recovery after 24 h from theta frequency and respiratory depression. HI6 fully removed the parietal delta spike increase and promoted a full recovery in theta frequency and respiratory depression. In summary, while all anticholinergic treatments promoted survival and moderated symptoms of DFP toxicity, the non-selective anti-cholinergic dequalinium chloride had the most potent therapeutic effects in reducing EEG abnormalities, moderating tremors and reducing respiratory depression.
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Kakarla B. Bronchocele, a common but underrecognized condition: a systematic review. Monaldi Arch Chest Dis 2022; 93. [PMID: 35477240 DOI: 10.4081/monaldi.2022.2133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/13/2022] [Indexed: 01/19/2023] Open
Abstract
Bronchocele is an abnormal accumulation of mucus often with associated bronchial dilatation. It can be due to either increased production or impaired drainage of mucus in the airways. Diseases like chronic bronchitis, bronchial asthma, bronchiectasis are characterized by high mucus production and other atypical conditions are bronchorrhea and plastic bronchitis with different physical characteristics and compositions of mucus. Improper drainage can lead to bronchocele formation due to underlying benign, malignant tumours or bronchial stenosis. Allergic bronchopulmonary aspergillosis (ABPA) has a peculiar appearance with high attenuated mucus (HAM) in imaging. Careful evaluation of bronchocele is needed as it can be associated with bronchial obstruction or rare causes like plastic bronchitis. Proper identification, evaluation for the underlying cause is key for not missing the underlying diagnosis and accurate treatment.
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Affiliation(s)
- Bhaskar Kakarla
- Department of Pulmonary Medicine, Nizam's Institute of Medical Sciences, Hyderabad.
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50
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Joson MVASG, Castor FRM, Micu-Oblefias CV. Role of intravenous lipid emulsion therapy and packed red blood cell transfusion as adjuvant treatment in the management of a child with severe organophosphate poisoning (chlorpyrifos). BMJ Case Rep 2022; 15:e246381. [PMID: 35396244 PMCID: PMC8995944 DOI: 10.1136/bcr-2021-246381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 11/04/2022] Open
Abstract
A previously well 3-year-old child presented with rapidly deteriorating clinical status minutes after ingestion of an orange-coloured liquid housed in a soda bottle (HomeTrek-chlorpyrifos). She had miotic pupils, copious oral secretions, crackles on lung auscultation, hyperactive bowel sounds, impending signs of respiratory failure and declining sensorium. A diagnosis of severe organophosphate (OP) toxicity was made. Despite resuscitation and atropine administration, she deteriorated and exhibited atropine toxicity. She was given 20% intravenous lipid emulsion therapy and red blood cell (RBC) transfusion as adjunctive therapy with favourable outcome. She was discharged after 11 days and her RBC cholinesterase levels were 45% and 17% below normal, taken on day 10 and day 35 postingestion, respectively. She showed no signs of intermediate syndrome and delayed polyneuropathy. This case highlights the need for timely recognition of severe OP poisoning, and the role of lipid emulsion therapy and packed RBC transfusion as adjunctive treatment.
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Affiliation(s)
- Marquis Von Angelo Syquio G Joson
- Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Fides Roxanne M Castor
- Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Charmaine Victoria Micu-Oblefias
- National Poison Management and Control Center, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
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