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Lazar S, Neufeld-Cohen A, Egoz I, Baranes S, Gez R, Glick P, Cohen M, Gutman H, Chapman S, Gore A. Efficacy of a combined anti-seizure treatment against cholinergic established status epilepticus following a sarin nerve agent insult in rats. Toxicol Appl Pharmacol 2024; 484:116870. [PMID: 38395364 DOI: 10.1016/j.taap.2024.116870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/11/2024] [Accepted: 02/19/2024] [Indexed: 02/25/2024]
Abstract
The development of refractory status epilepticus (SE) following sarin intoxication presents a therapeutic challenge. Here, we evaluated the efficacy of delayed combined double or triple treatment in reducing abnormal epileptiform seizure activity (ESA) and the ensuing long-term neuronal insult. SE was induced in rats by exposure to 1.2 LD50 sarin followed by treatment with atropine and TMB4 (TA) 1 min later. Double treatment with ketamine and midazolam or triple treatment with ketamine, midazolam and levetiracetam was administered 30 min post-exposure, and the results were compared to those of single treatment with midazolam alone or triple treatment with ketamine, midazolam, and valproate, which was previously shown to ameliorate this neurological insult. Toxicity and electrocorticogram activity were monitored during the first week, and behavioral evaluations were performed 2 weeks post-exposure, followed by biochemical and immunohistopathological analyses. Both double and triple treatment reduced mortality and enhanced weight recovery compared to TA-only treatment. Triple treatment and, to a lesser extent, double treatment significantly ameliorated the ESA duration. Compared to the TA-only or the TA+ midazolam treatment, both double and triple treatment reduced the sarin-induced increase in the neuroinflammatory marker PGE2 and the brain damage marker TSPO and decreased gliosis, astrocytosis and neuronal damage. Finally, both double and triple treatment prevented a change in behavior, as measured in the open field test. No significant difference was observed between the efficacies of the two triple treatments, and both triple combinations completely prevented brain injury (no differences from the naïve rats). Delayed double and, to a greater extent, triple treatment may serve as an efficacious delayed therapy, preventing brain insult propagation following sarin-induced refractory SE.
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Affiliation(s)
- Shlomi Lazar
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel.
| | - Adi Neufeld-Cohen
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Inbal Egoz
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Shlomi Baranes
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Rellie Gez
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Pnina Glick
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Maayan Cohen
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Hila Gutman
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Shira Chapman
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Ariel Gore
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel.
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Kadar T, Horwitz V, Cohen M, Egoz I, Gutman H, Gez R, Dachir S. Limbal stem cell deficiency (LSCD) in rats and mice following whole body exposure to sulfur mustard (SM) vapor. Exp Eye Res 2022; 223:109195. [DOI: 10.1016/j.exer.2022.109195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 11/04/2022]
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Gore A, Neufeld-Cohen A, Egoz I, Baranes S, Gez R, Efrati R, David T, Dekel Jaoui H, Yampolsky M, Grauer E, Chapman S, Lazar S. Neuroprotection by delayed triple therapy following sarin nerve agent insult in the rat. Toxicol Appl Pharmacol 2021; 419:115519. [PMID: 33823148 DOI: 10.1016/j.taap.2021.115519] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/25/2021] [Accepted: 04/01/2021] [Indexed: 02/08/2023]
Abstract
The development of refractory status epilepticus (SE) induced by sarin intoxication presents a therapeutic challenge. In our current research we evaluate the efficacy of a delayed combined triple treatment in ending the abnormal epileptiform seizure activity (ESA) and the ensuing of long-term neuronal insult. SE was induced in male Sprague-Dawley rats by exposure to 1.2LD50 sarin insufficiently treated by atropine and TMB4 (TA) 1 min later. Triple treatment of ketamine, midazolam and valproic acid was administered 30 min or 1 h post exposure and was compared to a delayed single treatment with midazolam alone. Toxicity and electrocorticogram activity were monitored during the first week and behavioral evaluation performed 3 weeks post exposure followed by brain biochemical and immunohistopathological analyses. The addition of both single and triple treatments reduced mortality and enhanced weight recovery compared to the TA-only treated group. The triple treatment also significantly minimized the duration of the ESA, reduced the sarin-induced increase in the neuroinflammatory marker PGE2, the brain damage marker TSPO, decreased the gliosis, astrocytosis and neuronal damage compared to the TA+ midazolam or only TA treated groups. Finally, the triple treatment eliminated the sarin exposed increased open field activity, as well as impairing recognition memory as seen in the other experimental groups. The delayed triple treatment may serve as an efficient therapy, which prevents brain insult propagation following sarin-induced refractory SE, even if treatment is postponed for up to 1 h.
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Affiliation(s)
- Ariel Gore
- Department of Pharmacology, Israel Institute for Biological, Chemical and Environmental Sciences, Ness-Ziona 74100, Israel.
| | - Adi Neufeld-Cohen
- Department of Pharmacology, Israel Institute for Biological, Chemical and Environmental Sciences, Ness-Ziona 74100, Israel
| | - Inbal Egoz
- Department of Pharmacology, Israel Institute for Biological, Chemical and Environmental Sciences, Ness-Ziona 74100, Israel
| | - Shlomi Baranes
- Department of Pharmacology, Israel Institute for Biological, Chemical and Environmental Sciences, Ness-Ziona 74100, Israel
| | - Rellie Gez
- Department of Pharmacology, Israel Institute for Biological, Chemical and Environmental Sciences, Ness-Ziona 74100, Israel
| | - Rahav Efrati
- Department of Pharmacology, Israel Institute for Biological, Chemical and Environmental Sciences, Ness-Ziona 74100, Israel
| | - Tse'ela David
- The Veterinary Center for Pre-clinical Research, Israel Institute for Biological, Chemical and Environmental Sciences, Ness- Ziona 74100, Israel
| | - Hani Dekel Jaoui
- The Veterinary Center for Pre-clinical Research, Israel Institute for Biological, Chemical and Environmental Sciences, Ness- Ziona 74100, Israel
| | - Michael Yampolsky
- The Veterinary Center for Pre-clinical Research, Israel Institute for Biological, Chemical and Environmental Sciences, Ness- Ziona 74100, Israel
| | - Ettie Grauer
- Department of Pharmacology, Israel Institute for Biological, Chemical and Environmental Sciences, Ness-Ziona 74100, Israel
| | - Shira Chapman
- Department of Pharmacology, Israel Institute for Biological, Chemical and Environmental Sciences, Ness-Ziona 74100, Israel
| | - Shlomi Lazar
- Department of Pharmacology, Israel Institute for Biological, Chemical and Environmental Sciences, Ness-Ziona 74100, Israel.
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Gore A, Neufeld-Cohen A, Egoz I, Baranes S, Gez R, Grauer E, Chapman S, Lazar S. Efficacy of retigabine in ameliorating the brain insult following sarin exposure in the rat. Toxicol Appl Pharmacol 2020; 395:114963. [PMID: 32209366 DOI: 10.1016/j.taap.2020.114963] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 03/17/2020] [Accepted: 03/20/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Sarin is an irreversible organophosphate cholinesterase inhibitor. Following toxic signs, an extensive long-term brain damage is often reported. Thus, we evaluated the efficacy of a novel anticonvulsant drug retigabine, a modulator of neuronal voltage gated K+ channels, as a neuroprotective agent following sarin exposure. METHODS Rats were exposed to 1 LD50 or 1.2 LD50 sarin and treated at onset of convulsions with retigabine (5 mg/kg, i.p.) alone or in combination with 5 mg/kg atropine and 7.5 mg/kg TMB-4 (TA) respectively. Brain biochemical and immunohistopathological analyses were processed 24 h and 1 week following 1 LD50 sarin exposure and at 4 weeks following exposure to 1.2 LD50 sarin. EEG activity in freely moving rats was also monitored by telemetry during the first week following exposure to 1.2 LD50 and behavior in the Open Field was evaluated 3 weeks post exposure. RESULTS Treatment with retigabine following 1 LD50 sarin exposure or in combination with TA following 1.2 LD50 exposure significantly reduced mortality rate compared to the non-treated groups. In both experiments, the retigabine treatment significantly reduced gliosis, astrocytosis and brain damage as measured by translocator protein (TSPO). Following sarin exposure the combined treatment (retigabine+ TA) significantly minimized epileptiform seizure activity. Finally, in the Open Field behavioral test the non-treated sarin group showed an increased mobility which was reversed by the combined treatment. CONCLUSIONS The M current modulator retigabine has been shown to be an effective adjunct therapy following OP induced convulsion, minimizing epileptiform seizure activity and attenuating the ensuing brain damage.
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Affiliation(s)
- Ariel Gore
- Department. of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel.
| | - Adi Neufeld-Cohen
- Department. of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Inbal Egoz
- Department. of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Shlomi Baranes
- Department. of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Rellie Gez
- Department. of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Ettie Grauer
- Department. of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Shira Chapman
- Department. of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel
| | - Shlomi Lazar
- Department. of Pharmacology, Israel Institute for Biological Research, Ness Ziona 74100, Israel.
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Blanca M, Shifrovitch A, Madmon M, Elgarisi M, Dachir S, Lazar S, Baranes S, Egoz I, Avraham M, Dekel Jaoui H, Dagan S, Weissberg A. Retrospective determination of regenerated nerve agent sarin in human blood by liquid chromatography-mass spectrometry and in vivo implementation in rabbit. Arch Toxicol 2019; 94:103-111. [PMID: 31720697 DOI: 10.1007/s00204-019-02622-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 11/06/2019] [Indexed: 02/04/2023]
Abstract
The highly toxic nerve agent sarin (o-isopropyl methyl-phosphonofluoridate, GB) has been used in several armed conflicts and terror attacks in recent decades. Due to its inherent high sensitivity, liquid chromatography-mass spectrometry (LC-MS/MS) has the potential to detect ultratrace levels of fluoride-regenerated G and V agents after appropriate chemical derivatization. A new method for the retrospective determination of exposure to sarin was developed. The method is based on sarin regeneration from blood using the fluoride-induced technique followed by derivatization with 2-[(dimethylamino)methyl]phenol (2-DMAMP) and LC-ESI-MS/MS (MRM) analysis. The validated method presents good linear response in the concentration range of 5-1000 pg/mL with a limit of quantitation (LOQ) of 5 pg/mL, 13.8% accuracy, 16.7% precision and a total recovery of 62% ± 9%. This new analytical approach has several advantages over existing GC/GC-MS-based methods in terms of sensitivity, specificity and simplicity, in addition to a short LC-MS cycle time of 12 min. The method was successfully applied in an in vivo experiment for retrospective determination of sarin in a rabbit exposed to 0.1 LD50 sarin (1.5 µg/kg, i.v.). GB-2-DMAMP was easily determined in samples drawn up to 11 days after exposure. The high S/N ratio (500) observed for the GB-2-DMAMP signal in the 11day sample poses the potential for an extended time frame of months for analysis with this new method for the retrospective detection of sarin exposure. To the best of our knowledge, this is the first report on LC-MS/MS trace analysis of regenerated GB from biological matrices.
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Affiliation(s)
- Merav Blanca
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), P.O.B. 19, Ness Ziona, Israel.
| | - Avital Shifrovitch
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), P.O.B. 19, Ness Ziona, Israel
| | - Moran Madmon
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), P.O.B. 19, Ness Ziona, Israel
| | - Maor Elgarisi
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), P.O.B. 19, Ness Ziona, Israel
| | - Shlomit Dachir
- Department of Pharmacology, Israel Institute for Biological Research (IIBR), P.O.B. 19, Ness Ziona, Israel
| | - Shlomi Lazar
- Department of Pharmacology, Israel Institute for Biological Research (IIBR), P.O.B. 19, Ness Ziona, Israel
| | - Shlomi Baranes
- Department of Pharmacology, Israel Institute for Biological Research (IIBR), P.O.B. 19, Ness Ziona, Israel
| | - Inbal Egoz
- Department of Pharmacology, Israel Institute for Biological Research (IIBR), P.O.B. 19, Ness Ziona, Israel
| | - Meir Avraham
- Veterinary Center for Preclinical Research, Israel Institute for Biological Research (IIBR), P.O.B. 19, Ness Ziona, Israel
| | - Hani Dekel Jaoui
- Veterinary Center for Preclinical Research, Israel Institute for Biological Research (IIBR), P.O.B. 19, Ness Ziona, Israel
| | - Shai Dagan
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), P.O.B. 19, Ness Ziona, Israel
| | - Avi Weissberg
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), P.O.B. 19, Ness Ziona, Israel
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Gore A, Lazar S, Yacov G, Gez R, Rabinowitz I, Nili U, Egoz I, Kadar T. Ocular surface histopathological insult following sarin and VX exposure and potential treatments in the rat model. Toxicol Lett 2019; 314:153-163. [PMID: 31408696 DOI: 10.1016/j.toxlet.2019.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/14/2019] [Accepted: 08/05/2019] [Indexed: 02/08/2023]
Abstract
Eye exposure to organophosphate (OP) chemical warfare irreversible acetylcholinesterase inhibitors, results in long-term miosis and impaired visual function. In contrast to the well-documented miotic and ciliary muscle spasm observed following chemical warfare, OP ocular exposure, little is known regarding the ocular surface histopathological insult. The aim of the present study was to determine the degree of the ocular surface insult following sarin or VX ocular exposure and to evaluate potential anti-cholinergic treatments in counteracting this insult. Rats that were whole body exposed to various sarin concentrations (0.049-43 μg/L; 5 min exposure), showed a dose-dependent miotic response and light reflex impairment. Following whole body sarin exposure, a dose dependent ocular surface histopathological insult was developed. A week following exposure to a low concentration of 0.05 μg/L, conjunctival pathology was observed, while corneal insult was noticed only following exposure to a concentration of 0.5 μg/L and above. Both tissues presented poorer outcomes when exposed to higher sarin concentrations. In contrast, eyes topically exposed to 1 μg sarin demonstrated no ocular insult a week following exposure. On the contrary, topical exposure to 1 μg VX resulted in a significant corneal insult. Anticholinergic treatments such as 0.1% atropine or 2% homatropine, given shortly following VX exposure, counteracted this insult. The results of this study show that not only do anti-cholinergic treatments counteract the miotic response, but also prevent the histopathological insult observed when given shortly following OP exposure.
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Affiliation(s)
- Ariel Gore
- Dept. Of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100, Israel.
| | - Shlomi Lazar
- Dept. Of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100, Israel
| | - Guy Yacov
- Dept. Of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100, Israel
| | - Rellie Gez
- Dept. Of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100, Israel
| | - Ishai Rabinowitz
- Dept. Of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100, Israel
| | - Uri Nili
- Dept. Of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100, Israel
| | - Inbal Egoz
- Dept. Of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100, Israel
| | - Tamar Kadar
- Dept. Of Pharmacology, Israel Institute for Biological Research, Ness Ziona, 74100, Israel
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Horwitz V, Cohen-Gihon I, Egoz I, Dachir S, Cohen M, Cohen L, Gutman H, Gez R, Kadar T, Gore A, Beth-Din A, Zvi A, Zaide G, Israeli O. A comprehensive analysis of corneal mRNA levels during sulfur mustard induced ocular late pathology in the rabbit model using RNA sequencing. Exp Eye Res 2019; 184:201-212. [DOI: 10.1016/j.exer.2019.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 04/12/2019] [Indexed: 01/21/2023]
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Bloch-Shilderman E, Yacov G, Cohen L, Egoz I, Gutman H, Gez R, Rabinovitz I, Nili U. Repetitive antidotal treatment is crucial in eliminating eye pathology, respiratory toxicity and death following whole-body VX vapor exposure in freely moving rats. Arch Toxicol 2019; 93:1365-1384. [DOI: 10.1007/s00204-019-02401-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 01/31/2019] [Indexed: 11/29/2022]
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Bloch-Shilderman E, Rabinovitz I, Egoz I, Yacov G, Allon N, Nili U. Determining a threshold sub-acute dose leading to minimal physiological alterations following prolonged exposure to the nerve agent VX in rats. Arch Toxicol 2017; 92:873-892. [DOI: 10.1007/s00204-017-2108-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/26/2017] [Indexed: 10/18/2022]
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Egoz I, Nili U, Grauer E, Gore A. Optimization of the Ocular Treatment Following Organophosphate Nerve Agent Insult. Toxicol Sci 2017; 159:50-63. [DOI: 10.1093/toxsci/kfx119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lazar S, Egoz I, Brandeis R, Chapman S, Bloch-Shilderman E, Grauer E. Propagation of damage in the rat brain following sarin exposure: Differential progression of early processes. Toxicol Appl Pharmacol 2016; 310:87-97. [DOI: 10.1016/j.taap.2016.09.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/07/2016] [Accepted: 09/12/2016] [Indexed: 02/07/2023]
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Chapman S, Yaakov G, Egoz I, Rabinovitz I, Raveh L, Kadar T, Gilat E, Grauer E. Sarin-induced brain damage in rats is attenuated by delayed administration of midazolam. Neurotoxicology 2015; 49:132-8. [PMID: 25976749 DOI: 10.1016/j.neuro.2015.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 04/28/2015] [Accepted: 05/02/2015] [Indexed: 01/27/2023]
Abstract
Sarin poisoned rats display a hyper-cholinergic activity including hypersalivation, tremors, seizures and death. Here we studied the time and dose effects of midazolam treatment following nerve agent exposure. Rats were exposed to sarin (1.2 LD50, 108 μg/kg, im), and treated 1 min later with TMB4 and atropine (TA 7.5 and 5 mg/kg, im, respectively). Midazolam was injected either at 1 min (1 mg/kg, im), or 1 h later (1 or 5 mg/kg i.m.). Cortical seizures were monitored by electrocorticogram (ECoG). At 5 weeks, rats were assessed in a water maze task, and then their brains were extracted for biochemical analysis and histological evaluation. Results revealed a time and dose dependent effects of midazolam treatment. Rats treated with TA only displayed acute signs of sarin intoxication, 29% died within 24h and the ECoG showed seizures for several hours. Animals that received midazolam within 1 min survived with only minor clinical signs but with no biochemical, behavioral, or histological sequel. Animals that lived to receive midazolam at 1h (87%) survived and the effects of the delayed administration were dose dependent. Midazolam 5 mg/kg significantly counteracted the acute signs of intoxication and the impaired behavioral performance, attenuated some of the inflammatory response with no effect on morphological damage. Midazolam 1mg/kg showed only a slight tendency to modulate the cognitive function. In addition, the delayed administration of both midazolam doses significantly attenuated ECoG compared to TA treatment only. These results suggest that following prolonged seizure, high dose midazolam is beneficial in counteracting adverse effects of sarin poisoning.
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Affiliation(s)
- Shira Chapman
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Guy Yaakov
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Inbal Egoz
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Ishai Rabinovitz
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Lily Raveh
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Tamar Kadar
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Eran Gilat
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel
| | - Ettie Grauer
- Department of Pharmacology, Israel Institute for Biological Research, Ness Ziona, Israel.
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Gore A, Brandeis R, Egoz I, Turetz J, Nili U, Grauer E, Bloch-Shilderman E. Synergism Between Anticholinergic and Oxime Treatments Against Sarin-Induced Ocular Insult in Rats. Toxicol Sci 2015; 146:301-10. [DOI: 10.1093/toxsci/kfv092] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gore A, Bloch-Shilderman E, Egoz I, Turetz J, Brandeis R. Efficacy assessment of a combined anticholinergic and oxime treatment against topical sarin-induced miosis and visual impairment in rats. Br J Pharmacol 2014; 171:2364-74. [PMID: 24428128 DOI: 10.1111/bph.12586] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 12/23/2013] [Accepted: 01/06/2014] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND AND PURPOSE Eye exposure to the organophosphorus (OP) irreversible cholinesterase inhibitor sarin results in long-term miosis and impaired visual function. We have previously shown that tropicamide is better at ameliorating this insult than topical atropine or cyclopentolate. However, to minimize side effects associated with repeated tropicamide applications and high treatment doses, we evaluated the effects of oximes (ChE re-activators) alone and combined with tropicamide at ameliorating OP-induced ocular impairments. EXPERIMENTAL APPROACH Rats were topically exposed to sarin, followed by topical treatment with various oximes alone or in combination with tropicamide. Pupil width and light reflex were measured by an infrared-based digital photograph system, while visual performance was assessed by employing the cueing version of the Morris water maze (MWM). KEY RESULTS Oxime treatment following sarin ocular exposure induced a slow persistent pupil widening with efficacy in the order of HLö-7 > HI-6 > obidoxime = TMB-4 = MMB-4. In the light reflex test, the ability of the iris to contract following oxime treatment was mostly impaired at 1 h and was back to normal at 4 h following sarin exposure. All oxime treatments ameliorated the sarin-induced visual impairment as tested in the visual task (MWM). The combined topical treatment of tropicamide with an oxime induced a rapid improvement in pupil widening, light reflex and visual performance, and enabled a reduction in tropicamide dose. CONCLUSIONS AND IMPLICATIONS The use of tropicamide combined with an oxime should be considered as the topical treatment of choice against the toxic effects of ocular OP exposure.
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Affiliation(s)
- A Gore
- Department of Pharmacology, Israel Institute for Biological Research, Ness-Ziona, Israel
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Gore A, Brandeis R, Egoz I, Peri D, Turetz J, Bloch-Shilderman E. Efficacy Assessment of Various Anticholinergic Agents Against Topical Sarin-Induced Miosis and Visual Impairment in Rats. Toxicol Sci 2012; 126:515-24. [DOI: 10.1093/toxsci/kfs009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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16
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Bloch-Shilderman E, Rabinovitz I, Egoz I, Raveh L, Allon N, Grauer E, Gilat E, Weissman BA. Subchronic exposure to low-doses of the nerve agent VX: Physiological, behavioral, histopathological and neurochemical studies. Toxicol Appl Pharmacol 2008; 231:17-23. [DOI: 10.1016/j.taap.2008.03.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Revised: 03/19/2008] [Accepted: 03/31/2008] [Indexed: 11/25/2022]
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Eisenkraft A, Gilat E, Chapman S, Baranes S, Egoz I, Levy A. Efficacy of the bone injection gun in the treatment of organophosphate poisoning. Biopharm Drug Dispos 2007; 28:145-50. [PMID: 17315239 DOI: 10.1002/bdd.541] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Immediate administration of antidotal treatment is crucial in severe organophosphate (OP) poisoning and the use of an open intravenous (i.v.) line might also be required. The state of casualties might prevent getting access to their veins. The bone injection gun (BIG) was established as a simple method for introducing an intraosseous (i.o.) line and could be applied while wearing a protective suit. The present study followed the pharmacokinetics of the anticonvulsive drug midazolam after i.o. administration in pigs compared with i.v. and the common intramuscular (i.m.) administration. A new method for monitoring midazolam concentrations in plasma was developed. Plasma concentrations following both i.v. and i.o. administrations peaked at 2 min post injection and only at 10 min following the i.m. route. In an antidotal treatment study against paraoxone poisoning, the anticonvulsive effect of midazolam appeared immediately following i.o. administration, while it took 5-10 min to exhibit a similar effect following i.m. administration. This study indicates that the use of i.o. administration after OP poisoning might provide the necessary fast response for rapid termination of convulsions. The BIG might offer a convenient method for treating casualties in the chemical arena by teams wearing full protective gear.
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Affiliation(s)
- Arik Eisenkraft
- CBRN Medical Branch, Medical Corps, Israel Defense Force, Israel.
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