Paraoxonase 1 gene polymorphism and enzymatic activity as a prognostic marker in cases of poisoning by cholinesterase inhibitor pesticides among Egyptians

Darwish, Ragaa; Megahed, Haidy; Attia, MennattAllah Hassan; Elneily, Dalia

doi:10.21608/ajfm.2017.18282

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…The higher percentage of suicidal ingestion of organophosphorus compounds (OPC) could be attributed to the low-price, easy availability, stressful lifestyle and jobs, loneliness, emotional liability in addition to, the lack of adequate regulations controlling their sale. They usually ingested a large amount, which can lead to rapid onset of the clinical features and complicating the management (Darwish et al, 2017 andKumar et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Role of Paraoxonase-1 Enzyme in Prediction of Severity and Outcome of Acute Organophosphorus Poisoning: A Prospective Study

Alí

El-Shafey

Eldin

et al. 2022

Zagazig Journal of Forensic Medicine

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Background: Human serum paraoxonase-1 (PON-1) hydrolyzes organophosphate compounds (OPC) and so significantly alters an individual's susceptibility to the toxicity of these chemicals. Aim: The study was designed to assess the serum PON-1 activity in patients with OPC poisoning and to correlate its level with the severity and outcome of acutely organophosphate poisoned patients. Patients and methods: This was a prospective clinical study that was performed at Benha Poison Treatment and Toxicological Research Unit (BPTTRU), Benha University Hospitals, Egypt, for one year, from 1 August 2020 till 31 July 2021. Patients were divided into case and control groups. Socio-demographic information of patients, clinical findings, treatments given, length of hospital stay and outcome were collected into datasheets. Patients were classified according to degree of toxicity according to Peradeniya Organophosphorus Poisoning (POP) scale. Blood samples were collected from patients to assess pseudocholiesterase and PON-1 activities. Results: Reduction of serum pseudocholinesterase and paraoxonase-1 (PON-1) activities in poisoned patients and patients can be graded according to (POP) scale into: mild, moderate and severe cases. In conclusion: This study concluded that serum paraoxonase-1 (PON-1) activity was significantly lower in patients with severe organophosphorus compounds (OPC) poisoning as compared to patients with moderate poisoning. Lower PON-1 activity was significantly associated with lower serum cholinesterase and poorer outcomes. PON-1 activity may be considered as an indicator of prognosis in OPC poisoning.

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Section: Discussionmentioning

confidence: 99%

Role of Paraoxonase-1 Enzyme in Prediction of Severity and Outcome of Acute Organophosphorus Poisoning: A Prospective Study

Alí

El-Shafey

Eldin

et al. 2022

Zagazig Journal of Forensic Medicine

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Albuterol as an adjuvant in acute anticholinesterase pesticide poisoning: a randomized, placebo-controlled clinical trial

Zein-Elabdeen,

Hassan,

El-Ebiary

et al. 2024

Toxicology Research

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Acute anticholinesterase pesticide poisoning is a serious clinical problem, particularly in developing countries. Atropine is the most acceptable treatment for acute anticholinesterase poisoning. However, it only stops fluid production. Albuterol is a beta-2 receptor agonist that can increase fluid removal and speed the return of effective oxygen exchange. This study aims to evaluate the safety and efficacy of nebulized albuterol as an adjuvant therapy in patients with acute anticholinesterase poisoning. This stratified block randomized, single-blinded, placebo-controlled, parallel-group clinical trial was conducted between November 2020 and October 2021. It enrolled 80 patients with acute anticholinesterase pesticide poisoning who were admitted to Tanta University Poison Control Center. Patients were allocated into two groups (40 patients each). The strata were based on the severity of poisoning (moderate and severe). Patients in group I received 10 mg of nebulized albuterol. Group II received an equivalent volume of nebulized normal saline. Additionally, standard treatment was provided to both groups. Outcomes included oxygenation, mortality, need for endotracheal intubation and mechanical ventilation, hospital stay duration, time to atropinization, and total doses of atropine and oxime. We found insignificant differences in sociodemographics, exposure characteristics, clinical manifestations, or routine laboratory tests between the studied groups. The median values of oxygen saturation by pulse oximetry were 99% in the albuterol moderate toxicity group and 98% in the control moderate toxicity group. Albuterol significantly improved oxygen saturation in moderate intoxicated patients (P = 0.039). Therefore, nebulized albuterol is a safe drug. Moreover, it may improve oxygenation in acute anticholinesterase pesticide poisoning.

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Prognostic Value of Insecticide Type and Enzymatic Activities on Severity of Acute Insecticides Poisoning

El-moneim

Al-Maghraby

Abd-El-hameed

et al. 2019

The Egyptian Journal of Forensic Sciences and Applied Toxicolog

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Background: Insecticides poisoning is a major problem worldwide, especially in developing countries. The most extensively utilized types are pseudocholinesterase (PChE) inhibitors, predominantly organophosphorus compounds and carbamates. They are metabolized by microsomal oxidases to oxygen analogues, which are active neurotoxic metabolites. These oxygen analogues are further hydrolyzed by the serum arylesterase; paraoxonase (PON1), which appears to play a pivotal role in their detoxification. Objectives: This study aimed to 1-Identification and quantitation of common insecticides in acutely poisoned patients presented to Assiut University hospitals. 2-Detection of paraoxonase and cholinesterase levels in poisoned patients. 3-Evaluate the prognostic value of pesticide type and enzymes level in relation to the severity of insecticidal poisoning. Methods: This casecontrol study was conducted on 50 patients who have been admitted to the Emergency Unit and Intensive Care Units in Assiut University Hospitals along with 50 controls. Age, residence and sex were matched. History and clinical data and other related laboratory investigations were gathered for each patient. Blood plasma samples (5ml) were collected from patients on admission alongside controls then analyzed for level of pseudocholinesterase (PChE) and paraoxonase (PON1) enzymes activity by a spectrophotometer. The insecticide types were identified using Gas Chromatography/Mass spectrometry (GC-MS). Results: The patients were mostly males, of young age group and residing in rural areas. The mode of poisoning was mainly accidental by oral route (66%). Tachycardia, tachypnea and hypotension were most commonly presenting muscarinic signs. The detected insecticides were mainly of the organophosphate types specifically malathion. A highly significant decrease in PChE and PON1 level were detected in patients compared to controls that the decline in their levels was also significantly associated with the severity of acute poisoning. A positive correlation was also observed between PChE and PON1 levels. Conclusion: the present study identified more than one type of pesticides mainly of organophosphate category among acutely poisoned patients. Furthermore, it pointed to those persons with higher paraoxonase activity and less cholinesterase inhibition may have a better chance of toxic effects amelioration.

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Paraoxonase 1 gene polymorphism and enzymatic activity as a prognostic marker in cases of poisoning by cholinesterase inhibitor pesticides among Egyptians

Cited by 3 publications

References 24 publications

Role of Paraoxonase-1 Enzyme in Prediction of Severity and Outcome of Acute Organophosphorus Poisoning: A Prospective Study

Role of Paraoxonase-1 Enzyme in Prediction of Severity and Outcome of Acute Organophosphorus Poisoning: A Prospective Study

Albuterol as an adjuvant in acute anticholinesterase pesticide poisoning: a randomized, placebo-controlled clinical trial

Prognostic Value of Insecticide Type and Enzymatic Activities on Severity of Acute Insecticides Poisoning

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