Pulmonary histopathology in fatal paraquat poisoning

Kumar, Surendra; Gupta, Shikha; Bansal, Yogender Singh; Bal, Amanjit; Rastogi, Pulkit; Muthu, Valliappan; Arora, V

doi:10.4322/acr.2021.342

Cited by 10 publications

(3 citation statements)

References 23 publications

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“…Macroscopic and microscopic autopsy findings in the lungs of those who died within the first 24 h after hospitalization were characterized by interstitial edema and hemorrhage in lungs [ 70 ] and tubular degeneration in the kidney (acute tubular necrosis); also, in those who died later after OP poisoning [ 75 , 76 , 77 , 78 , 79 , 80 ], the findings mostly resemble those observed in people who died of acute respiratory distress syndrome (ARDS) [ 81 , 82 ] of different causes, including viral infections of the upper respiratory tract [ 83 , 84 , 85 , 86 ] and also paraquat intoxication [ 87 ]. Similar histopathological (microscopic) changes can be induced in minipigs by bronchoscopic instillation of gastric juice containing OP (40% dimethoate 0.5 mL/kg) into the lung [ 88 ], simulating aspiration of gastric content, as may happen after ingestion of the insecticide mostly with suicidal intention.…”

Section: Organophosphorus Compounds As Insecticides and As Nerve Agentsmentioning

confidence: 99%

Organophosphorus Poisoning: Acute Respiratory Distress Syndrome (ARDS) and Cardiac Failure as Cause of Death in Hospitalized Patients

Ramadori

2023

IJMS

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Industrial production of food for animals and humans needs increasing amounts of pesticides, especially of organophosphates, which are now easily available worldwide. More than 3 million cases of acute severe poisoning are estimated to occur worldwide every year, and even more cases remain unreported, while 200,000–350,000 incidentally or intentionally poisoned people die every year. Diagnostic and therapeutic procedures in organophosphate poisoning have, however, remained unchanged. In addition to several neurologic symptoms (miosis, fasciculations), hypersecretion of salivary, bronchial, and sweat glands, vomiting, diarrhea, and loss of urine rapidly induce dehydration, hypovolemia, loss of conscience and respiratory distress. Within hours, signs of acidosis due to systemic hypoxia can be observed at first laboratory investigation after hospitalization. While determination of serum-cholinesterase does not have any diagnostic value, it has been established that hypoalbuminemia alone or accompanied by an increase in creatinine, lactate, or C-reactive protein serum levels has negative prognostic value. Increased serum levels of C-reactive protein are a sign of systemic ischemia. Protective mechanical ventilation should be avoided, if possible. In fact, acute respiratory distress syndrome characterized by congestion and increased weight of the lung, accompanied by heart failure, may become the cause of death. As the excess of acetylcholine at the neuronal level can persist for weeks until enough newly, locally synthesized acetylcholinesterase becomes available (the value of oximes in reducing this time is still under debate), after atropine administration, intravenous albumin and fluid infusion should be the first therapeutic interventions to reestablish normal blood volume and normal tissue oxygenation, avoiding death by cardiac arrest.

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Section: Organophosphorus Compounds As Insecticides and As Nerve Agentsmentioning

confidence: 99%

Organophosphorus Poisoning: Acute Respiratory Distress Syndrome (ARDS) and Cardiac Failure as Cause of Death in Hospitalized Patients

Ramadori

2023

IJMS

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“…Due to the continuous occurrence of paraquat poisoning, researchers in various countries have conducted numerous clinical and basic studies. Studies on the mechanism of paraquat poisoning and damage have revealed that oxidative stress, such as the generation of reactive oxygen species (ROS) and other immune stimulatory effects released in large quantities, is associated with paraquat poisoning and damage, leading to tissue damage and intracellular calcium overload [8][9][10]. Many researchers have studied the early lesions of paraquat poisoning and have determined that early diagnosis and treatment are key factors in saving patients with paraquat poisoning [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Construction of prognosis prediction model and visualization system of acute paraquat poisoning based on improved machine learning model

Li,

Han,

Zhang

et al. 2024

Preprint

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Objective: This study aims to develop a prognosis prediction model and visualization system for acute paraquat poisoning based on an improved machine learning model. Methods: A total of 101 patients with acute paraquat poisoning admitted to 6 hospitals from March 2020 to March 2022 were selected for this study. The patients were divided into two groups, the survival group (n=37) and the death group (n=64), based on treatment results. The biochemical indexes of the patients were analyzed, and a prognosis prediction model for acute paraquat poisoning was constructed using HHO-XGBoost, an improved machine learning algorithm. Multivariate logistic analysis was used to verify the value of the self-screening features in the model. Results: Seven features were selected in the HHO-XGBoost model, including oral dose, serum creatinine, alanine aminotransferase (ALT), white blood cell (WBC) count, neutrophil count, urea nitrogen level, and thrombin time. Univariate analysis showed statistically significant differences between the survival group and death group for these features (P<0.05). Multivariate logistic analysis identified four features that were significantly associated with prognosis-serum creatinine level, oral dose, ALT level, and WBC count - indicating their critical significance in predicting outcomes. Conclusion: The HHO-XGBoost model based on machine learning is highly valuable in constructing a prognosis prediction model and visualization system for acute paraquat poisoning, which can provide important help for clinical prognosis prediction of patients with paraquat poisoning.

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“…Paraquat [1,1′-dimethyl-4,4′-bipyridinium dichloride (PQ)], as one of the widely used broad-spectrum cationic herbicides, 1 – 3 has been associated with a variety of toxicities, including pulmonary, 4 neuro-, 5 and nephrotoxicity. 6 Experimental and epidemiological studies have shown that PQ is closely related to Parkinson’s disease (PD) risk.…”

Section: Introductionmentioning

confidence: 99%

Role of OCT3 and DRP1 in the Transport of Paraquat in Astrocytes: A Mouse Study

Han

Feng

Guo

et al. 2022

Environ Health Perspect

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Background: Paraquat (PQ) is a pesticide, exposure to which has been associated with an increased risk of Parkinson’s disease; however, PQ transport mechanisms in the brain are still unclear. Our previous studies indicated that the organic cation transporter 3 (OCT3) expressed on astrocytes could uptake PQ and protect the dopaminergic (DA) neurons from a higher level of extracellular PQ. At present, it is unknown how OCT3 levels are altered during chronic PQ exposure or aging, nor is it clear how the compensatory mechanisms are triggered by OCT3 deficiency. Dynamic related protein 1 (DRP1) was previously reported to ameliorate the loss of neurons during Parkinson’s disease. Nowadays, mounting studies have revealed the functions of astrocyte DRP1, prompting us to hypothesize that DRP1 could regulate the PQ transport capacity of astrocytes. Objectives: The present study aimed to further explore PQ transport mechanisms in the nigrostriatal system and identify pathways involved in extracellular PQ clearance. Methods: Models of PQ-induced neurodegeneration were established by intraperitoneal (i.p.) injection of PQ in wild-type (WT) and organic cation transporter-3–deficient ( ) mice. DRP1 knockdown was achieved by viral tools in vivo and small interfering RNA (siRNA) in vitro . Extracellular PQ was detected by in vivo microdialysis. In vitro transport assays were used to directly observe the functions of different transporters. PQ-induced neurotoxicity was evaluated by tyrosine hydroxylase immunohistochemistry, in vivo microdialysis for striatal DA and behavior tests. Western blotting analysis or immunofluorescence was used to evaluate the expression levels and locations of proteins in vitro or in vivo . Results: Older mice and those chronically exposed to PQ had a lower expression of brain OCT3 and, following exposure to a i.p. loading dose, a higher concentration of extracellular PQ. DRP1 levels were higher in astrocytes and neurons of WT and mice after chronic exposure to PQ; this was supported by finding higher levels of DRP1 after PQ treatment of dopamine transporter-expressing neurons with and without OCT3 inhibition and in primary astrocytes of WT and mice. Selective astrocyte DRP1 knockdown ameliorated the neurotoxicity in mice but not in WT mice. GL261 astrocytes with siRNA-mediated DRP1 knockdown had a higher expression of alanine–serine–cysteine transporter 2 (ASCT2), and transport studies suggest that extracellular PQ was transported into astrocytes by ASCT2 when OCT3 was absent. Discussion: The present study mainly focused on the transport mechanisms of PQ between the dopaminergi...

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Pulmonary histopathology in fatal paraquat poisoning

Cited by 10 publications

References 23 publications

Organophosphorus Poisoning: Acute Respiratory Distress Syndrome (ARDS) and Cardiac Failure as Cause of Death in Hospitalized Patients

Organophosphorus Poisoning: Acute Respiratory Distress Syndrome (ARDS) and Cardiac Failure as Cause of Death in Hospitalized Patients

Construction of prognosis prediction model and visualization system of acute paraquat poisoning based on improved machine learning model

Role of OCT3 and DRP1 in the Transport of Paraquat in Astrocytes: A Mouse Study

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