Caspases as prognostic markers and mortality predictors in acute organophosphorus poisoning

Shimaa Tallat,Rania Hussien,Rania Hassan Mohamed,Mahmoud B Abd El Wahab,Magdy Mahmoud

doi:10.1186/s43141-020-00024-y

Shimaa Tallat, Rania Hussien + Show 3 more

Open Access

https://doi.org/10.1186/s43141-020-00024-y

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Abstract

BackgroundOrganophosphorus (OP) compounds have been widely available for decades in agriculture for crop protection and as cheap pest controllers, which increases the rate of exposure and poisoning cases. Using serum cholinesterase as prognostic markers for the acute OP toxicity is controversial; therefore, we aim to find out prognostic biomarkers that best correlate with mortality and outcomes of patients with acute OP toxicity. Levels of serum oxidative stress biomarkers (malondialdehyde (MDA) and total antioxidant capacity (TAC)) and activity of the apoptotic biomarkers (caspase 3 and caspase 9) and pseudo-cholinesterase (p.ChE) were performed. Also, we evaluated the apoptotic capacity through determining the genotoxic effects and chromosomal abnormalities among OP intoxicated patients. ResultsWe found the activity of caspases and serum MDA and TAC were significantly increased after OP poisoning and decreased after the appropriate atropine and oxime treatment course. The ROC curve suggested caspases as mortality and outcome predictive markers for acute OP poisoning patients. However, OP poisoning cases before treatment showed significant DNA damage, and they did not show any chromosomal aberration. ConclusionThe mentioned results strongly suggest apoptotic-related markers (caspase 3, caspase 9) as prognostic markers for evaluation of the treatment, outcomes, and mortality rate in the acute OP toxicity patients.

Highlights

Organophosphorus (OP) compounds have been widely available for decades in agriculture for crop protection and as cheap pest controllers, which increases the rate of exposure and poisoning cases
We aim to find out the prognostic biomarkers and to identify their cutoff values that best correlate with mortality of patients with acute OP toxicity
The gas chromatograph (GC) analysis of the OP compounds showed that malathion was the most common type (40%) in the studied cases, followed by diazinon (30%) and chloropyrifos (30%)

Summary

Introduction

Organophosphorus (OP) compounds have been widely available for decades in agriculture for crop protection and as cheap pest controllers, which increases the rate of exposure and poisoning cases. According to the World Health Organization (WHO), 3 × 106 cases of pesticide poisoning (mainly OP compounds) occur every year, resulting in an excess of 250,000 deaths [2]. There are 2 different types of cholinesterase in the human body, which differ according to their tissue distribution and physiological functions. These two types are acetylcholinesterase (true cholinesterase, AChE), which occurs in higher concentration in central nervous system and the outer membrane of red blood cells, in addition to the cholinesterase present in plasma, liver, cerebrospinal fluid, and glial cells (pseudo-cholinesterase, p.ChE) [4].

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