Study of acyl-peptide hydrolase as a probable marker of severity in cases of acute poisoning by cholinesterase enzyme inhibitor insecticides

Abstract

Introduction Organophosphorus poisoning is a major clinical problem worldwide, with thousands of deaths occurring every year. Objective The aim of the study was to investigate the validity of acyl-peptide hydrolase (APH) enzyme as a probable marker of severity in patients with poisoning by cholinesterase enzyme inhibitor insecticides who were admitted to the Poison Center, Alexandria Main University Hospital. Patients and methods The study was conducted on 80 cholinesterase inhibitor insecticide-poisoned patients, after taking their consent, who had been admitted to the Poison Center or the Department of Emergency Medicine at Alexandria Main University Hospital over a period of 6 months (from 1 June 2014 to 30 November 2014). Another 15 healthy volunteers were included as the control group. Results When compared with healthy controls, the activities of acetyl cholinesterase and APH were significantly decreased in the 80 cholinesterase inhibitor-poisoned patients. Conclusion The study showed that APH is an alternative reliable marker to the acetyl cholinesterase enzyme in determining the level of severity of cholinesterase enzyme inhibitor insecticide poisoning. Recommendations In addition to extensive health education, larger, controlled experimental and clinical studies are needed for further assessment of the validity of APH as a marker of severity for cholinesterase enzyme inhibitor insecticide toxicity.