Dihydroxyacetone as a definitive treatment for aluminium phosphide poisoning in rats

Abstract

Aluminium phosphide (AlP), a very toxic pesticide also known as the rice tablet, releases phosphine gas upon contact with water, moisture, or gastric acid. Its mortality rate in humans is 70-100 % due to cardiogenic shock and refractory hypotension. Dihydroxyacetone (DHA) is a simple ketonic carbohydrate, mainly used for sunless skin tanning. It also plays a beneficial role in the treatment of hypotension and cardiogenic shock by restoring blood volume and cellular respiration. The aim of this study was to investigate the its effect on the haemodynamics and electrocardiogram (ECG) in male rats poisoned with AlP. The animals were divided into the following groups: control (received 1 mL corn oil, orally), AlP (received 15 mg kg-1 AlP solved in corn oil, orally), AlP plus DHA (treated with 50 mg kg-1 of DHA 30 min after receiving AlP), and AlP plus N-acetyl cysteine (NAC) (treated with 200 mg kg-1 of NAC 30 min after receiving AlP). The animals were then anaesthetised and ECG, blood pressure, and heart rate were recorded for 120 min. Treatment with AlP alone and in combination with NAC was associated with progressive hypotension, tachycardia, and ECG disturbances in rats, resulting in 100 % mortality 3 h after poisoning. However, DHA achieved 100 % survival in the poisoned rats and prevented AlP-induced ECG and haemodynamic abnormalities. The main mechanism of DHA in the treatment of AlP poisoning is unclear, but the findings suggest the promising therapeutic potential of DHA against AlP poisoning.

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“…The median weight in our series was 70 kilograms (IQR 63-84). The medians for vital signs recorded in the ED were the following: temperature of 100.2º Fahrenheit (IQR 98.6-102.6); Clinical Practice and Cases in Emergency Medicine [64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79]. Three (43%; 95% CI, 9-81) patients had documented fever in the ED.…”

Adjuvant potential of selegiline in treating acute toxicity of aluminium phosphide in rats

“…In our study, AlP exposure did not elevate ST segment, but selegiline treatment declined ST segment at 90‐120 minutes in AlP‐treated rats (Table ). Previous reports showed that AlP‐induced elevation in ST is correlated with mortality, and lowering ST segment has good prognosis . However, a previous study on patients with Parkinson's disease showed that selegiline treatment was not concomitant with a change in QT interval, even in patients with ventricular tachycardia …”

“…Previous reports showed that AlP-induced elevation in ST is correlated with mortality, and lowering ST segment has good prognosis. 48,52 However, a previous study on patients with Parkinson's disease showed that selegiline treatment was not concomitant with a change in QT interval, even in patients with ventricular tachycardia. 53 Our results showed that AlP poisoning is associated with pathological consequences in the duodenum and stomach tissues of rats such as congestive vessels, dilation and hyperaemia in stomach, and dilated crypts and inflammatory cells in some areas of duodenum.…”

Successful treatment of aluminium phosphide poisoning by dihydroxyacetone: A two‐case report study

“…It has been demonstrated that dihydroxyacetone (DHA) as a simple carbohydrate can overcome hypovolemic hypotension 17 and can reduce toxicity of PH3 in HepG2 cells by increasing ATP production 7 . In another study, it has been shown that a single dose of DHA completely prevented the death caused by AlP poisoning in rats through improving blood pressure and heart rate 18 …”

“…It has been shown that DHA normalized blood pressure and heart rate in AlP poisoning in rats 18 which might be through activation of cytochrome C oxidase, tissue oxygenation improvement and recovery of blood volume 17,37,38 . DHA reacts with nitrogen group of amino acids in corneocytes in the upper layers of the stratum corneum and is used as an ingredient in tanning products 21,39,40 .…”