Oxidative stress has recently been implicated as a factor in the mortality and morbidity induced by organophosphorus (OP) compound poisoning. An overwhelming number of research papers are based on studying at the cellular and organ level. Such studies have concluded that antioxidants can be used as an adjunct compound in the treatment of both chronic as well as acute OP poisoning. Still, the role of antioxidants in reducing the mortality and morbidity induced by OP compounds has scarcely been verifi ed, as well as their role as adjunct treatment compounds for both structurally and functionally different OP compounds. The present review of the literature was undertaken to establish the role of antioxidants in survival studies following acute exposure to OP compounds. The review found no substantial evidence that antioxidants demonstrate any positive effect following extremely toxic poisoning. However, for a more comprehensive and rational conclusion, further research needs to be conducted. Nurulain SM et al. ANTIOXIDANTS AND ORGANOPHOSPHORUS POISONING Arh Hig Rada Toksikol 2013;64:169-177
KEY WORDS: acute poisoning, oxidative stress, survival study
Intoxication by organophosphorus compoundsThe history of organophosphorus compounds (OP) and their poisonous effect stretches throughout more than a century. These compounds manifest their toxicity by irreversibly inhibiting the enzyme acetylcholinesterase at the nerve synapse. Despite decades-long research, mortality caused by acute OP poisoning continues to be high (1), while no new standard therapies are being introduced. There are over 150 different types of synthesized OPs, though their generalized structure is much the same. Each OP has a unique profile of toxicity and behaviour. For instance, death due to dichlorvos poisoning occurs very rapidly, while dimethoate toxicity takes several hours to develop (2), even though both belong to the same OP class. From the standpoint of chemistry, OP c o m p o u n d s c o m p r i s e o rg a n o p h o s p h a t e s , organophosphonates and organophosphinates, each of which is further divided into sub-groups. Other classifi cations of OPs are based on the lethality of a compound. According to the classifi cation of the World Health Organisation (WHO) (3), Class Ia belongs to extremely toxic OPs, Ib are highly toxic, Class II comprises moderately toxic, whereas Class III consists of mildly toxic OP compounds. Some examples are shown in Table 1. In addition, there are also the deadly organophosphorus chemical weapons (OPWs), called nerve agents.Acute organophosphate insecticide poisoning manifests itself through three different phases of toxicity; namely, acute cholinergic crisis, which occurs from within a few minutes to twenty-four hours;Brought to you by |