Hyperamylasemia as an early predictor of mortality in patients with acute paraquat poisoning

Huang, Changbao; Bai, Lianhua; Xue, Xiang; Peng, Liangfei; Jiang, Jinghan; Zhang, Xigang

doi:10.1177/0300060520910037

Cited by 9 publications

(13 citation statements)

References 36 publications

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“…Analysis on the results of pancreatic function examinations for patients with PQ poisoning revealed that amylase level was significantly associated with mortality (P < 0:05), in that patients with higher amylase concentrations had poorer outcomes. This is consistent with the results of two recent studies [31,32]. A related investigation suggested that amylase was strongly associated with the severities of nephrotoxicity, hepatotoxicity, and pancreas injury induced by PQ [33].…”

Section: Discussionsupporting

confidence: 92%

Comparison of Biochemical Parameters between Mouse Model and Human after Paraquat Poisoning

Zhang

et al. 2022

BioMed Research International

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Background. This study was designed to investigate differences in biochemical parameters between mouse and humans after paraquat (PQ) poisoning and develop a suitable animal model for studying organ damage after PQ poisoning. The prognostic factors of PQ-poisoned patients were further analyzed. Methods. Thirty C57BL/6J mice were randomly divided into five groups (control, sham, and 3 PQ doses), and the mouse model was established by intragastric administration of PQ. Physiological indexes such as the body weight, mental state, and mortality rate were observed. Biochemical parameters were analyzed 24 h after PQ poisoning. We also performed a retrospective analysis of clinical data from 29 patients with PQ poisoning admitted to the Emergency Department of the Affiliated Hospital of Taishan Medical College between April 2016 and February 2018. Biochemical parameters were compared between the mouse model and patients with PQ poisoning. Results. In the PQ poisoning mouse model, the lethal dose group PQ360 showed remarkable increases in serum levels of potassium (K+), carbon dioxide (CO2), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) compared with the nonlethal dose PQ100 and PQ200 groups. The biochemical results of the patients showed that K+ and Cl- levels were significantly reduced in the death group compared to the survival group. Levels of ALT, AST, blood urea nitrogen (BUN), and amylase were higher, and the neutrophil-to-lymphocyte ratio (NLR) was increased in the death group compared with the survival group. Conclusions. The combination of age, PQ dosage, K+, Cl-, BUN, ALT, AST, amylase, and NLR can be used to more accurately predict the outcome of patients with PQ poisoning. C57 mice are an appropriate animal model to study liver and kidney functions following PQ exposure.

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Section: Discussionsupporting

confidence: 92%

Comparison of Biochemical Parameters between Mouse Model and Human after Paraquat Poisoning

Zhang

et al. 2022

BioMed Research International

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“…PQ poisoning by iG administration led to elevated levels of serum amylase, which is consistent with our previous research and clinical reports (Soontornniyomkij and Bunyaratvej, 1992;Wang and Qian, 2005;Gong et al, 2016). Serum amylase levels did not significantly increase in group PQ-iP compared with group NC-iP, a finding that is consistent with that of Silfeler et al The fact that the increased serum amylase levels in group PQ-iG is more significant than that in group PQ-iP can be explained as follows: 1. pancreatic damage in group PQ-iG was more severe than in group PQ-iP; 2. the increased serum amylase levels in group PQ-iG may have been caused in part by gastrointestinal damage (Liu et al, 2016;Huang et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Some clinical studies have shown elevated serum amylase levels in PQ poisoning patients, which suggests that PQ may cause pancreatic damage (Soontornniyomkij and Bunyaratvej, 1992;Wang and Qian, 2005;Gong et al, 2016). It has been shown that patients diagnosed with PQ poisoning who have elevated levels of serum amylase have a worse prognosis than other patients (Gil et al, 2009;Li et al, 2015;Huang et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…Regarding pancreatic damage, there is still a controversy in academia. Some researchers believe that PQ poisoning-induced increased amylase may be caused by gastrointestinal damage, which is not strong evidence that pancreatic damage exists (Huang et al, 2020). However, others maintain that PQ in the digestive tract may retrograde into the pancreatic duct due to causes like vomiting and gastric lavage after PQ poisoning, leading to pancreatic damage (Gong et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Pancreatic Damage in Rats for Two Methods of Paraquat Administration

et al. 2021

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It is noted that elevated serum amylase levels suggesting pancreatic damage has an association with prognosis in PQ patients. This study aimed to determine whether PQ can cause pancreatic damage. The two conventional models (intragastric infusion (iG) and intraperitoneal injection (iP)) may exhibit different effects on the pancreas depending on whether or not they pass through the digestive tract. In this study, the rats were divided into four groups: the intragastric infusion group (PQ-iG, n = 45), intraperitoneal injection group (PQ-iP, n = 53), normal control group 1 (NC-iG, n = 6) and normal control group 2 (NC-iP, n = 6). Pancreatic damage was compared between groups using serum amylase activity assay, hematoxylin and eosin (H&E) staining, TUNEL assay, and transmission electron microscopy (TEM). Serum amylase levels in group PQ-iG were significantly higher than in group PQ-iP (p < 0.05). Examination of the H&E sections showed damage to the pancreas. Both experimental groups were displayed inflammatory infiltration within 9 h of PQ treatment. After 9 h, patchy necrosis was observed in group PQ-iP, when inflammatory infiltration was still the dominant pathology. Necrosis appeared and gradually worsened in group PQ-iG, in which necrosis was the dominant pathology. The TUNEL assay showed significantly higher numbers of apoptotic cells in the pancreas of PQ-groups than in the control NC- groups (p < 0.05). TEM showed expansive endoplasmic reticulum lumens and mitochondria swelling in the pancreas of the PQ-groups. It is concluded that both methods of modeling could cause pancreatic damage and the type and degree of damage would change over time. Note that pancreatic damage in group PQ-iG was more severe than that in group PQ-iP. Therefore, clinical practitioners should pay close attention to pancreatic damage caused by PQ, especially when the route of PQ administration was oral.

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“…Studies of decades discovered that serum amylase levels depend on a balance between secretion and clearance [ 12 ]. Although recent research had identified its novel roles acting as promising diagnostic, therapeutic and prognostic biomarker applied to infection, cancer, and wound healing [ 13 – 15 ], none of previous studies with sufficient patients had evaluated the robust role of serum amylase in the COVID-19 progression. In addition, attribution elevated amylase in patients with COVID-19 to pancreatic injury is still a highly controversial issue [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Serum amylase elevation is associated with adverse clinical outcomes in patients with coronavirus disease 2019

Liu

Jin

et al. 2021

Aging

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Hyperamylasemia as an early predictor of mortality in patients with acute paraquat poisoning

Cited by 9 publications

References 36 publications

Comparison of Biochemical Parameters between Mouse Model and Human after Paraquat Poisoning

Comparison of Biochemical Parameters between Mouse Model and Human after Paraquat Poisoning

Comparison of Pancreatic Damage in Rats for Two Methods of Paraquat Administration

Serum amylase elevation is associated with adverse clinical outcomes in patients with coronavirus disease 2019

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