Lymphocyte and its CD4+ and CD8+ subgroup changes after paraquat poisoning

Abstract

<jats:sec><jats:title>Objective:</jats:title><jats:p> Paraquat (PQ) poisoning is a significant cause of mortality and morbidity in developing countries. Poor prognostic outcomes have been attributed to the herbicide’s toxicity and the lack of effective treatments. Our study aims to investigate the changes in lymphocyte count in both patients who survived and died from PQ poisoning and explore the prognostic value. </jats:p></jats:sec><jats:sec><jats:title>Method:</jats:title><jats:p> This is a retrospective case serials observational study. Adult patients admitted with acute PQ poisoning. The notes of 1000 patients who presented with acute PQ poisoning were reviewed. One hundred thirty patients having the T lymphocyte met the inclusion criteria and were grouped into those that survived the poisoning (95) and non-survivors (35). </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> On admission, non-survivors had a higher ingestion volume of PQ and urine PQ concentration as well as higher severity indices (Acute Physiology and Chronic Health Evaluation 2, Sequential Organ Failure Assessment, and Poisoning Severity Score). Patients in the survival group had a higher dosage of immunosuppressant and a longer hospital stay. Leukocytes, especially neutrophils, were higher among non-survivors; however, the converse was found with lymphocytes. T lymphocyte (CD3) count was consistently higher among survivors as well as the subgroups CD4+ and CD8+. No differences in the ratio of CD4/CD8 were found between the groups. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Our study has shown that changes in lymphocyte count as its subgroups could indicate a host’s immune status and lymphocytes play an important role as a surrogate marker of host immunity, which could be a useful prognostic tool in the assessment of this disease. </jats:p></jats:sec>

To substantiation of the list of hazardous highly toxic chemicals that are subject to special control regarding handling, storage, use and disposal. Part III (bipyridyl herbicides paraquat and diquat)

“…An unfavourable consequence of paraquat poisoning is predicted when taking large doses of a concentrate or solutions with a significant amount of it orally, if a high content of the herbicide in blood plasma and urine is determined, as well as in the case of early development of multiple organ failure and severe alveolitis [1-9, 18,40]. Analysing 130 clinical observations of acute paraquat poisoning, of which 35 (26,8%) were fatal, it was found that an important indicator for such a prognosis is also the severity of immunity disorders, including changes in the number of CD4 + and CD8 + lymphocytes [46].…”

До Обґрунтування Переліку Небезпечних Високотоксичних Хімічних Речовин, Які Підлягають Особливому Контролю Щодо Обігу, Зберігання, Використання Та Утилізації. Частина ІІІ (Дипіридилові Гербіциди Паракват І Дикват)

“…Несприятливий наслідок при отруєнні паракватом прогнозується при пероральному прийомі великих доз його концентрату або розчинів із значним його вмістом, якщо визначено високий вміст гербіциду у плазмі крові та сечі, а також у разі раннього розвитку поліорганної недостатності та вираженого альвеоліту [1-9, 18, 40]. Аналізуючи 130 клінічних спостережень гострого отруєння паракватом, з яких 35 (26,8%) завершилися летально, встановлено: важливим показником для такого прогнозу також є ступінь вираженості порушення імунітету, в тому числі зміна числа СД4 + і СД8 + лімфоцитів [46].…”