Surfactant toxicity in a case of (4-chloro-2-methylphenoxy) acetic acid herbicide intoxication

Hwang, In Chul; Lee, J W; Kim, J S; Gil, Hyo‐Wook; Song, Ho‐Yeon; Hong, Sae‐Yong

doi:10.1177/0960327114559612

Cited by 6 publications

(5 citation statements)

References 38 publications

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“…In conclusion, the current in vitro experiments, in conjunction with previous reports regarding NP-40 toxicity, [ 8 , 16 , 17 , 18 ] suggest that NP-40 is a strong candidate for the chemical responsible for the irreversible hepatic injury, accompanied by intracytoplasmic and intracanalicular cholestasis, in a patient who ingested an iminoctadine fungicide.…”

Section: Discussionsupporting

confidence: 68%

“…We have previously performed a number of studies investigating the roles of surfactants in pesticide intoxication. [ 8 , 16 ] These studies revealed that surfactants stimulate cell damage in a variety of ways, including breaking down the cell membrane, altering metabolic and mitochondrial activity, disrupting protein synthesis, and facilitating mitochondrial damage-induced apoptosis and necrosis. [ 17 ] A study has shown that NP-40 induces gene expression changes leading to genotoxicity and activates genes involved in the cell death (necrosis signaling) pathway.…”

Section: Discussionmentioning

confidence: 99%

“…In some cases, the toxicity of the additives may be greater than that of the active ingredient. [ 8 , 9 ]…”

Section: Introductionmentioning

confidence: 99%

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Human cholestatic hepatitis owing to polyoxyethylene nonylphenol ingestion

Min

Han²,

Kim³

et al. 2017

Medicine

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Rationale:The purpose of this study was to identify the chemical responsible for cholestatic hepatitis in a 55-year-old woman who ingested 1,1′-iminodi (octamethylene) diguanidinium triacetate (iminoctadine triacetate), a fungicide. The fungicide formulation was also composed of polyoxyethylene nonylphenol (NP-40) and methanol.Patient concerns:Severe cholestatic hepatitis developed, which led to the patient's death on day 88 of hospitalization. Post-mortem necropsy of the liver showed focal hepatocyte necrosis involving mostly the mid-zone, along with intracytoplasmic and intracanalicular cholestasis.Diagnoses:To identify the chemical responsible for hepatic injury, the cellular toxicity of all chemicals in the fungicide formulation was assessed in HepG2 cells using the 3-(4,5-dimethylthiaxol-2yl)-2, 5-diphenyl tetrazolium bromide test.Outcomes:Viability of cells treated with the surfactant NP-40 was significantly lower (P < .001), but that of cells treated with other components of the fungicide, including the active ingredient, iminoctadine triacetate, was unaffected. Fluorescence-activated cell sorting analysis confirmed that necrosis was induced in HepG2 cells treated with 25–80 μM of NP-40, while significant numbers of apoptotic cells were not detected.Lessons:NP-40 appears to be the chemical responsible for the patient's irreversible hepatic injury, accompanied by intracytoplasmic and intracanalicular cholestasis.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Human cholestatic hepatitis owing to polyoxyethylene nonylphenol ingestion

Min

Han²,

Kim³

et al. 2017

Medicine

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“…Substantial evidence from in vitro experiments [7][8][9] and in vivo observations [1,9,10] supports the possible toxicity of surfactants to humans. However, there is no direct evidence of surfactant-mediated toxicity in humans, even in patients who ingested undiluted pesticides containing surfactants.…”

Section: Discussionmentioning

confidence: 95%

Dialyzability of Surfactants Commonly Used in Pesticide Formulations

Lee¹,

Park²

2016

J Clinic Toxicol

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Objective: This study aimed to determine the dialyzability of common pesticide surfactants. Methods:Hemodialysis and hemoperfusion were performed for three surfactants-sodium dodecylbenzenesulfonate, lignosulfonic acid sodium, and naphthalenesulfonic acid polymer with formaldehyde-with buffer solutions (2 L) containing 0.2% surfactant with or without bovine serum albumin (3.0 g/dL). Results:The dialyzability of sodium dodecylbenzenesulfonate during hemodialysis was high and increased with ultrafiltration. The final reduction rates of naphthalene sulfonic acid polymer with formaldehyde and sodium dodecylbenzenesulfonate in bovine serum albumin were higher for hemoperfusion (25.8% and 26.8%, respectively) than for hemodialysis (8.2% and 0%, respectively). In contrast, the final reduction rate of lignosulfonic acid sodium in bovine serum albumin was higher for hemodialysis (37.5%) than for hemoperfusion (13.2%). Conclusion:Our results suggest that extracorporeal elimination may be an effective treatment modality in patients who ingested surfactant mixed pesticides. However, the dialysis method looks likely to be tailored to each surfactant, based on its dialyzability.

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“…Sometimes toxicity of the additives is greater than that of the main ingredient [4,5] . Therefore, a treatment modality for acute pesticide intoxication that focuses on all the chemicals in the pesticide formulation should be developed.…”

mentioning

confidence: 99%

Concurrent Hemoperfusion and Hemodialysis in Patients with Acute Pesticide Intoxication

et al. 2016

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Background: Water soluble and insoluble chemicals in the pesticide formulation may be eliminated more effectively in time if hemodialysis (HD) and hemoperfusion (HP) are performed concurrently. Aim: This study is aimed at evaluating the efficacy of concurrent HP and HD in patients with acute pesticide intoxication. Methods: Between January 2011 and December 2012, we used HP and HD consecutively (HP-HD group, 347 cases), and then during the next 2 years (January 2013 to December 2014), we used concurrent HP and HD (HPD group, 383 cases). We compared the clinical outcomes between the 2 groups. Results: The mortality was higher in the HP-HD group than in the HPD group: (48.1 vs. 20.9%) for the overall mortality and (81.8 vs. 57.9%) for the paraquat (bipyridylium) mortality (p < 0.001). In multiple logistic analyses, age (p = 0.013), ingested volume (p < 0.001), and HP-HD (p = 0.014) were significant risk factors for mortality in the paraquat ingested group. Conclusion: Concurrent HP and HD would be an effective and safe treatment for patients with acute pesticide intoxication, in particular, paraquat intoxication.

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Surfactant toxicity in a case of (4-chloro-2-methylphenoxy) acetic acid herbicide intoxication

Cited by 6 publications

References 38 publications

Human cholestatic hepatitis owing to polyoxyethylene nonylphenol ingestion

Human cholestatic hepatitis owing to polyoxyethylene nonylphenol ingestion

Dialyzability of Surfactants Commonly Used in Pesticide Formulations

Concurrent Hemoperfusion and Hemodialysis in Patients with Acute Pesticide Intoxication

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