Caspases as prognostic markers and mortality predictors in acute organophosphorus poisoning

Shimaa Tallat, Rania Hussien, Rania Hassan Mohamed, Mahmoud B Abd El Wahab, Magdy Mahmoud, Shimaa Tallat, Rania Hussien, Rania Hassan Mohamed, Mahmoud B Abd El Wahab, Magdy Mahmoud

Abstract

Background: Organophosphorus (OP) compounds have been widely available for decades in agriculture for crop protection and as cheap pest controllers, which increases the rate of exposure and poisoning cases. Using serum cholinesterase as prognostic markers for the acute OP toxicity is controversial; therefore, we aim to find out prognostic biomarkers that best correlate with mortality and outcomes of patients with acute OP toxicity. Levels of serum oxidative stress biomarkers (malondialdehyde (MDA) and total antioxidant capacity (TAC)) and activity of the apoptotic biomarkers (caspase 3 and caspase 9) and pseudo-cholinesterase (p.ChE) were performed. Also, we evaluated the apoptotic capacity through determining the genotoxic effects and chromosomal abnormalities among OP intoxicated patients.

Results: We found the activity of caspases and serum MDA and TAC were significantly increased after OP poisoning and decreased after the appropriate atropine and oxime treatment course. The ROC curve suggested caspases as mortality and outcome predictive markers for acute OP poisoning patients. However, OP poisoning cases before treatment showed significant DNA damage, and they did not show any chromosomal aberration.

Conclusion: The mentioned results strongly suggest apoptotic-related markers (caspase 3, caspase 9) as prognostic markers for evaluation of the treatment, outcomes, and mortality rate in the acute OP toxicity patients.

Keywords: Acute organophosphorus poisoning; Apoptosis; Caspases; Genotoxicity; Oxidative stress.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The receiving operating characteristic (ROC) curve for caspase 3, caspase 9, MAD and TAC in acute OP poisoning cases
Fig. 2
Fig. 2
Comet assay of OP poisoning cases before treatment showing maximum damage
Fig. 3
Fig. 3
Karyotyping for male OP-intoxicated patient showing normal male karyotyping 46, XY: by G-banding technique

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