Acute and long-term consequences of exposure to organophosphate nerve agents in humans.
Acute and long-term consequences of exposure to organophosphate nerve agents in humans.
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DOI：
10.1111/epi.14500
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发表时间：
2018-10
期刊：
影响因子：
5.6
通讯作者：
Marini AM
中科院分区：
文献类型：
--
作者：
Figueiredo TH;Apland JP;Braga MFM;Marini AM
神经毒剂是有机磷(OP)化合物，是人类已知的最强毒物之一。对平民或军人发动恐怖袭击，造成大规模伤亡，这是一个真正的威胁。OP神经毒剂包括梭曼、沙林、环沙林、他布恩和VX。急性毒性的主要机制是对乙酰胆碱酯酶(AChE)的不可逆抑制。AChE抑制会导致过量的乙酰胆碱在突触中积聚，导致中毒症状的进展，包括过度分泌、震颤、癫痫持续状态、呼吸窘迫和死亡。对于那些急性暴露于OP神经毒剂的人来说，缩影和鼻漏是最常见的临床表现。长时间的癫痫发作是导致神经病理的原因。大脑损伤最严重的区域是杏仁核，其次是梨状皮质、海马体、皮质、丘脑和尾状/壳核。目前的医学对策在减轻癫痫发作和神经病理方面只有一定的效果。抗惊厥药物，如苯二氮卓类药物，可减少癫痫发作并改善预后，但其疗效取决于暴露于神经毒剂后的给药时间。服用苯二氮卓类药物可能会增加癫痫复发的风险。最近的研究记录了长期的神经和行为缺陷，而技术进步则通过磁共振成像显示了大脑结构的变化。
Nerve agents are organophosphate (OP) compounds and among the most powerful poisons known to man. A terrorist attack on civilian or military populations causing mass casualties is a real threat. The OP nerve agents include soman, sarin, cyclosarin, tabun and VX. The major mechanism of acute toxicity is the irreversible inhibition of acetylcholinesterase (AChE). AChE inhibition results in the accumulation of excessive acetylcholine levels in synapses leading to progression of toxic signs including hypersecretions, tremors, status epilepticus, respiratory distress and death. Miosis and rhinorrhea are the most common clinical findings in those individuals acutely exposed to OP nerve agents. Prolonged seizures are responsible for the neuropathology. The brain region that shows the most severe damage is the amygdala followed by the piriform cortex, hippocampus, cortex, thalamus, and caudate/putamen. Current medical countermeasures are only modestly effective in attenuating the seizures and neuropathology. Anticonvulsants such as benzodiazepines decrease seizure activity and improve outcome but their efficacy depends upon the administration time post-exposure to the nerve agent. Administration of benzodiazepines may increase the risk for seizure recurrence. Recent studies document long-term neurologic and behavior deficits while technological advances demonstrate structural brain changes on magnetic resonance imaging.
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影响因子：
3.4
作者：
Chao LL;Rothlind JC;Cardenas VA;Meyerhoff DJ;Weiner MW
通讯作者：
Weiner MW
影响因子：
2.9
作者：
LALLEMENT, G;CARPENTIER, P;BLANCHET, G
通讯作者：
BLANCHET, G
影响因子：
--
作者：
Lallement, G;Dorandeu, F;Blanchet, G
通讯作者：
Blanchet, G
DOI：
10.1124/jpet.114.217299
发表时间：
2014-11-01
影响因子：
3.5
作者：
Apland, James P.;Aroniadou-Anderjaska, Vassiliki;Braga, Maria F. M.
通讯作者：
Braga, Maria F. M.
影响因子：
3.4
作者：
Aroniadou-Anderjaska, Vassiliki;Figueiredo, Taiza H.;Braga, Maria F. M.
通讯作者：
Braga, Maria F. M.