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Hye-sung Lee - One of the best experts on this subject based on the ideXlab platform.
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monoclonal antibody based enzyme linked immunosorbent assays for the Organophosphorus Insecticide o ethyl o 4 nitrophenyl phenylphosphonothioate epn
Journal of Agricultural and Food Chemistry, 2010Co-Authors: Jee Youn Shim, Yong Tae Lee, Bruce D Hammock, Young Ah Kim, Hye-sung LeeAbstract:This study aimed at developing competitive direct and indirect enzyme-linked immunosorbent assays (ELISAs) for the Organophosphorus Insecticide O-ethyl O-4-nitrophenyl phenylphosphonothioate (EPN) using a monoclonal antibody (mAb). Of the five EPN derivatives (haptens) prepared for use as an immunogen or as a competitor, two of them were used as the immunogen for the production of the mAbs. By using the antibody with the highest specificity and a coating antigen (hapten-OVA conjugate), a competitive indirect ELISA was developed, which showed an IC(50) of 2.9 ng/mL with a detection limit of 0.3 ng/mL. A competitive direct ELISA using a different antibody and an enzyme tracer was also developed, which showed an IC(50) of 0.6 ng/mL with a detection limit of 0.09 ng/mL. The mAbs in both assays showed negligible cross-reactivity with other Organophosphorus pesticides. The recoveries of EPN from spiked samples determined by the developed ELISA ranged from 59 to 143%. Dilution of the samples improved the recovery. The assay performance of the present ELISAs based on the mAb was compared with that of the EPN ELISAs based on polyclonal antibodies (pAbs) that had been developed previously and was found to be better in dynamic response.
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development of enzyme linked immunosorbent assays for the Organophosphorus Insecticide epn
Journal of Agricultural and Food Chemistry, 2008Co-Authors: Jee Youn Shim, Yong Tae Lee, Young Ah Kim, Eun Hye Lee, Hye-sung LeeAbstract:Competitive enzyme-linked immunosorbent assays (ELISAs) in indirect and direct format were developed for the quantitative detection of the Organophosphorus Insecticide EPN. Five EPN derivatives (haptens) were synthesized and coupled to carrier proteins to use as an immunogen or as a competitor. Rabbits were immunized with two of the five haptens coupled to KLH for production of polyclonal antibodies, and the sera were screened against one of the haptens coupled to ovalbumin (OVA). Using the serum with the highest specificity and a coating antigen (hapten−OVA conjugate), an indirect (antigen-coated) ELISA was developed, which showed an IC50 of 5.6 ng/mL with a detection limit of 0.2 ng/mL (20% inhibition). A direct (antibody-coated) ELISA using an enzyme tracer (hapten−enzyme conjugate) was also developed, which showed an IC50 of 8.4 ng/mL with a detection limit of 0.9 ng/mL (20% inhibition). The antibodies showed negligible cross-reactivity with other Organophosphorus pesticides except with the insecticid...
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Development of a dipstick enzyme-linked immunosorbent assay for the Organophosphorus Insecticide parathion-methyl
International Journal of Food Science and Technology, 2006Co-Authors: Min Jung Kim, Yong Tae Lee, Jee Youn Shim, Hye-sung LeeAbstract:Summary In our previous study, polyclonal antibodies against the Organophosphorus Insecticide parathion-methyl were obtained and competitive enzyme-linked immunosorbent assays (ELISAs) for this pesticide were developed. In this study, using these antibodies and an enzyme tracer, a direct competitive ELISA for parathion-methyl in dipstick format was developed. The dipstick ELISA using Immunodyne membrane as a solid support, allowed the quick visual detection of parathion-methyl in concentrations above 10 μg L−1. The IC50 value of the dipstick ELISA using reflectance detection was 8.8 μg L−1 with a detection limit of 0.3 μg L−1. The recoveries of parathion-methyl from spiked lettuce and rice samples using the dipstick ELISA ranged from 89% to 106%.
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development of a microtiter plate elisa and a dipstick elisa for the determination of the Organophosphorus Insecticide fenthion
Journal of Agricultural and Food Chemistry, 2003Co-Authors: Young Ae Cho, Yong Tae Lee, Yoo Jung Kim, Bruce D Hammock, Hye-sung LeeAbstract:In previous studies, polyclonal antibodies against the Organophosphorus Insecticide fenthion were obtained and an indirect competitive enzyme-linked immunosorbent assay (ELISA) was developed for th...
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development of an enzyme linked immunosorbent assay for the Organophosphorus Insecticide bromophos ethyl
Journal of Agricultural and Food Chemistry, 2002Co-Authors: Kwang Ok Kim, Yong Tae Lee, Yoo Jung Kim, Bruce D Hammock, Hye-sung LeeAbstract:A competitive enzyme-linked immunosorbent assay (ELISA) was developed for the quantitative detection of the Organophosphorus Insecticide bromophos-ethyl. Four bromophos-ethyl derivatives (haptens) were synthesized and were coupled to carrier proteins through the pesticide thiophosphate group to use as an immunogen or as a coating antigen. Rabbits were immunized with either one of two haptens coupled to bovine serum albumin for production of polyclonal antibodies, and the sera were screened against one of the haptens coupled to ovalbumin. Using the serum with highest titer, an antigen-coated ELISA was developed, which showed an IC 5 0 of 3.9 ng/mL with a detection limit of 0.3 ng/mL (20% inhibition). An antibody-coated ELISA using an enzyme tracer was also developed, which showed an IC 5 0 of 6.5 ng/mL with a detection limit of 1.0 ng/mL (20% inhibition). The antibodies showed negligible cross-reactivity with other Organophosphorus pesticides except with the Insecticides bromophos-methyl and chlorpyrifos in the antibody-coated assay only. Recoveries of bromophos-ethyl from fortified crop and water samples ranged from 82 to 128% and from 95 to 127%, respectively.
Yong Tae Lee - One of the best experts on this subject based on the ideXlab platform.
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monoclonal antibody based enzyme linked immunosorbent assays for the Organophosphorus Insecticide o ethyl o 4 nitrophenyl phenylphosphonothioate epn
Journal of Agricultural and Food Chemistry, 2010Co-Authors: Jee Youn Shim, Yong Tae Lee, Bruce D Hammock, Young Ah Kim, Hye-sung LeeAbstract:This study aimed at developing competitive direct and indirect enzyme-linked immunosorbent assays (ELISAs) for the Organophosphorus Insecticide O-ethyl O-4-nitrophenyl phenylphosphonothioate (EPN) using a monoclonal antibody (mAb). Of the five EPN derivatives (haptens) prepared for use as an immunogen or as a competitor, two of them were used as the immunogen for the production of the mAbs. By using the antibody with the highest specificity and a coating antigen (hapten-OVA conjugate), a competitive indirect ELISA was developed, which showed an IC(50) of 2.9 ng/mL with a detection limit of 0.3 ng/mL. A competitive direct ELISA using a different antibody and an enzyme tracer was also developed, which showed an IC(50) of 0.6 ng/mL with a detection limit of 0.09 ng/mL. The mAbs in both assays showed negligible cross-reactivity with other Organophosphorus pesticides. The recoveries of EPN from spiked samples determined by the developed ELISA ranged from 59 to 143%. Dilution of the samples improved the recovery. The assay performance of the present ELISAs based on the mAb was compared with that of the EPN ELISAs based on polyclonal antibodies (pAbs) that had been developed previously and was found to be better in dynamic response.
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development of enzyme linked immunosorbent assays for the Organophosphorus Insecticide epn
Journal of Agricultural and Food Chemistry, 2008Co-Authors: Jee Youn Shim, Yong Tae Lee, Young Ah Kim, Eun Hye Lee, Hye-sung LeeAbstract:Competitive enzyme-linked immunosorbent assays (ELISAs) in indirect and direct format were developed for the quantitative detection of the Organophosphorus Insecticide EPN. Five EPN derivatives (haptens) were synthesized and coupled to carrier proteins to use as an immunogen or as a competitor. Rabbits were immunized with two of the five haptens coupled to KLH for production of polyclonal antibodies, and the sera were screened against one of the haptens coupled to ovalbumin (OVA). Using the serum with the highest specificity and a coating antigen (hapten−OVA conjugate), an indirect (antigen-coated) ELISA was developed, which showed an IC50 of 5.6 ng/mL with a detection limit of 0.2 ng/mL (20% inhibition). A direct (antibody-coated) ELISA using an enzyme tracer (hapten−enzyme conjugate) was also developed, which showed an IC50 of 8.4 ng/mL with a detection limit of 0.9 ng/mL (20% inhibition). The antibodies showed negligible cross-reactivity with other Organophosphorus pesticides except with the insecticid...
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Development of a dipstick enzyme-linked immunosorbent assay for the Organophosphorus Insecticide parathion-methyl
International Journal of Food Science and Technology, 2006Co-Authors: Min Jung Kim, Yong Tae Lee, Jee Youn Shim, Hye-sung LeeAbstract:Summary In our previous study, polyclonal antibodies against the Organophosphorus Insecticide parathion-methyl were obtained and competitive enzyme-linked immunosorbent assays (ELISAs) for this pesticide were developed. In this study, using these antibodies and an enzyme tracer, a direct competitive ELISA for parathion-methyl in dipstick format was developed. The dipstick ELISA using Immunodyne membrane as a solid support, allowed the quick visual detection of parathion-methyl in concentrations above 10 μg L−1. The IC50 value of the dipstick ELISA using reflectance detection was 8.8 μg L−1 with a detection limit of 0.3 μg L−1. The recoveries of parathion-methyl from spiked lettuce and rice samples using the dipstick ELISA ranged from 89% to 106%.
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Monoclonal antibody-based enzyme-linked immunosorbent assays for the detection of the Organophosphorus Insecticide isofenphos
Analytica Chimica Acta, 2005Co-Authors: Won Young Lee, Won Chul Park, Eunkyung Lee, Yoo Jung Kim, Taeowan Chung, Yong Tae LeeAbstract:Abstract In our previous study, polyclonal antibodies against the Organophosphorus Insecticide isofenphos were generated and enzyme-linked immunosorbent assays (ELISAs) for this pesticide were developed. In this study, isofenphos ELISAs with higher performance were developed by using a monoclonal antibody and a larger number of immunoreagents. Using the antibody and a coating antigen, an indirect competitive ELISA for isofenphos was developed, which showed an IC 50 value of 35 ng/mL with a detection limit of 5.8 ng/mL. A direct competitive ELISA using an enzyme tracer was also developed, which showed an IC 50 value of 26 ng/mL with a detection limit of 4.8 ng/mL. The antibodies in both assays showed negligible cross-reactivity with other OP pesticides. Recoveries of isofenphos from fortified rice and lettuce samples ranged 30–328 and 52–197%, respectively. The bias in the recovery values was rationalized by using the standard curves obtained in the matrix extract.
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development of a microtiter plate elisa and a dipstick elisa for the determination of the Organophosphorus Insecticide fenthion
Journal of Agricultural and Food Chemistry, 2003Co-Authors: Young Ae Cho, Yong Tae Lee, Yoo Jung Kim, Bruce D Hammock, Hye-sung LeeAbstract:In previous studies, polyclonal antibodies against the Organophosphorus Insecticide fenthion were obtained and an indirect competitive enzyme-linked immunosorbent assay (ELISA) was developed for th...
Bruce D Hammock - One of the best experts on this subject based on the ideXlab platform.
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monoclonal antibody based enzyme linked immunosorbent assays for the Organophosphorus Insecticide o ethyl o 4 nitrophenyl phenylphosphonothioate epn
Journal of Agricultural and Food Chemistry, 2010Co-Authors: Jee Youn Shim, Yong Tae Lee, Bruce D Hammock, Young Ah Kim, Hye-sung LeeAbstract:This study aimed at developing competitive direct and indirect enzyme-linked immunosorbent assays (ELISAs) for the Organophosphorus Insecticide O-ethyl O-4-nitrophenyl phenylphosphonothioate (EPN) using a monoclonal antibody (mAb). Of the five EPN derivatives (haptens) prepared for use as an immunogen or as a competitor, two of them were used as the immunogen for the production of the mAbs. By using the antibody with the highest specificity and a coating antigen (hapten-OVA conjugate), a competitive indirect ELISA was developed, which showed an IC(50) of 2.9 ng/mL with a detection limit of 0.3 ng/mL. A competitive direct ELISA using a different antibody and an enzyme tracer was also developed, which showed an IC(50) of 0.6 ng/mL with a detection limit of 0.09 ng/mL. The mAbs in both assays showed negligible cross-reactivity with other Organophosphorus pesticides. The recoveries of EPN from spiked samples determined by the developed ELISA ranged from 59 to 143%. Dilution of the samples improved the recovery. The assay performance of the present ELISAs based on the mAb was compared with that of the EPN ELISAs based on polyclonal antibodies (pAbs) that had been developed previously and was found to be better in dynamic response.
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development of a microtiter plate elisa and a dipstick elisa for the determination of the Organophosphorus Insecticide fenthion
Journal of Agricultural and Food Chemistry, 2003Co-Authors: Young Ae Cho, Yong Tae Lee, Yoo Jung Kim, Bruce D Hammock, Hye-sung LeeAbstract:In previous studies, polyclonal antibodies against the Organophosphorus Insecticide fenthion were obtained and an indirect competitive enzyme-linked immunosorbent assay (ELISA) was developed for th...
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development of an enzyme linked immunosorbent assay for the detection of the Organophosphorus Insecticide acephate
Journal of Agricultural and Food Chemistry, 2003Co-Authors: Jaekoo Lee, Ki Chang Ahn, Donald W Stoutamire, Shirley J Gee, Bruce D HammockAbstract:A competitive indirect enzyme-linked immunosorbent assay (ciELISA) for the Organophosphorus Insecticide acephate, O,S-dimethyl acetylphosphoramidothioate, was developed using a polyclonal antibody. Five different haptens mimicking the analyte were synthesized and conjugated with the carrier proteins bovine serum albumin (BSA) and keyhole limpet hemocyanin (KLH) by the N-hydroxysuccinimide active ester and diazotization methods. Polyclonal antibodies raised against hapten−KLH conjugates in rabbits and hapten−BSA conjugates as coating antigens were screened and selected for the assay in the homologous and heterologous ELISA systems. The effects of various assay conditions such as detergent, organic solvents, pH, and preincubation of the mixture of the polyclonal antibody and the analyte on the sensitivity were evaluated. The IC50 value for acephate was 25 ng/mL in an optimized heterologous system using hapten-4−BSA as a coating antigen and a polyclonal antibody no. 8377 against hapten-1−KLH, showing the det...
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development of an enzyme linked immunosorbent assay for the Organophosphorus Insecticide bromophos ethyl
Journal of Agricultural and Food Chemistry, 2002Co-Authors: Kwang Ok Kim, Yong Tae Lee, Yoo Jung Kim, Bruce D Hammock, Hye-sung LeeAbstract:A competitive enzyme-linked immunosorbent assay (ELISA) was developed for the quantitative detection of the Organophosphorus Insecticide bromophos-ethyl. Four bromophos-ethyl derivatives (haptens) were synthesized and were coupled to carrier proteins through the pesticide thiophosphate group to use as an immunogen or as a coating antigen. Rabbits were immunized with either one of two haptens coupled to bovine serum albumin for production of polyclonal antibodies, and the sera were screened against one of the haptens coupled to ovalbumin. Using the serum with highest titer, an antigen-coated ELISA was developed, which showed an IC 5 0 of 3.9 ng/mL with a detection limit of 0.3 ng/mL (20% inhibition). An antibody-coated ELISA using an enzyme tracer was also developed, which showed an IC 5 0 of 6.5 ng/mL with a detection limit of 1.0 ng/mL (20% inhibition). The antibodies showed negligible cross-reactivity with other Organophosphorus pesticides except with the Insecticides bromophos-methyl and chlorpyrifos in the antibody-coated assay only. Recoveries of bromophos-ethyl from fortified crop and water samples ranged from 82 to 128% and from 95 to 127%, respectively.
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development of an elisa for the Organophosphorus Insecticide chlorpyrifos
Bulletin of The Korean Chemical Society, 2002Co-Authors: Young Ae Cho, Ki Chang Ahn, Yong Tae Lee, Hye-sung Lee, Bruce D Hammock, Eunyoung Park, Jaekoo LeeAbstract:A selective enzyme-linked immunosorbent assay (ELISA) for the Insecticide chlorpyrifos was developed. Four haptens for chlorpyrifos were synthesized and two of them were used as immunogens after coupling to keyhole limpethemocyanin by two different approaches. Rabbits were immunized with either of them and the sera were screened against 4 haptens coupled to ovalbumin (OVA). Using the sera of highest specificity, an antigen-coated ELISA was developed, which shows an I 5 0 of 160 ppb with a detection limit of 10 ppb. An antibody-coated ELISA was also developed, which shows an I 5 0 of 20 ppb with a detection limit of 0.1 ppb. The antibodies showed negligible cross-reactivity with other Organophosphorus pesticides except for Insecticides chlorpyrifos-methyl and bromophos-ethyl, which makes these assays suitable for the selective detection of chlorpyrifos.
Hassan Karimimaleh - One of the best experts on this subject based on the ideXlab platform.
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a novel detection method for Organophosphorus Insecticide fenamiphos molecularly imprinted electrochemical sensor based on core shell co3o4 mof 74 nanocomposite
Journal of Colloid and Interface Science, 2021Co-Authors: Hassan Karimimaleh, Mehmet Lutfi Yola, Necip Atar, Yasin Orooji, Fatemeh Karimi, Senthil P Kumar, Jalal Rouhi, Mehdi BaghayeriAbstract:Abstract Organophosphorus Insecticide fenamiphos (FEN) is utilized to control the detrimental nematode pests. In this report, a novel molecular imprinted electrochemical sensor for Insecticide FEN detection was prepared. The molecular imprinted sensor was prepared based on Co3O4 nanowire and core-shell Co3O4@MOF-74 nanocomposite. Firstly, hydrothermal method followed by thermal annealing was applied for the preparation of Co3O4 nanowire. Then, solvothermal technique was used in no presence of metal salts to prepare core-shell Co3O4@MOF-74 nanocomposite. In addition, several solvothermal cycles were tried to optimally adjust the reaction efficiency. After the modification of the clean carbon electrode surfaces with Co3O4@MOF-74 nanocomposites, the molecular imprinted electrodes based on Co3O4@MOF-74 nanocomposites were prepared in presence of 100.0 mM pyrrole as monomer and 25.0 mM FEN as analyte molecule between +0.30 V and +1.50 V by cyclic voltammetry (CV). The prepared molecularly imprinted sensor based on Co3O4 nanowire and core-shell Co3O4@MOF-74 nanocomposite was characterized by transmission electron microscopy (TEM), scanning electron microscope (SEM), x-ray diffraction (XRD) method, x-ray photoelectron spectroscopy (XPS), fourier transform infrared spectroscopy (FTIR), electrochemical impedance spectroscopy (EIS) and CV. The quantification limit (LOQ) and the detection limit (LOD) were obtained as 1.0 × 10−11 M and 3.0 × 10−12 M, respectively, by using the developed sensor. Hence, the developed molecularly imprinting electrochemical sensor having high selectivity, stability and reproducibility was presented in this study for Insecticide FEN detection.
Michael Eddleston - One of the best experts on this subject based on the ideXlab platform.
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novel clinical toxicology and pharmacology of Organophosphorus Insecticide self poisoning
Annual Review of Pharmacology and Toxicology, 2019Co-Authors: Michael EddlestonAbstract:Organophosphorus Insecticide self-poisoning is a major global health problem, killing over 100,000 people annually. It is a complex multi-organ condition, involving the inhibition of cholinesterases, and perhaps other enzymes, and the effects of large doses of ingested solvents. Variability between Organophosphorus Insecticides-in lipophilicity, speed of activation, speed and potency of acetylcholinesterase inhibition, and in the chemical groups attached to the phosphorus-results in variable speed of poisoning onset, severity, clinical toxidrome, and case fatality. Current treatment is modestly effective, aiming only to reactivate acetylcholinesterase and counter the effects of excess acetylcholine at muscarinic receptors. Rapid titration of atropine during resuscitation is lifesaving and can be performed in the absence of oxygen. The role of oximes in therapy remains unclear. Novel antidotes have been tested in small trials, but the great variability in poisoning makes interpretation of such trials difficult. More effort is required to test treatments in adequately powered studies.
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salbutamol in acute Organophosphorus Insecticide poisoning a pilotdose response phase ii study
Clinical Toxicology, 2018Co-Authors: Fazle Rabbi Chowdhury, Mustafezur Rahman, Parash Ullah, Abdul Mumith Ruhan, Shafiqul Bari, Jahangir M Alam, M A Uddin, Shomik Maruf, Ismail Patwary, Michael EddlestonAbstract:Background: Treatment of acute Organophosphorus (OP) Insecticide poisoning is difficult, with many patients dying despite best care. Pre-clinical studies have shown benefit from salbutamol, possibl...
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pharmacological treatment of Organophosphorus Insecticide poisoning the old and the possible new
British Journal of Clinical Pharmacology, 2016Co-Authors: Michael Eddleston, Fazle Rabbi ChowdhuryAbstract:Despite being a major clinical and public health problem across the developing world, responsible for at least 5 million deaths over the last three decades, the clinical care of patients with Organophosphorus (OP) Insecticide poisoning has little improved over the last six decades. We are still using the same two antidotes - atropine and oximes - that first came into clinical use in the late 1950s. Clinical research in South Asia has shown how improved regimens of atropine can prevent deaths. However, we are still unsure about which patients are most likely to benefit from the use of oximes. Supplemental antidotes, such as magnesium, clonidine and sodium bicarbonate, have all been proposed and studied in small trials without production of definitive answers. Novel antidotes such as nicotinic receptor antagonists, beta-adrenergic agonists and lipid emulsions are being studied in large animal models and in pilot clinical trials. Hopefully, one or more of these affordable and already licensed antidotes will find their place in routine clinical care. However, the large number of chemically diverse OP Insecticides, the varied poisoning they produce and their varied response to treatment might ultimately make it difficult to determine definitively whether these antidotes are truly effective. In addition, the toxicity of the varied solvents and surfactants formulated with the OP active ingredients complicates both treatment and studies. It is possible that the only effective way to reduce deaths from OP Insecticide poisoning will be a steady reduction in their agricultural use worldwide.
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pralidoxime in acute Organophosphorus Insecticide poisoning a randomised controlled trial
PLOS Medicine, 2009Co-Authors: Franz Worek, Peter Eyer, Michael Eddleston, Edmund Juszczak, Nicola Alder, Fahim Mohamed, Lalith Senarathna, Ariyasena Hittarage, Shifa AzherAbstract:Background: Poisoning with Organophosphorus (OP) Insecticides is a major global public health problem, causing an estimated 200,000 deaths each year. Although the World Health Organization recommends use of pralidoxime, this antidote's effectiveness remains unclear. We aimed to determine whether the addition of pralidoxime chloride to atropine and supportive care offers benefit. Methods and Findings: We performed a double-blind randomised placebo-controlled trial of pralidoxime chloride (2 g loading dose over 20 min, followed by a constant infusion of 0.5 g/h for up to 7 d) versus saline in patients with Organophosphorus Insecticide self-poisoning. Mortality was the primary outcome; secondary outcomes included intubation, duration of intubation, and time to death. We measured baseline markers of exposure and pharmacodynamic markers of response to aid interpretation of clinical outcomes. Two hundred thirty-five patients were randomised to receive pralidoxime (121) or saline placebo (114). Pralidoxime produced substantial and moderate red cell acetylcholinesterase reactivation in patients poisoned by diethyl and dimethyl compounds, respectively. Mortality was nonsignificantly higher in patients receiving pralidoxime: 30/121 (24.8%) receiving pralidoxime died, compared with 18/114 (15.8%) receiving placebo (adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 0.88-3.26, p = 0.12). Incorporating the baseline amount of acetylcholinesterase already aged and plasma OP concentration into the analysis increased the HR for patients receiving pralidoxime compared to placebo, further decreasing the likelihood that pralidoxime is beneficial. The need for intubation was similar in both groups (pralidoxime 26/121 [21.5%], placebo 24/114 [21.1%], adjusted HR 1.27 [95% CI 0.71-2.29]). To reduce confounding due to ingestion of different Insecticides, we further analysed patients with confirmed chlorpyrifos or dimethoate poisoning alone, finding no evidence of benefit. Conclusions: Despite clear reactivation of red cell acetylcholinesterase in diethyl Organophosphorus pesticide poisoned patients, we found no evidence that this regimen improves survival or reduces need for intubation in patients with Organophosphorus Insecticide poisoning. The reason for this failure to benefit patients was not apparent. Further studies of different dose regimens or different oximes are required. Trial Registration: Controlled-trials.com ISRCTN55264358. © 2009 Eddleston et al.
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differences between Organophosphorus Insecticides in human self poisoning a prospective cohort study
The Lancet, 2005Co-Authors: Franz Worek, Peter Eyer, Michael Eddleston, Edmund Juszczak, Fahim Mohamed, Lalith Senarathna, Ariyasena Hittarage, Ludwig Von Meyer, Shifa AzharAbstract:Summary Background Although more than 100 Organophosphorus Insecticides exist, Organophosphorus poisoning is usually regarded as a single entity, distinguished only by the compound's lethal dose in animals. We aimed to determine whether the three most common Organophosphorus Insecticides used for self-poisoning in Sri Lanka differ in the clinical features and severity of poisoning they cause. Methods We prospectively studied 802 patients with chlorpyrifos, dimethoate, or fenthion self-poisoning admitted to three hospitals. Blood cholinesterase activity and Insecticide concentration were measured to determine the compound and the patients' response to Insecticide and therapy. We recorded clinical outcomes for each patient. Findings Compared with chlorpyrifos (35 of 439, 8·0%), the proportion dying was significantly higher with dimethoate (61 of 264, 23·1%, odds ratio [OR] 3·5, 95% CI 2·2–5·4) or fenthion (16 of 99, 16·2%, OR 2·2, 1·2–4·2), as was the proportion requiring endotracheal intubation (66 of 439 for chlorpyrifos, 15·0%; 93 of 264 for dimethoate, 35·2%, OR 3·1, 2·1–4·4; 31 of 99 for fenthion, 31·3%, 2·6, 1·6–4·2). Dimethoate-poisoned patients died sooner than those ingesting other pesticides and often from hypotensive shock. Fenthion poisoning initially caused few symptoms but many patients subsequently required intubation. Acetylcholinesterase inhibited by fenthion or dimethoate responded poorly to pralidoxime treatment compared with chlorpyrifos-inhibited acetylcholinesterase. Interpretation Organophosphorus Insecticide poisoning is not a single entity, with substantial variability in clinical course, response to oximes, and outcome. Animal toxicity does not predict human toxicity since, although chlorpyrifos is generally the most toxic in rats, it is least toxic in people. Each Organophosphorus Insecticide should be considered as an individual poison and, consequently, patients might benefit from management protocols developed for particular Organophosphorus Insecticides.