RESUMEN
PURPOSE: Forensic verification of cyanide (CN) poisoning by direct CN analysis in postmortem blood is challenging due to instability of CN in biological samples. CN metabolites, thiocyanate (SCN-) and 2-aminothiazoline-4-carboxylic acid (ATCA), have been proposed as more stable biomarkers, yet it is unclear if either is appropriate for this purpose. In this study, we evaluated the behavior of CN biomarkers in postmortem swine and postmortem blood to determine which serves as the best biomarker of CN exposure. METHODS: CN, SCN-, and ATCA were measured in postmortem swine (N = 8) stored at 4 °C and postmortem blood stored at 25 °C (room temperature, RT) and 37 °C (typical human body temperature, HBT). RESULTS: Following CN poisoning, the concentration of each CN biomarker increased well above the baseline. In postmortem swine, CN concentrations declined rapidly (t1/2 = 34.3 h) versus SCN- (t1/2 = 359 h, 15 days) and ATCA (t1/2 = 544 h, 23 days). CN instability in postmortem blood increased at RT (t1/2 = 10.7 h) and HBT (t1/2 = 6.6 h). SCN- and ATCA were more stable than CN at all storage conditions. In postmortem swine, the t1/2s of SCN- and ATCA were 15 and 23 days, respectively. While both the t1/2s of SCN- and ATCA were relatively lengthy, endogenous levels of SCN- were much more variable than ATCA. CONCLUSION: While there are still questions to be answered, ATCA was the most adept forensic marker of CN poisoning (i.e., ATCA produced the longest half-life, the largest increase above baseline levels, and most stable background concentrations).
Asunto(s)
Biomarcadores , Cianuros , Animales , Cianuros/envenenamiento , Cianuros/sangre , Biomarcadores/sangre , Porcinos , Tiocianatos/envenenamiento , Tiocianatos/sangre , Tiocianatos/metabolismo , Toxicología Forense/métodos , Modelos Animales , Temperatura , Manejo de Especímenes/métodos , TiazolesRESUMEN
Cyanide is a highly toxic agent that has been frequently used for suicide in South Korea. It is also used in various industrial fields, such as metal plating, in which many accidental cyanide intoxications have occurred. To overcome the disadvantages of conventional cyanide analysis methods, a simple and fast method for the analysis of cyanide in whole blood using ion chromatography (IC) with amperometric detection was developed in this study. Whole blood samples were deproteinized, diluted, and analyzed using an IC-amperometric detection system. The limits of detection and quantitation were 0.1 and 0.2 mg/L, respectively. The method showed good linearity in the range of 0.2 to 50 mg/L with R2 > 0.99. The intra- and inter-assay precision and accuracy values were <10%. The established method was successfully applied to analyze whole blood samples from three cyanide intoxication cases.
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Cromatografía , Cianuros , Toxicología Forense , Cianuros/análisis , Cianuros/sangre , Humanos , República de CoreaRESUMEN
Cyanide-based blood poisoning can seriously damage fire victims and cause death if not detected quickly. Previous conventional methods require laboratory equipment, which are expensive and increase the duration of the analysis. Here, a simple origami based microfluidic device was introduced for point of need detection of blood cyanide concentration in people involved in fire. The device is made of four layers of paper. Each layer was in the size of 1 × 1 cm folded on each other. In this work, the blood sample was acidified by trichloroacetic acid to separate cyanide from methaemoglobin in the form of HCN gas. The produced gas released into borate buffer to recover free cyanide ions which interacted with the Pt complex ([Pt(p-MeC6H4)2(phen)]) used as a receptor in this study. Optimized conditions were applied to have a suitable interaction causing the color of the receptor to change from yellow to colorless. The color changes were recorded by a smartphone, and the sensor response was calculated by the routine image analysis software. The assay was capable of determining cyanide ions at different concentrations in the range of 1.0 to 100.0 µmol L-1. The detection limit of these determination was equal to 0.4 µmol L-1. The assay responses were not affected by the interfering species. As a practical analysis, the proposed sensor was applied to determine cyanide ions in the blood sample of 20 studied fire survivors and 10 controls with high accuracy.
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Cianuros/análisis , Cianuros/sangre , Cianuro de Hidrógeno/farmacología , Lesión por Inhalación de Humo/inducido químicamente , Sobrevivientes , Incendios , Humanos , Metahemoglobina/análisisRESUMEN
The congener analysis is routinely used for the determination of volatile compounds in body fluids and beverages for forensic investigations. Although intoxications with cyanide via smoke inhalation or ingestion of cyanide salts are frequently encountered in forensic medicine, the inclusion of hydrogen cyanide in this analysis was never studied in detail. In this work, a very simple, fast, and sensitive quantification method with headspace gas chromatography and flame ionization detection for the analysis of cyanide in whole blood-was developed and validated. In contrast to the standard sample preparation of the congener analysis, an acidification step with tartaric acid was added. A limit of detection of 50 ng/ml, good linearity (coefficient of correlation > 0.9997), high accuracy (101.5%-106.4%), and precision (relative standard deviation 1.8%-3.7%) were achieved. Authentic blood samples of 10 forensic cases were investigated with the new method. Furthermore, the method was used for the quantification of cyanide in other body fluids (serum and urine) and diverse beverages. Interferences were investigated, and the addition of aldehydes produced a clear concentration-dependent decrease of the cyanide signal. Besides, the method offers an economical use of limited sample material by the simultaneous determination of cyanide, ethanol, and congener alcohols.
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Bebidas/análisis , Cromatografía de Gases/métodos , Cianuros/sangre , Ionización de Llama/métodos , Autopsia , Cianuros/análisis , Cianuros/orina , Medicina Legal , Humanos , Límite de DetecciónRESUMEN
A simple screening analysis of cyanide in blood has been developed, using 4-(4,6-dimethoxy-1,3,5-triazin-2-yl)-4-methylmorpholinium chloride (DMTMM). DMTMM, a convenient reagent for dehydrocondensation, converted cyanide to 2-cyano-4,6-dimethoxy-1,3,5-triazine, the dimethoxytriazinyl derivative of cyanide. This reaction proceeded in whole blood samples after treatment with trichloroacetic acid, and in basic aqueous solution samples. Sufficient sensitivity was observed by the method using gas chromatography/mass spectrometry. Intra- and inter-day repeated analyses (0.05, 0.1, 0.25, 1 and 5 µg/mL, n = 5) were performed and the accuracy and precision were within 20% for the lower limit of quantification (LLOQ) and within 15% for other concentrations. LLOQs for the aqueous solution and blood were 0.05 and 0.1 µg/mL, respectively, which are suitable for detecting cyanide poisoning. The limits of detection (signal-to-noise ratio ≥ 3) for aqueous solution and blood were 0.01 and 0.05 µg/mL, respectively. Interference from 13 other anions was tested and no false positive response was obtained, even in the case of thiocyanate, nitrite and nitrate, which are known to yield cyanide by acid treatment of blood. This method is practical because it uses readily available reagents and equipment and is sensitive enough for the rapid screening of cyanide poisoning in forensic and clinical toxicology.
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Cianuros/sangre , Cromatografía de Gases y Espectrometría de Masas/métodos , Morfolinas/química , Humanos , Límite de Detección , Modelos Lineales , Reproducibilidad de los ResultadosRESUMEN
A liquid chromatographic (LC) method with fluorous derivatization for the determination of cyanide in human plasma is described. In this method, the cyanide was transformed to a fluorous and fluorogenic compound by derivatizing with 2,3-naphthalenedialdehyde and perfluoroalkylamine reagent under mild reaction conditions (a reaction time of 5 min at room temperature). The obtained derivative was successfully retained on the perfluoroalkyl-modified LC column with the use of a high concentration of organic solvent in the mobile phase, whereas non-fluorous derivative was hardly retained, followed by fluorometric detection at excitation and emission wavelengths of 420 and 490 nm, respectively. Under the optimized conditions, the limit of detection and the limit of quantification for cyanide in a 5-µL injection volume were 1.3 µg/L (S/N = 3) and 4.4 µg/L (S/N = 10), respectively. The recovery from spiked human plasma was achieved in the range of 54 - 90% within a relative standard deviation of 3.5%. The feasibility of this method was further evaluated by applying it to the analysis of human plasma samples.
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Cianuros/sangre , Colorantes Fluorescentes/química , Hidrocarburos Fluorados/química , Cromatografía Liquida , Colorantes Fluorescentes/síntesis química , Humanos , Hidrocarburos Fluorados/síntesis química , Estructura MolecularRESUMEN
Cyanide (both HCN and CN- are represented by CN) has multiple industrial applications, is commonly found in some foods, and is a component of fire smoke. Upon exposure, CN blocks production of adenosine triphosphate, causing cellular hypoxia and cytotoxic anoxia, which can eventually result in death. Considering CN's quick onset of action and the long analysis times associated with current techniques, the objective of this study was to develop and validate a rapid and field-portable sensor to detect blood CN concentrations focusing on both concentration and diagnostic accuracy. The sensor takes advantage of the chemical properties of CN by converting it exclusively to HCN via acidification of whole blood. High-speed headspace transfer is used to deliver HCN to a capture solution where it is reacted with naphthalene dialdehyde and taurine to produce a fluorescent ß-isoindole product. Simple spectrofluorometric analysis of the product provides quantitative analysis of CN from whole blood in 60 s and requires only 25 µL of blood (obtainable via fingerstick). A limit of detection of 5 µM, a linear range of 10-200 µM (with ≥15 µM considered CN exposed), and excellent accuracy (100 ± 15%) and precision (≤15.2% relative standard deviation) were obtained. To evaluate the diagnostic accuracy of the sensor, rabbit blood samples (N = 190, including 24 blinded samples) were analyzed by both the sensor and a lab-based spectrophotometric method. An excellent positive correlation was obtained between the sensor and the lab-based method (R2 Ë 0.995) confirming the concentration accuracy of the CN sensor. Moreover, the sensor produced no false positives or negatives when diagnosing CN poisoning.
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Automatización , Cianuros/sangre , Animales , Cianuros/envenenamiento , Cromatografía de Gases y Espectrometría de Masas , Conejos , Espectrofotometría UltravioletaRESUMEN
In recent years, Cobinamide (Cbi) has shown promise as a therapeutic for cyanide poisoning. There are several forms of Cbi based on the identity of the ligands bound to the cobalt in Cbi and these different forms of Cbi have divergent behavior (e.g., the aquo and hydroxo forms of Cbi readily bind to proteins, limiting their distribution significantly, whereas [Cbi(CN)2] does not). While current analysis techniques only measure total Cbi, methods to elucidate the behavior of 'available' Cbi versus cyanide-complexed Cbi would be valuable for biomedical and pharmacokinetic studies. Therefore, a method was developed for the analysis of cyanide-complexed Cbi in plasma via liquid chromatography tandem mass spectrometry (LC-MS-MS). Plasma samples were prepared by denaturing proteins with 10% ammonium hydroxide in acetonitrile. The resulting mixture was centrifuged, and the supernatant was removed, dried, and reconstituted. Cyanide-complexed Cbi was then analyzed via LC-MS-MS. The limit of detection was 0.2⯵M, and the linear dynamic range was between 1 and 200⯵M. The accuracy was 100⯱â¯17% and the precision, measured by relative standard deviation (%RSD), was ≤18.5%. Carryover, a severe problem when analyzing Cbi via liquid chromatography was eliminated using a polymeric-based stationary phase (PLRP-S) and a controlled washing protocol. The method allowed evaluation of the cyanide-bound and 'available' Cbi from treated animals and, when paired with a method for total Cbi analysis, allows for estimation of Cbi utilization when treating cyanide poisoning.
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Cromatografía Líquida de Alta Presión/métodos , Cobamidas/sangre , Espectrometría de Masas en Tándem/métodos , Animales , Cianuros/sangre , Límite de Detección , Plasma/química , Conejos , PorcinosRESUMEN
The natural compound amygdalin has gained high popularity among tumor patients as a complementary or alternative treatment option. However, due to metabolization of amygdalin to cyanide (HCN) following oral consumption, there could be a high risk of lactic acidosis caused by cyanide intoxication. The present retrospective study was undertaken to evaluate cyanide blood and lactate plasma levels of tumor patients (n = 55) before and after intravenous (i.v.) amygdalin infusion. All patients had also continuously ingested amygdalin tablets (3 x 500 mg/day), excepting on the days of i.v. administration. Each patient received one to five intravenous amygdalin treatments. The time period between each i.v. application ranged between 4-6 days. The initial i.v. dose was 6 mg (n = 28), 9 mg (n = 1), 15 mg (n = 1) or 18 mg (n = 25). The mean cyanide blood level before i.v. amygdalin administration was 34.74 µg/L, which increased significantly to a mean value of 66.20 µg/L after i. v. amygdalin application. In contrast, lactate decreased significantly from 1266 µmol/L pre-infusion to 868 µmol/L post-infusion. Increasing i.v. amygdalin by 1 mg was also associated with a significant increase in the cyanide level, while the lactate blood level significantly decreased. This is the first study evaluating cyanide levels under conditions employed by amygdalin administrators, i.e. after chronic oral amygdalin intake and then again after a closely subsequent intravenous amygdalin administration. Since lactate decreased, whilst cyanide increased, it is concluded that elevation of cyanide does not induce metabolic acidosis in terms of an increased lactate level.
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Amigdalina/administración & dosificación , Antineoplásicos Fitogénicos/administración & dosificación , Cianuros/sangre , Lactatos/sangre , Administración Intravenosa/métodos , Administración Oral , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/sangre , Neoplasias/tratamiento farmacológico , Estudios RetrospectivosRESUMEN
The direct analysis of cyanide (HCN or CN- inclusively symbolized as CN) to confirm exposure has major limitations due to cyanide's volatility, reactivity, and short half-life in biological fluids. These limitations have led to the exploration of cyanide detoxification products for indirect verification of cyanide exposure. Although cyanide interacts strongly with sulfur-containing molecules, to date, biomarkers resulting from the interaction of cyanide with glutathione (GSH; i.e., a biologically abundant sulfur-donating biomolecule) have yet to be discovered. In this study, we studied the interaction of CN and GSH to produce 2-aminothiazoline-4-oxoaminoethanioc acid (ATOEA). An LC-MS/MS method was developed and validated to analyze ATOEA from plasma, producing a linear range of 0.5-50 µM, a limit of detection of 200 nM, and excellent precision and accuracy. ATOEA concentrations were significantly elevated in the plasma of animals following cyanide exposure. Moreover, the production of ATOEA from cyanide exposure was confirmed by detection of both ATOEA and ATOEA-13C15N in rabbit plasma ( N = 11 animals) following administration of NaCN:K13C15N (1:1), with a similar amount of ATOEA and ATOEA-13C15N formed ( R2 = 0.9924, p < 0.05). The concentration of ATOEA increased with cyanide dose and then decreased rapidly when an antidote was administrated. This study definitively showed that ATOEA is produced from interaction of CN and GSH and can serve as a biomarker of cyanide exposure.
Asunto(s)
Cianuros/metabolismo , Glutatión/metabolismo , Tiazolidinas/metabolismo , Animales , Cianuros/sangre , Cianuros/química , Glutatión/sangre , Glutatión/química , Cinética , Estructura Molecular , Conejos , Tiazolidinas/sangre , Tiazolidinas/químicaRESUMEN
Intramuscular bleeding of the tongue (ImBT) is occasionally found during post mortem examination. Despite its frequent reports, its cause has not yet been clarified. In this study, forensic autopsy data of 799 cadavers were examined and the relationship between ImBT and cause of death was investigated. A total of 74 cases showed ImBT (16 of 66 cases of fire fatality, 17 of 108 cases of drowning, 23 of 74 cases of asphyxiation, and 18 of 551 cases of other causes of death). The frequency of bleeding was significantly greater in cases with causes of death including fire fatality, drowning, and asphyxiation compared to those with other causes of death (pâ¯<â¯0.01). Among asphyxiation cases, ImBT was confirmed in two of five cases of typical hanging, three of 16 cases of atypical hanging, six of six cases of ligature strangulation, two of two cases of manual strangulation, eight of 38 cases of airway obstruction, and two of seven cases of oxygen deficiency. Among fire fatalities, the carboxyhemoglobin (CO-Hb) concentration of cases with ImBT was significantly lower than that in cases without ImBT (pâ¯<â¯0.01). In addition, the frequency of bleeding was significantly higher (pâ¯<â¯0.05) in cases where the blood cyanide concentration was 0.05â¯ppm or less. These observations suggested that ImBT during fire fatality occurs in a manner similar to that of ligature or manual strangulation, in which the flames cause the contraction and decrease in elasticity of the skin. Past reports indicated that bleeding frequency in cases of drowning did not significantly differ from that in cases with other causes of death. However, our cases showed a statistically higher incidence of bleeding compared to that in the other causes of death (pâ¯<â¯0.01). These results suggested that ImBT is a characteristic finding in cases of asphyxia and is an important evaluation for the diagnosis of death. When the relationship between ImBT and petechial hemorrhage was examined in three of the causes of death, no significant difference was observed between fire fatality and asphyxiation, but drowning was significantly different (pâ¯<â¯0.05). In cases without ImBT, the secretion of noradrenaline and adrenaline was significantly higher (pâ¯<â¯0.01). This finding suggests that it is unlikely that excessive secretion of catecholamine causes ImBT.
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Hemorragia/patología , Lengua/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Asfixia/patología , Quemaduras/patología , Carboxihemoglobina/análisis , Catecolaminas/sangre , Causas de Muerte , Niño , Preescolar , Cianuros/sangre , Ahogamiento/patología , Femenino , Incendios , Patologia Forense , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Púrpura/patología , Estudios Retrospectivos , Adulto JovenRESUMEN
BACKGROUND: Carbon monoxide and cyanide poisoning are important causes of death due to fire. Carbon monoxide is more regularly assessed than cyanide at the site of burn or smoke inhalation treatment due to its ease in assessment and simplicity to treat. Although several forensic studies have demonstrated the significance of cyanide poisoning in fire victims using blood cyanide levels, the association between the cause of cardiac arrest and the concentration of cyanide among fire victims has not been sufficiently investigated. This study aimed to investigate the frequency of cyanide-induced cardiac arrest in fire victims and to assess the necessity of early empiric treatment for cyanide poisoning. METHODS: This study was a retrospective analysis of fire victims with cardiac arrest at the scene who were transported to a trauma and critical care center, Kyorin University Hospital, from January 2014 to June 2017. Patients whose concentration of cyanide was measured were included. RESULTS: Five patients were included in the study; all died despite cardiopulmonary resuscitation. Three of these victims were later found to have lethal cyanide levels (>3⯵g/ml). Two of the patients had non-lethal carboxyhemoglobin levels under 50% and might have been saved if hydroxocobalamin had been administered during resuscitation. CONCLUSION: According to our results, cyanide-induced cardiac arrest may be more frequently present among fire victims than previously believed, and early empiric treatment with hydroxocobalamin may improve outcomes for these victims in cases where cardiac arrest is of short duration.
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Intoxicación por Monóxido de Carbono/mortalidad , Cianuros/envenenamiento , Incendios , Paro Cardíaco Extrahospitalario/etiología , Lesión por Inhalación de Humo/mortalidad , Anciano , Carboxihemoglobina/metabolismo , Cianuros/sangre , Femenino , Humanos , Hidroxocobalamina/uso terapéutico , Masculino , Persona de Mediana Edad , Paro Cardíaco Extrahospitalario/mortalidad , Lesión por Inhalación de Humo/tratamiento farmacológicoRESUMEN
BACKGROUND: Various autopsy findings are used for the diagnosis of burning death, including inhalation injury, soot in the respiratory tract, vital reaction, blood carboxyhemoglobin (COHb), and blood cyanide. However, not all findings are necessarily complete, and autopsy diagnosis can be difficult in cases where there are few findings. In this study, we analyzed combustion-derived volatile substances (CVSs) in post-mortem blood in fire-related cases, focusing on those that occur when buildings and furniture thermally decompose during a fire, and evaluated these as potential new autopsy findings. METHODS: The blood CVSs of 61 fire-related cases from 2013 to 2015 were analyzed by a rapid and operationally simple method that employed a gas chromatograph-mass spectrometer coupled to a NeedlEx®, an extraction needle packed with a medium that selectively adsorbs volatile organic compounds. RESULTS: A total of 39 types of aliphatic and aromatic hydrocarbons were detected in the blood of fire victims. They could be detected even in post-mortem blood with COHb <10%, cyanide concentration <0.25µg/ml, and no soot in the respiratory tract. Styrene was detected in all cases except for one case of burning suicide with kerosene. The blood CVSs could be readily differentiated between the victims of building fires, self-immolation with kerosene, and self-immolation with gasoline: the presence of alpha-methylstyrene with a large amount styrene indicated a building fire; the detection of C9-C12 aliphatic hydrocarbons and C3 alkylbenzenes suggested a kerosene-related fire; and the detection of large amount of toluene and C3 alkylbenzenes indicated a gasoline-related fire. The number of blood CVSs detected for the building fire victims showed correlations with COHb level, cyanide concentration, and the amount of soot. With self-immolation, the number of blood CVSs detected showed weak correlation with COHb level, cyanide concentration, or amount of soot. CONCLUSION: Analysis of blood CVSs enabled the identification of the type of fire-related death, which is impossible by conventional autopsy findings.
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Incendios , Cromatografía de Gases y Espectrometría de Masas/instrumentación , Cromatografía de Gases y Espectrometría de Masas/métodos , Compuestos Orgánicos Volátiles/sangre , Quemaduras/sangre , Carboxihemoglobina/análisis , Estudios Transversales , Cianuros/sangre , Humanos , Hollín/análisisRESUMEN
Cyanide (CN) blood concentration is hardly considered during routine when evaluating smoke gas intoxications and fire victims, although some inflammable materials release a considerable amount of hydrogen cyanide. CN can be significant for the capacity to act and can in the end even be the cause of death. Systematic data concerning the influence of different fire conditions, especially those of various inflammable materials, on the CN-blood concentration of deceased persons do not exist. This study measured the CN level in 92 blood samples of corpses. All persons concerned were found dead in connection with fires and/or smoke gases. At the same time, the carboxyhemoglobin (COHb) level was determined, and the corpses were examined to detect pharmaceutical substances, alcohol and drugs. Furthermore, we analysed autopsy findings and the investigation files to determine the inflammable materials and other circumstances of the fires. Due to the inflammable materials, the highest concentration of CN in the victims was found after enclosed-space fires (n = 45) and after motor-vehicle fires (n = 8). The CN levels in these two groups (n = 53) were in 47 % of the cases toxic and in 13 % of the cases lethal. In victims of charcoal grills (n = 17) and exhaust gases (n = 6), no or only traces of CN were found. Only one case of the self-immolations (n = 12) displayed a toxic CN level. The results show that CN can have considerable significance when evaluating action ability and cause of death with enclosed-space fires and with motor-vehicle fires.
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Cianuros/sangre , Incendios , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Nivel de Alcohol en Sangre , Monóxido de Carbono/sangre , Carboxihemoglobina/análisis , Niño , Espacios Confinados , Femenino , Humanos , Masculino , Persona de Mediana Edad , Preparaciones Farmacéuticas/sangre , Lesión por Inhalación de Humo/sangre , Adulto JovenRESUMEN
Threats by fundamentalist leaders to use chemical weapons have resulted in renewed interest in cyanide toxicity. Relevant insights may be gained from studies on cyanide mass intoxication in populations relying on cyanogenic cassava as the main source of food. In these populations, sublethal concentrations (up to 80 µmol/l) of cyanide in the blood are commonplace and lead to signs of acute toxicity. Long-term toxicity signs include a distinct and irreversible spastic paralysis, known as konzo, and cognition deficits, mainly in sequential processing (visual-spatial analysis) domains. Toxic culprits include cyanide (mitochondrial toxicant), thiocyanate (AMPA-receptor chaotropic cyanide metabolite), cyanate (protein-carbamoylating cyanide metabolite), and 2-iminothiazolidine-4-carboxylic acid (seizure inducer). Factors of susceptibility include younger age, female gender, protein-deficient diet, and, possibly, the gut functional metagenome. The existence of uniquely exposed and neurologically affected populations offers invaluable research opportunities to develop a comprehensive understanding of cyanide toxicity and test or validate point-of-care diagnostic tools and treatment options to be included in preparedness kits in response to cyanide-related threats.
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Encéfalo/efectos de los fármacos , Encéfalo/patología , Cianuros/envenenamiento , Enfermedades Transmitidas por los Alimentos/diagnóstico , Manihot/envenenamiento , Encéfalo/fisiopatología , Cianuros/sangre , Enfermedades Transmitidas por los Alimentos/sangre , Enfermedades Transmitidas por los Alimentos/fisiopatología , HumanosRESUMEN
CONTEXT: Cyanide poisoning may be caused by acetonitrile, a common industrial organic solvent and laboratory agent. OBJECTIVE: To describe the potential use of disulfiram in treating acetonitrile poisoning in a human clinical case and to further study its effect in human liver microsomes in vitro. CASE DETAILS: A 30-year-old man initially presented with a cholinergic toxic syndrome following ingestion of aldicarb. Toxicological analysis revealed coingestion of ethanol. He subsequently developed severe metabolic acidosis caused by the cyanogenic compound acetonitrile which was erroneously interpreted as acetone in the chromatogram. After three treatments with hydroxocobalamin (5 g i.v.) and sodium thiosulfate (12.5 g i.v.) on days 2, 3, and 5, he had transient improvement but recurrent lactic acidosis. Treatment with disulfiram was associated on day 7 with resolution of metabolic acidosis and slowing of the decrease in acetonitrile concentration. He recovered from acetonitrile toxicity completely. The time course of acetonitrile, thiocyanate, and cyanide concentrations suggested that disulfiram inhibited cyanide formation. RESULTS: In vitro experiments with human liver microsomes showed the cyanide concentration was significantly lower after incubation with acetonitrile and disulfiram than acetonitrile alone (a mean 60% reduction in cyanide level). DISCUSSION: Although disulfiram was given late in the course of the poisoning it is possible that it contributed to the recovery.
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Acetonitrilos/envenenamiento , Acidosis Láctica/tratamiento farmacológico , Cianuros/sangre , Disulfiram/uso terapéutico , Intoxicación/tratamiento farmacológico , Acetonitrilos/sangre , Acidosis Láctica/sangre , Acidosis Láctica/inducido químicamente , Acidosis Láctica/diagnóstico , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/sangre , Aldicarb/sangre , Aldicarb/envenenamiento , Biomarcadores/sangre , Nivel de Alcohol en Sangre , Inhibidores de la Colinesterasa/sangre , Inhibidores de la Colinesterasa/envenenamiento , Etanol/efectos adversos , Etanol/sangre , Humanos , Masculino , Microsomas Hepáticos/efectos de los fármacos , Microsomas Hepáticos/metabolismo , Intoxicación/sangre , Intoxicación/diagnóstico , Factores de Tiempo , Resultado del TratamientoRESUMEN
The acute toxicity of cyanide is determined by its peak levels reached in the body. Compared to the ingestion of free cyanide, lower peak levels may be expected after consumption of foods containing cyanogenic glycosides with the same equivalent dose of cyanide. This is due to possible delayed and/or incomplete release of cyanide from the cyanogenic glycosides depending on many factors. Data on bioavailability of cyanide after consumption of foods containing high levels of cyanogenic glycosides as presented herein were necessary to allow a meaningful risk assessment for these foods. A crossover study was carried out in 12 healthy adults who consumed persipan paste (equivalent total cyanide: 68 mg/kg), linseed (220 mg/kg), bitter apricot kernels (about 3250 mg/kg), and fresh cassava roots (76-150 mg/kg), with each "meal" containing equivalents of 6.8 mg cyanide. Cyanide levels were determined in whole blood using a GC-MS method with K(13)C(15)N as internal standard. Mean levels of cyanide at the different time points were highest after consumption of cassava (15.4 µM, after 37.5 min) and bitter apricot kernels (14.3 µM, after 20 min), followed by linseed (5.7 µM, after 40 min) and 100 g persipan (1.3 µM, after 105 min). The double dose of 13.6 mg cyanide eaten with 200 g persipan paste resulted in a mean peak level of 2.9 µM (after 150 min). An acute reference dose of 0.075 mg/kg body weight was derived being valid for a single application/meal of cyanides or hydrocyanic acid as well as of unprocessed foods with cyanogenic glycosides also containing the accompanying intact ß-glucosidase. For some of these foods, this approach may be overly conservative due to delayed release of cyanide, as demonstrated for linseed. In case of missing or inactivated ß-glucosidase, the hazard potential is much lower.
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Cianuros/farmacocinética , Enfermedades Transmitidas por los Alimentos , Glicósidos/farmacocinética , Manihot/química , Adulto , Disponibilidad Biológica , Estudios Cruzados , Cianuros/sangre , Cianuros/envenenamiento , Femenino , Lino/química , Glicósidos/toxicidad , Humanos , Masculino , Persona de Mediana Edad , Prunus armeniaca/químicaRESUMEN
The metabolism of yellow cassava (variety TMS 01/1368) was investigated in male albino rats fed a diet containing yellow cassava for 7 to 28 days. There were significant increases (P < 0.05) in total and free cyanide and thiocyanate in the sera and urine samples of the experimental rats compared with the control, significant increases (P < 0.05) in serum glucose, alanine aminotransaminase, aspartate aminotransaminase, and alkaline phosphatase levels of the experimental rats compared with the control, significant decreases (P < 0.05) in serum albumin of the experimental rats compared with the control, but no significant differences (P > 0.05) in the serum total proteins of the experimental rats compared with the control. The experimental rats treated for 7, 14, 21, or 28 days exhibited body weight decreases of 5.11%, 11.10%, 19.16%, and 24.18%, respectively, whereas the control group showed 9.17% gain in body weight. Total and free cyanide concentrations were detected in the liver, kidney, and heart of most of the rats in both the experimental and control groups, except for free cyanide in the control group that was not detected. Metabolism of the yellow cassava variety in experimental rats was capable of exposing the animals to cyanide, underscoring the need for its proper processing before consumption by humans.
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Manihot/toxicidad , Metabolismo/efectos de los fármacos , Animales , Glucemia/metabolismo , Peso Corporal/efectos de los fármacos , Cianuros/sangre , Cianuros/metabolismo , Dieta , Riñón/química , Riñón/metabolismo , Hígado/química , Hígado/metabolismo , Masculino , Miocardio/química , Miocardio/metabolismo , Raíces de Plantas/química , Ratas , Ratas Wistar , Tiocianatos/sangre , Tiocianatos/metabolismo , Distribución TisularRESUMEN
Naphthimidazolium based monocationic chemodosimeters CD-1 and CD-2 undergo cyanide mediated catalytic transformation in the presence of cyanide ions (0.01% to 1% of CD-1/CD-2 concentrations) with a turnover number from 70 to 360. These chemodosimeters can detect as low as 0.5 nM and 1 nM cyanide ions under nearly physiological conditions (HEPES buffer-DMSO (5%), pH 7.4). The structures of CD-1 and its cyanide induced hydrolyzed product 4 have been confirmed by single crystal X-ray crystallography. CD-1 can also be used for the determination of 2 nM cyanide in the presence of blood serum. CD-1 and CD-2 also find applications in live cell imaging of 10 nM cyanide ions in rat brain C6 glioma cells. To the best of our knowledge, this is the first report where high sensitivity towards cyanide ions has been achieved through catalytic hydrolysis of the fluorescent chemodosimeter.
Asunto(s)
Cianuros/análisis , Cianuros/sangre , Colorantes Fluorescentes/química , Quinazolinas/química , Agua/análisis , Animales , Catálisis , Línea Celular Tumoral , Cristalografía por Rayos X , Hidrólisis , Modelos Moleculares , Imagen Óptica , Ratas , Espectrometría de FluorescenciaRESUMEN
We assessed the relationship between key trace elements and neurocognitive and motor impairments observed in konzo, a motor neuron disease associated with cassava cyanogenic exposure in nutritionally challenged African children. Serum concentrations of iron, copper, zinc, selenium, and neurotoxic lead, mercury, manganese, cadmium, and cobalt were measured in 123 konzo children (mean age 8.53 years) and 87 non-konzo children (mean age 9.07 years) using inductively coupled plasma mass spectrometry (ICPMS). Concentrations of trace elements were compared and related to performance scores on the Kaufman Assessment Battery for Children, 2nd edition (KABC-II) for cognition and Bruininks-Oseretsky Test, 2nd edition (BOT-2) for motor proficiency. Children with konzo had low levels of selenium, copper, and zinc relative to controls. Selenium concentration significantly correlated with serum 8,12-iso-iPF2α-VI isoprostane (Spearman r=0.75, p<0.01) and BOT-2 scores (r=0.31, p=0.00) in children with konzo. Elemental deficiency was not associated with poor cognition. Mean (SD) urinary level of thiocyanate was 388.03 (221.75) µmol/l in non-konzo compared to 518.59 (354.19) µmol/l in konzo children (p<0.01). Motor deficits associated with konzo may possibly be driven by the combined effects of cyanide toxicity and Se deficiency on prooxidant mechanisms. Strategies to prevent konzo may include dietary supplementation with trace elements, preferentially, those with antioxidant and cyanide-scavenging properties.