Satoh T, Hosokawa M
Laboratory of Biochemical Pharmacology and Toxicology, Faculty of Pharmaceutical Sciences, Chiba University, Japan.
Neurotoxicology. 2000 Feb-Apr;21(1-2):223-7.
Serious intoxications and incidences due to misuse of organophosphorus insecticides (OP) have been reported for over three decades. In this meeting I am talking about the following three topics. (1) Epidemiological studies on the use of OP in Japan, Taiwan and Thailand. The National Research Institute of Police Science (NRIPS) in Japan has published the annual report of the epidemiological studies on the criminal and suicide events. The numbers of the incidence of pesticides are approximately 22%-30% of the total incidences, during 1991 and 1996. The incidence of pesticides has been gradually reduced for past six years. This seems to be influenced by the decrease of the incidences of paraquat having extremely high toxicity. According to the epidemiological data in the National Poison Center in Taiwan, unlike the prevalence of drug poisoning exposures in most western countries, pesticides poisoning exposures are numerous in Taiwan. The number of pesticide intoxication cases is 6,872 out of 23,436 of total case numbers of various intoxications during the 1985 and 1997. The fatality rate is much higher in Taiwan than in most western countries, with 5.65% of all poisoning exposures resulted in death. Paraquot is the leading cause of death in Taiwan. The ratio of death to total OP intoxication cases is 11.5% including accidental exposure and suicide. According to the report of the Division of Epidemiology, Ministry of Public Health, Thailand during the 1990-1995, the overall morbidity due to poisoning was 30 per 100,000 population with 300 deaths per year. The morbidity rate of reported pesticide poisoning in the whole country was 10 per 100,000 population. (2) Sarin victims in Tokyo. On March 20, 1995, a terrorist attack using sarin (isopropylmethylphosphonofluoridate) occurred on the Tokyo subway. Many people inhaled the sarin gas and collapsed in the train. Eventually, 12 people died and over 5,000 were injured. The results of the forensic studies showed that methylphosphonic acid, the hydrolysis product of sarin, bound to AChE in the cerebellums of the victims was separated and identified using GCMS. (3) A sensitive and rapid biomarker of OP-poisoning. Beta-glucuronidase (beta-G) is loosely bound to egasyn which is one of carboxylesterase isozymes in the liver microsomes. The oxon formed from OP in the liver microsomes is covalently bound to egasyn and causes the cleavage of the egasyn-glucuronidase complex, leading to the release of beta-G into the blood. In fact, plasma beta-G activities is a much more sensitive and rapid biomarker than the blood cholinesterase inhibition. In conclusion, OPs cause serious toxicity in both acute and chronic exposures. The epidemiological data in Taiwan and Thailand show that paraquat intoxication cause the most serious irreversible damage in the patients. In 1995, terrorists attack using sarin which is one of the most toxic OP, on the Tokyo subway, and 12 people died. This is an example of the acute intoxication of OP and some people have been still in hospitalized. Recently, the present authors have reported that the plasma beta-G activity is a novel biomarker of OP intoxication. The plasma beta-G is rapidly and significantly increased after OP exposure, and this is a much more sensitive to OP intoxication than ChE inhibition.
三十多年来,一直有关于因滥用有机磷杀虫剂(OP)导致严重中毒和事故的报道。在本次会议上,我将讨论以下三个主题。(1)日本、台湾和泰国有机磷杀虫剂使用情况的流行病学研究。日本国立警察科学研究所(NRIPS)发布了关于犯罪和自杀事件的流行病学研究年度报告。在1991年至1996年期间,农药中毒事件的数量约占总中毒事件的22% - 30%。在过去六年中,农药中毒事件的发生率逐渐下降。这似乎受到具有极高毒性的百草枯中毒事件减少的影响。根据台湾地区毒物中心的流行病学数据,与大多数西方国家药物中毒暴露的普遍情况不同,台湾地区农药中毒暴露事件众多。在1985年至1997年期间,各种中毒事件的总病例数为23436例,其中农药中毒病例数为6872例。台湾地区的死亡率远高于大多数西方国家,所有中毒暴露事件中有5.65%导致死亡。百草枯是台湾地区的主要致死原因。包括意外暴露和自杀在内,百草枯导致的死亡占有机磷杀虫剂中毒总病例数的比例为11.5%。根据泰国公共卫生部流行病学司1990 - 1995年的报告,中毒导致的总体发病率为每10万人30例,每年有300人死亡。全国报告的农药中毒发病率为每10万人10例。(2)东京的沙林受害者。1995年3月20日,东京地铁发生了一起使用沙林(异丙基甲基膦酰氟)的恐怖袭击事件。许多人吸入沙林气体后在列车上倒下。最终,12人死亡,5000多人受伤。法医研究结果表明,沙林的水解产物甲基膦酸与受害者小脑中的乙酰胆碱酯酶(AChE)结合,通过气相色谱 - 质谱联用(GCMS)分离并鉴定。(3)有机磷杀虫剂中毒的一种灵敏快速的生物标志物。β - 葡萄糖醛酸酶(β - G)与肝微粒体中羧酸酯酶同工酶之一的egasyn松散结合。在肝微粒体中由有机磷杀虫剂形成的氧磷与egasyn共价结合,导致egasyn - 葡萄糖醛酸酶复合物裂解,从而使β - G释放到血液中。事实上,血浆β - G活性是一种比血液胆碱酯酶抑制更为灵敏快速的生物标志物。总之,有机磷杀虫剂在急性和慢性暴露中都会导致严重毒性。台湾和泰国的流行病学数据表明,百草枯中毒对患者造成的不可逆损害最为严重。1995年,恐怖分子在东京地铁使用了毒性最强的有机磷杀虫剂之一沙林,导致12人死亡。这是有机磷杀虫剂急性中毒的一个例子,至今仍有一些人住院治疗。最近,本文作者报告血浆β - G活性是有机磷杀虫剂中毒的一种新型生物标志物。有机磷杀虫剂暴露后,血浆β - G迅速且显著升高,并且它对有机磷杀虫剂中毒的敏感性远高于胆碱酯酶抑制。