Department of Hygiene and Public Health, Osaka Medical College, 2-7 Daigakumachi, 569-8686, Takatsuki City, Osaka, Japan,
Environ Health Prev Med. 2004 Mar;9(2):58-62. doi: 10.1007/BF02897933.
Monochloroacetic acid (MCA) is corrosive to skin, and causes not only chemical injury but also fatal systemic poisoning. Little is known about the cause of death. We studied the acute toxicity of MCA before clinical symptoms appeared in fasting rats.
Blood samples were analyzed 2 h after subcutaneous MCA injection (Ld(90): 162 mg/ml kg body weight). Control rats were injected with saline.
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were about 1.5-fold higher than in the controls, and mitochondrial AST (mAST) was 2-fold higher. Blood urea nitrogen and creatinine were significantly increased, while serum glucose was significantly decreased in the treated group. Lactate was 6-fold higher and pyruvate was 13-fold higher than in the controls.
MCA caused injury to the liver and kidneys but these injuries were slight. However, the larger increase in mAST indicated that hepatocellular mitochondria were selectively targeted. Hepatocellular mitochondrial injury decreased gluconeogenesis and caused hypoglycemia and extremely high levels of lactate and pyruvate. Hypoglycemia and lactic acidosis were insidious before the critical symptoms appeared and this combination accelerated to death, affecting other organs such as the heart and brain. Nosotropic therapy of these abnormalities up to the appearance of symptoms may help to establish an early therapy for skin exposure to MCA.
一氯乙酸(MCA)对皮肤具有腐蚀性,不仅会造成化学损伤,还会导致致命的全身中毒。目前对于其致死原因知之甚少。本研究旨在观察 MCA 在空腹大鼠出现临床症状之前的急性毒性。
MCA 经皮下注射后 2 小时,采集血样进行分析(LD90:162mg/ml 体重)。对照组大鼠注射生理盐水。
与对照组相比,AST 和 ALT 约升高 1.5 倍,mAST 升高 2 倍。治疗组的血尿素氮和肌酐明显升高,而血清葡萄糖明显降低。与对照组相比,乳酸升高 6 倍,丙酮酸升高 13 倍。
MCA 导致肝、肾损伤,但程度较轻。然而,mAST 较大幅度的升高提示肝细胞线粒体受到了选择性靶向损伤。肝细胞线粒体损伤导致糖异生减少,引起低血糖和极高水平的乳酸和丙酮酸。在出现危急症状之前,低血糖和乳酸酸中毒较为隐匿,且二者共同作用加速了死亡进程,影响了心脏和大脑等其他器官。在出现症状之前对这些异常进行神经保护治疗可能有助于建立 MCA 皮肤暴露的早期治疗方法。