Department of Emergency Medicine, School of Medicine, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran; Emergency Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Faculty of Architecture and Urbanism, UTE University, Calle Rumipamba S/N and Bourgeois, Quito, Ecuador; Department of Biomaterials, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, 600 077, India; Process Systems Engineering Centre (PROSPECT), Faculty of Chemical and Energy Engineering, Faculty of Engineering, Universiti Teknologi Malaysia, Skudai, Johor, Malaysia.
Environ Res. 2023 Jul 1;228:115886. doi: 10.1016/j.envres.2023.115886. Epub 2023 Apr 16.
Intoxication with methanol most commonly occurs as a consequence of ingesting, inhaling, or coming into contact with formulations that include methanol as a base. Clinical manifestations of methanol poisoning include suppression of the central nervous system, gastrointestinal symptoms, and decompensated metabolic acidosis, which is associated with impaired vision and either early or late blindness within 0.5-4 h after ingestion. After ingestion, methanol concentrations in the blood that are greater than 50 mg/dl should raise some concern. Ingested methanol is typically digested by alcohol dehydrogenase (ADH), and it is subsequently redistributed to the body's water to attain a volume distribution that is about equivalent to 0.77 L/kg. Moreover, it is removed from the body as its natural, unchanged parent molecules. Due to the fact that methanol poisoning is relatively uncommon but frequently involves a large number of victims at the same time, this type of incident occupies a special position in the field of clinical toxicology. The beginning of the COVID-19 pandemic has resulted in an increase in erroneous assumptions regarding the preventative capability of methanol in comparison to viral infection. More than 1000 Iranians fell ill, and more than 300 of them passed away in March of this year after they consumed methanol in the expectation that it would protect them from a new coronavirus. The Atlanta epidemic, which involved 323 individuals and resulted in the deaths of 41, is one example of mass poisoning. Another example is the Kristiansand outbreak, which involved 70 people and resulted in the deaths of three. In 2003, the AAPCC received reports of more than one thousand pediatric exposures. Since methanol poisoning is associated with high mortality rates, it is vital that the condition be addressed seriously and managed as quickly as feasible. The objective of this review was to raise awareness about the mechanism and metabolism of methanol toxicity, the introduction of therapeutic interventions such as gastrointestinal decontamination and methanol metabolism inhibition, the correction of metabolic disturbances, and the establishment of novel diagnostic/screening nanoparticle-based strategies for methanol poisoning such as the discovery of ADH inhibitors as well as the detection of the adulteration of alcoholic drinks by nanoparticles in order to prevent methanol poisoning. In conclusion, increasing warnings and knowledge about clinical manifestations, medical interventions, and novel strategies for methanol poisoning probably results in a decrease in the death load.
甲醇中毒最常见于摄入、吸入或接触以甲醇为基础的制剂。甲醇中毒的临床表现包括中枢神经系统抑制、胃肠道症状和失代偿性代谢性酸中毒，这与视力损害有关，摄入后 0.5-4 小时内可出现早发性或迟发性失明。摄入后，血液中甲醇浓度大于 50mg/dl 应引起关注。摄入的甲醇通常被醇脱氢酶 (ADH) 消化，随后重新分布到身体的水中，以达到与 0.77L/kg 相当的体积分布。此外，它以其自然、未改变的母体分子的形式从体内排出。由于甲醇中毒相对罕见，但同时通常涉及大量受害者，因此这种事件在临床毒理学领域占有特殊地位。COVID-19 大流行开始导致人们错误地认为甲醇在预防病毒感染方面的能力。今年 3 月，1000 多名伊朗人因饮用甲醇而生病，其中 300 多人死亡，他们希望甲醇能保护他们免受新冠病毒的侵害。涉及 323 人的亚特兰大疫情和导致 41 人死亡的疫情就是大规模中毒的一个例子。另一个例子是涉及 70 人并导致 3 人死亡的克里斯蒂安桑疫情。2003 年，AAPCC 收到了一千多例儿科暴露的报告。由于甲醇中毒死亡率高，因此必须认真对待并尽快治疗这种情况。本综述的目的是提高对甲醇毒性的机制和代谢的认识，介绍胃肠道去污和甲醇代谢抑制等治疗干预措施，纠正代谢紊乱，以及建立新的诊断/筛查基于纳米颗粒的策略，如发现 ADH 抑制剂以及检测纳米颗粒对酒精饮料的掺假，以预防甲醇中毒。总之，增加对甲醇中毒临床表现、医学干预和新策略的警告和认识，可能会降低死亡率。
