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从动物研究的系统评价中发现对磷化铝心脏毒性最有影响的治疗方法。

Discovering the most impactful treatments for aluminum phosphide cardiotoxicity gleaned from systematic review of animal studies.

机构信息

Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center (PSRC), Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Hum Exp Toxicol. 2024 Jan-Dec;43:9603271241290922. doi: 10.1177/09603271241290922.

Abstract

INTRODUCTION

Aluminum phosphide (AlP) is a chemical compound that can cause death in some countries. AlP inhibits the functioning of cytochrome C oxidase in the mitochondria of cardiomyocytes, leading to toxicity. Oxidative stress and ROS production, as well as inflammatory signaling, mediate the mechanisms of AlP-related toxicity in the poisoned patient. Unfortunately, there are no approved medicines available to treat AlP poisoning yet. To address this issue, researchers have explored various interventions to reduce the toxicity associated with AlP tablets.

METHODS

We systematically searched relevant databases for English articles published between 2013 and 2024.

RESULTS

The evaluated treatments included correcting oxidative stress parameters, enhancing exogenous antioxidant capacity, modifying electrocardiographic abnormalities, and improving heart contraction strength. Our evaluation indicated that compounds like Triiodothyronine, Vasopressin and milrinone, Iron sucrose, Acetyl-l-carnitine, Melatonin, Fresh red blood cell transfusion, Minocycline, extract, Dihydroxyacetone, Selegiline, Nanocurcumin, Levosimendan, Exenatide, Taurine, Cannabidiol and Edaravone are effective in lessening AlP-induced cardiotoxicity.

CONCLUSION

Based on the present study's findings and the evaluation of clinical studies, dihydroxyacetone, fresh red blood cell infusion, Oil-based disinfection, and gastric lavage have the most potential to save patients' lives and treat acute aluminum phosphide. However, there is a need for more research in this regard.

摘要

简介

磷化铝(AlP)是一种在某些国家可能导致死亡的化学化合物。AlP 抑制心肌细胞线粒体细胞色素 C 氧化酶的功能,导致毒性。氧化应激和 ROS 产生以及炎症信号转导介导了中毒患者中与 AlP 相关的毒性机制。不幸的是,目前尚无治疗 AlP 中毒的批准药物。为了解决这个问题,研究人员已经探索了各种干预措施来减少与 AlP 片剂相关的毒性。

方法

我们系统地搜索了 2013 年至 2024 年期间发表的英文相关数据库文章。

结果

评估的治疗方法包括纠正氧化应激参数、增强外源性抗氧化能力、纠正心电图异常和改善心肌收缩力。我们的评估表明,三碘甲状腺原氨酸、血管加压素和米力农、蔗糖铁、乙酰左旋肉碱、褪黑素、新鲜红细胞输注、米诺环素、二羟丙酮、司来吉兰、纳米姜黄素、左西孟旦、艾塞那肽、牛磺酸、大麻二酚和依达拉奉等化合物在减轻 AlP 诱导的心脏毒性方面有效。

结论

根据本研究的结果和临床研究的评估,二羟丙酮、新鲜红细胞输注、油性消毒和洗胃最有潜力挽救患者生命并治疗急性磷化铝中毒。然而,这方面需要更多的研究。

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