Citation

Yen JS, Wang IK, Liang CC, Fu JF, Hou YC, Chang CC, Gu PW, Tsai KF, Weng CH, Huang WH, Hsu CW, Yen TH. Am. J. Transl. Res. 2021; 13(10): 11571-11584.

Copyright

(Copyright © 2021, e-Century Publishing)

DOI

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PMID

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Abstract

Cytokine-mediated inflammation is involved in the pathophysiology of paraquat toxicity. Nevertheless, few human studies have examined fluctuations in circulating cytokine levels. Blood samples were obtained from 21 patients with paraquat poisoning and compared to those of 18 healthy controls. All paraquat patients received a standard detoxification protocol composed of hemoperfusion, pulse therapies of methylprednisolone and cyclophosphamide, followed by dexamethasone therapy. Nonsurvivors not only had higher scores for the severity index of paraquat poisoning (P=0.004) but also presented with higher white blood cell counts (P=0.046) than survivors. Multiplex immunoassays revealed higher circulating levels of interleukin 2 (IL-2), interleukin 9 (IL-9), interleukin 10 (IL-10) and macrophage inflammatory protein-1 beta (MIP-1β) in survivors than in healthy controls. Furthermore, the circulating levels of interleukin 1 beta (IL-1β), IL-2, interleukin 5 (IL-5), interleukin 8 (IL-8), IL-9, IL-10, interleukin 12 (IL-12 p70), interleukin 17A (IL-17A), eotaxin, granulocyte colony-stimulating factor (G-CSF), monocyte chemoattractant protein-1 (MCP-1), interferon gamma-induced protein 10 (IP-10) and MIP-1β were higher in nonsurvivors than in healthy controls. Finally, the circulating levels of IL-1β and MCP-1 were higher in nonsurvivors than in survivors. Therefore, the observation of cytokine-mediated inflammation is in line with the detoxification protocol because glucocorticoids and cyclophosphamide are potent anti-inflammatory agents. Additionally, circulating levels of IL-1β and MCP-1 could serve as promising prognostic markers for patients with paraquat poisoning. © 2021 E-Century Publishing Corporation. All rights reserved.

Language: en

Keywords

adult; human; Mortality; female; male; multiple organ failure; shock; Inflammation; suicide attempt; C reactive protein; inflammation; intoxication; paraquat; controlled study; clinical article; stomach lavage; seizure; hospital discharge; detoxification; acute kidney failure; glucocorticoid; hypertension; dexamethasone; diabetes mellitus; alanine aminotransferase; aspartate aminotransferase; Glasgow coma scale; creatinine; creatinine blood level; leukocyte count; respiratory failure; aspiration pneumonia; charcoal; interleukin 2; methylprednisolone; gastrointestinal hemorrhage; blood pressure; cytokine; urea nitrogen blood level; acute pancreatitis; oxygen therapy; urinary tract infection; Article; hemoperfusion; interleukin 1beta; cyclophosphamide; paraquat poisoning; alanine aminotransferase blood level; aspartate aminotransferase blood level; interleukin 10; acute respiratory failure; granulocyte colony stimulating factor; fetus mortality; blood gas; Paraquat poisoning; Cytokine; interleukin 12; interleukin 5; QTc interval; platelet count; fraction of inspired oxygen; eotaxin; interleukin 12p70; interleukin 17 antibody; interleukin 9; Multiplex immunoassays; organ dysfunction score; Severity index of paraquat poisoning