Therapeutic effects of smecta or smectite powder on rats with paraquat toxication

doi:10.5847/wjem.j.issn.1920-8642.2013.02.011

Abstract

Abstract:

BACKGROUND: The plasma concentration of paraquat is closely related to the prognosis of patients with paraquat toxication, and the most common cause of death from paraquat poisoning is multiple organ failure (MOF). This study aimed to evaluate therapeutic effect of smecta on the plasma concentrations of paraquat and multi-organ injury induced by paraquat intoxication in rats.
METHODS: A total of 76 healthy adult SD rats were randomly divided into group A (control group, n=6), group B (poisoned group, n=30) and group C (smecta-treated group, n=30). Rats in groups B and C were treated intragastrically with PQ at 50 mg/kg, and rats in group A was treated intragastrically with saline (1 mL). Rats in group C were given intragastrically smecta at 400 mg/kg 10 minutes after administration of PQ, while rats in other two groups were treated intragastrically with 1 mL saline at the same time. Live rats in groups B and C were sacrificed at 2, 6, 24, 48, 72 hours after administration of PQ for the determination of paraquat plasma concentrations and for HE staining of the lung, stomach and jejunum. The rats were executed at the end of trial by the same way in group A.
RESULTS: The plasma concentration of paraquat (ng/mL) ranged from 440.314±49.776 to 4320.6150±413.947. Distinctive pathological changes were seen in the lung, stomach and jejunum in group B. Lung injuries deteriorated gradually, edema, leukocyte infiltration, pneumorrhagia, incrassated septa and lung consolidation were observed. Abruption of mucosa, hyperemic gastric mucosa and leukocyte infiltration were obvious in the stomach. The hemorrhage of jejunum mucosa, the abruption of villus, the gland damage with the addition of inflammatory cell infiltration were found. Compared to group B, the plasma concentration of paraquat reduced (P<0.01) and the pathological changes mentioned above were obviously alleviated in group C (P<0.05, P<0.01).
CONCLUSION: Smecta reduced the plasma concentration of paraquat and alleviated pathologic injury of rats with PQ poisoning.

Key words: Smecta, Paraquat, Pathological change, Therapeutic injury

Yin-song Jiang, Yu-ying Ma, Zhan-qing Wang, Guang-jun Li. Therapeutic effects of smecta or smectite powder on rats with paraquat toxication[J]. World Journal of Emergency Medicine, 2013, 4(2): 144-150.

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References 41

1	Gunnell D, Eddleston M, Phillips MR, Konradsen F. The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health 2007; 7:357. doi: 10.1186/1471-2458-7-357 pmid: 18154668
2	Lin JL, Lin DT, Chen KH, Huang WH. Repeated pulse of methylprednisolone and cyclophosphamide with continuous dexamethasone therapy for patients with severe paraquat poisoning. Crit Care Med 2006; 34:368-373. pmid: 16424716
3	Kang MS, Gil HW, Yang JO, Lee EY, Hong SY. Comparision between kidney and hemoperfusion for paraquat elimination. Korean Med Sci 2009; 24:S156-160.
4	Roberts DM, Wilks MF, Roberts MS, Swaminathan R, Mohamed F, Dawson AH, et al. Changes in the concentrations of creatinine, cystatin C and NGAL in patients with acute paraquat self-poisoning. Toxicol Lett 2011; 202:69-74. pmid: 21291964
5	Gupta SP, Patel S, Yadav S, Singh AK, Singh S, Singh MP. Involvement of nitric oxide in maneb- and paraquat-induced Parkinson’s disease phenotype in mouse: is there any link with lipid peroxidation? Neurochem Res 2010; 35:1206-1213. doi: 10.1007/s11064-010-0176-5 pmid: 20455021
6	Tung JN, Lang YD, Wang LF, Chen CM. Paraquat increases connective tissue growth factor and collagen expression via angiotensin signaling pathway in human lung fibroblasts, Toxicology in Vitro 2010; 24:803-808.
7	Petry TW, Wolfgang GH, Jolly RA, Ochoa R, Donarski WJ. Antioxidant-dependent inhibition of diquat-induced toxicity in vivo. Toxicology 1992; 74:33-43.
8	Kim YT, Jou SS, Lee HS, Gil HW, Yang JO, Lee EY, et al. The area of ground glass opacities of the lungs as a predictive factor in acute paraquat intoxication. J Korean Med Sci 2009; 24:636-640. doi: 10.3346/jkms.2009.24.4.636
9	Vale JA, Meredith TJ, Buckly BM. Paraquat poisoning: clinical features and immediate general management. Hum Toxicol 1987; 6:41-47.
10	Lin JL, Liu L, Leu ML. Recovery of respiratory function in survivors with paraquat intoxication. Arch Environ Health 1986; 50:432-439. pmid: 8572721
11	Chen GH, Lin JL, Huang YK. Combined methylprednisolone and dexamethasone therapy for paraquat poisoning. Crit Care Med 2002; 30:2584-2587. pmid: 12441774
12	Lin NC, Lin JL, Lin DT, Yu CC. Combined initial cyclophosphamide with repeated methylprednisolone pulse therapy for severe paraquat poisoning from dermal exposure. J Toxicol Clin Toxicol 2003; 41:877-881. doi: 10.1081/clt-120025356 pmid: 14677801
13	Lin JL, Lin DT, Chen KH, Huang WH. Repeated pulse of methylprednisolone and cyclophosphamide with continuous dexamethasone therapy for patients with severe paraquat poisoning. CritCare Med 2006; 34:368-373.
14	Lin JL, Lin-Tan DT, Chen KH, Huang WH, Hsu CW, Hsu HH, et al. Improved survival in severe paraquat poisoning with repeated pulse therapy of cyclophosphamide and steroids. Intensive Care Med 2011; 37:1006-1013. pmid: 21327593
15	Dinis-Oliveira RJ, Duarte JA, Sánchez-Navarro A, Remião F, Bastos ML, Carvalho F. Paraquat poisonings: mechanisms of lung toxicity, clinical features, and treatment. Crit Rev Toxicol 2008; 38:13-71. pmid: 18161502
16	Suzuki K, Takasu N, Okabe T, Ishimatsu S, Ueda A, Tanaka S, et al. Effect of aggressive haemoperfusion on the clinical course of patients with paraquat poisoning. Hum Exp Toxicol 1993; 12:323-327.
17	Zheng CD, Duan YQ, Gao JM, Ruan ZG. Screening for anti-lipase properties of 37 traditional Chinese medicinal herbs. J Chin Med Assoc 2010; 73:319-324. pmid: 20603090
18	Szajewska H, Dziechciarz P, Mrukowicz J. Meta-analysis: smectite in the treatment of acute infectious diarrhoea in children. Aliment Pharmacol Ther 2006; 23:217-227. pmid: 16393300
19	Dupont C, Foo JL, Garnier P, Moore N, Mathiex-Fortunet H, Salazar-Lindo E, et al. Oral diosmectite reduces stool output and diarrhea duration in children with acute watery diarrhea. Clin Gastroenterol Hepatol 2009; 7:456-462. pmid: 19268266
20	Kuge T, Shibata T, Willett MS. Multicenter, double-blind, randomized comparison of wood creosote, the principal active ingredient of Seirogan, an herbal antidiarrheal medication, and loperamide in adults with acute nonspecific diarrhea. Clin Ther 2004; 26:1644-1651. pmid: 15598481
21	Allen A, Leonard A. Mucus structure. Gastroenterol Clin Biol 1985; 9:9215.
22	Khediri F, Mrad AI, Azzouz M, Doughi H, Najjar T, Mathiex-Fortunet H, et al. Efficacy of diosmectite (smecta) in the treatment of acute watery diarrhoea in adults: a multicentre, randomized, double-blind, placebo-controlled, parallel group study. Gastroenterol Res Pract 2011; 2011:783196.
23	Chang FY, Lu CL, Chen CY, Luo JC. Efficacy of dioctahedral smectite in treating patients of diarrhea-predominant irritable bowel syndrome. J Gastroenterol Hepatol 2007; 22: 2266-2272. Epub 2007 Jun 7. pmid: 17559369
24	Duffour J, Gourgou S, Seitz JF, Senesse P, Boutet O, Castera D, et al. Efficacy of prophylactic anti-diarrhoeal treatment in patients receiving Campto for advanced colorectal cancer. Anticancer Res 2002; 22:3727-3731. pmid: 12552984
25	Degtiareva II, Opanasiuk ND, Golota OV. The use of Smecta for the treatment of the basic digestive tract diseases. Lik Sprava 1994; 9-12:88-92. pmid: 10878991
26	Fuke C, Arao T, Morinaga Y, Takaesu H, Ameno K, Miyazaki T. Analysis of paraquat, diquat and two diquat metabolites in biological materials by high-performance liquid chromatography. Leg Med (Tokyo) 2002; 4:156-163.
27	Fuke C, Ameno K, Ameno S, Kiriu T, Shinohara T, Sogo K, et al. A rapid,simultaneous determination of paraquat and diquat in serum and urine using second-derivative spectroscopy. J Anal Toxicol 1992; 16:214-216.
28	Mikawa K, Nishina K, Takao Y, Obara H. ONO-1714, a nitric oxide synthase inhibitor, attenuates endo-toxin-induced acute lung injury in rabbits. Anesth Analg 2003; 97:1751-1755. doi: 10.1213/01.ane.0000086896.90343.13 pmid: 14633554
29	Bustos SP, Reithmeier RA. Structure and stability of hereditary spherocytosis mutants of the cytosolic domain of the erythrocyte anion exchanger 1 protein. Biochemistry 2006; 45:1026-1034.
30	Caplan MS, Jilling T. Neonatal Necrotizing enterocolitis:possible role of probiotic supplementation. J Pediatr Gastroenterol Nutr 2000; 30:S18-22. pmid: 10749397
31	Bullivant CM. Accidental poisoning by paraquat: a report of two cases in man. Br Med J 1966; 1:1272-1273.
32	Lock EA, Wilks MF. Paraquat. In: Handbook of Pesticide Toxicology, 2nd edn. San Diego, Academic Press, 2001: 1559-1603.
33	Suntres ZE. Role of antioxidants in paraquat toxicity. Toxicology 2002; 180:65-77. pmid: 12324200
34	Koo JR, Yoon JW, Han SJ, Choi MJ, Park II, Lee YK, et al. Rapid analysis of plasma paraquat using sodium dithionite as a predictor of outcome in acute paraquat poisoning. Am J Med Sci 2009; 338:373-377. pmid: 19826241
35	Houze P, Baud FJ, Mouy R, Bismuth C, Bourdon R, Scherrmann JM. Toxicokinetics of paraquat in humans. Hum Exp Toxicol 1990; 9:5-12.
36	Hawksworth GH, Bennett PN, Davies DS. Kinetics of paraquat elimination in the dog. Toxicol Appl Pharmacol 1981; 57:139-145. pmid: 7222029
37	Bennett PN, Davies DS, Hawkesworth GM. In vivo absorption studies with paraquat and diquat in the dog. Br J Pharmacol 1976; 58:284.
38	Ma YT, Tian YP, Shi HW, Lv CH, Liu JH, Sun ZP. Effects of high dose ambroxol on lung injury induced by paraquat in rats. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2007; 25:523-526.
39	Nagao M, Zhang WD, Itakura Y, Kobayashi M, Yamada Y, Yagi K, et al. Immunohistochemical localization and dynamics of paraquat in the stomach and esophagus of rats. Int J Leg Med 1993; 106:142-144.
40	Tiwary AK, Poppenga RH, Puschner B. In vitro study of the effectiveness of three commercial adsorbents for binding oleander toxins. Clin Toxicol (Phila) 2009; 47:213-218.
41	Amany AA. Protective effect of montelukast on paraquat-induced lung toxicity in rats. Biosci Trends 2009; 3:63-72.

Groups	Lung	Stomach	Jejunum
A	0.500±0.632	0.333±0.516	0.555±0.403
B
2 h	2.000±0.447^**	4.000±1.788^**	2.444±0.455^**
6 h	2.916±0.801^**	7.000±0.894^**	1.944±0.389^**
24 h	4.500±0.707^**	6.000±0.894^**	2.445±0.455^**
48 h	5.250±0.861^**	4.000±0.894^**	2.444±0.455^**
72 h	7.833±1.032^**	3.833±0.752^**	1.778±0.621^**
C
2 h	1.500±0.447^**	2.000±0.894^*#	1.777±0.621^**
6 h	1.917±0.585^**#	3.000±0.895^**##	1.333±0.298^**##
24 h	3.500±0447^**#	4.333±1.862^**	1.389±0.389^**##
48 h	4.083±0.917^**#	3.6670±1.633^**#	1.333±0.471^*##
72 h	5.583±0.585^**##	2.833±1.169^**	1.000±0.298^##

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