title: Recent advances in evaluation of oxime efficacy in nerve agent poisoning by in vitro analysis.
abstract: The availability of highly toxic organophosphorus (OP) warfare agents (nerve agents) underlines the necessity for an effective medical treatment. Acute OP toxicity is primarily caused by inhibition of acetylcholinesterase (AChE). Reactivators (oximes) of inhibited AChE are a mainstay of treatment, however, the commercially available compounds, obidoxime and pralidoxime, are considered to be rather ineffective against various nerve agents, e.g. soman and cyclosarin. This led to the synthesis and investigation of numerous oximes in the past decades. Reactivation of OP-inhibited AChE is considered to be the most important reaction of oximes. Clinical data from studies with pesticide-poisoned patients support the assumption that the various reactions between AChE, OP and oxime, i.e. inhibition, reactivation and aging, can be investigated in vitro with human AChE. In contrast to animal experiments such in vitro studies with human tissue enable the evaluation of oxime efficacy without being affected by species differences. In the past few years numerous in vitro studies were performed by different groups with a large number of oximes and methods were developed for extrapolating in vitro data to different scenarios of human nerve agent poisoning. The present status in the evaluation of new oximes as antidotes against nerve agent poisoning will be discussed.
authors.affiliation: Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstrasse 11, 80937 Munich, Germany. FranzWorek@Bundeswehr.org <FranzWorek@Bundeswehr.org>
authors.forename: F
authors.initials: F
authors.lastname: Worek
authors.forename: P
authors.initials: P
authors.lastname: Eyer
authors.forename: N
authors.initials: N
authors.lastname: Aurbek
authors.forename: L
authors.initials: L
authors.lastname: Szinicz
authors.forename: H
authors.initials: H
authors.lastname: Thiermann
mesh_terms: D000818:Animals; D002619:Chemical Warfare Agents / Q000737:chemistry / Q000506:poisoning*; D002800:Cholinesterase Inhibitors / Q000737:chemistry / Q000506:poisoning*; D002801:Cholinesterase Reactivators / Q000737:chemistry / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D066298:In Vitro Techniques; D015394:Molecular Structure; D062025:Organophosphate Poisoning; D009943:Organophosphorus Compounds / Q000737:chemistry; D010091:Oximes / Q000737:chemistry / Q000494:pharmacology* / Q000627:therapeutic use; D011041:Poisoning / Q000201:enzymology / Q000517:prevention & control; D013045:Species Specificity
chemical_list: D002619:Chemical Warfare Agents; D002800:Cholinesterase Inhibitors; D002801:Cholinesterase Reactivators; D009943:Organophosphorus Compounds; D010091:Oximes