Central respiratory failure during acute organophosphate poisoning
Department of Emergency Medicine; Department of Neurology
Medical Subject Headings
Acute Disease; Animals; Humans; Nerve Net; Organophosphate Poisoning; Organophosphorus Compounds; Respiratory Center; Respiratory Insufficiency
Circulatory and Respiratory Physiology | Emergency Medicine | Medical Physiology | Medical Toxicology | Neurology | Respiratory System | Respiratory Tract Diseases | Toxicology
Organophosphate (OP) pesticide poisoning is a global health problem with over 250,000 deaths per year. OPs affect neuronal signaling through acetylcholine (Ach) neurotransmission via inhibition of acetylcholinesterase (AChE), leading to accumulation of Ach at the synaptic cleft and excessive stimulation at post-synaptic receptors. Mortality due to OP agents is attributed to respiratory dysfunction, including central apnea. Cholinergic circuits are integral to many aspects of the central control of respiration, however it is unclear which mechanisms predominate during acute OP intoxication. A more complete understanding of the cholinergic aspects of both respiratory control as well as neural modification of pulmonary function is needed to better understand OP-induced respiratory dysfunction. In this article, we review the physiologic mechanisms of acute OP exposure in the context of the known cholinergic contributions to the central control of respiration. We also discuss the potential central cholinergic contributions to the known peripheral physiologic effects of OP intoxication.
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Citation: Respir Physiol Neurobiol. 2013 Nov 1;189(2):403-10. doi: 10.1016/j.resp.2013.07.022. Epub 2013 Aug 7. Link to article on publisher's site
Carey, Jennifer L.; Dunn, Courtney; and Gaspari, Romolo J., "Central respiratory failure during acute organophosphate poisoning" (2013). University of Massachusetts Medical School Faculty Publications. 512.