UMass Chan Medical School Faculty Publications


Central respiratory failure during acute organophosphate poisoning

UMMS Affiliation

Department of Emergency Medicine; Department of Neurology

Publication Date


Document Type



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.

DOI of Published Version



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

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Respiratory physiology and neurobiology

PubMed ID