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Du Z, Zhang YH, Sun L. Challenges and Limitations of Extracorporeal Membrane Oxygenation Therapy in Severe Paraquat Poisoning: An Analysis of Unsuccessful Cases. Arch Bronconeumol 2024:S0300-2896(24)00063-2. [PMID: 38641437 DOI: 10.1016/j.arbres.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/25/2024] [Accepted: 03/07/2024] [Indexed: 04/21/2024]
Affiliation(s)
- Zhenhua Du
- Characteristic Medical Center of the Chinese People's Armed Police Force, 220#, Cheng-Lin Road, Tianjin 300162, China
| | - Yu-Hua Zhang
- Characteristic Medical Center of the Chinese People's Armed Police Force, 220#, Cheng-Lin Road, Tianjin 300162, China
| | - Liang Sun
- Characteristic Medical Center of the Chinese People's Armed Police Force, 220#, Cheng-Lin Road, Tianjin 300162, China.
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Hou L, Yang F, Zhang Y, Li Y, Yan H, Meng C, Du Y, Zhu H, Yuan D, Gao Y. 2-Methoxyestradiol ameliorates paraquat-induced pulmonary fibrosis by inhibiting the TGF-β1/Smad2/3 signaling pathway. PESTICIDE BIOCHEMISTRY AND PHYSIOLOGY 2023; 197:105647. [PMID: 38072522 DOI: 10.1016/j.pestbp.2023.105647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/02/2023] [Accepted: 10/11/2023] [Indexed: 12/18/2023]
Abstract
Paraquat (PQ) is a highly effective and highly toxic herbicide that is highly toxic to both humans and animals. Pulmonary fibrosis is the primary cause of fatality in patients with PQ poisoning, there is no effective drug treatment yet. 2-Methoxyestradiol (2ME) is a natural metabolite of estradiol with anti-tumor, anti-angiogenesis, and anti-proliferative effects. Whether 2ME has the potential to inhibit pulmonary fibrosis induced by PQ is unclear. This study aims to investigate the potential effects and mechanism of 2ME on PQ-induced pulmonary fibrosis. C57BL/6 mice and A549 cells were exposed to PQ to establish pulmonary fibrosis model. In vivo, Hematoxylin and eosin (H&E) staining was utilized to assess the pathological characteristics. Masson's trichrome staining was employed to evaluate the collagen deposition. Western blot and immunohistochemistry were conducted to determine the expressions of fibrosis markers. In vitro, the expressions of epithelial-mesenchymal transition (EMT) markers were detected using western blot and immunofluorescence to evaluated the potential inhibition of PQ-induced EMT by 2ME. And proteins associated with the TGF-β1/Smad2/3 signaling pathway were measured by western blot in vivo and in vitro. The result found that 2ME can ameliorated PQ-induced pulmonary fibrosis and inhibit the activation of TGF-β1/Smad2/3 signaling pathway. These findings suggest that 2ME may serve as a potential therapeutic agent for treating PQ-induced pulmonary fibrosis.
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Affiliation(s)
- Linlin Hou
- Emergency Department, The First Affiliated Hospital of Zhengzhou University, Medical Key Laboratory of Poisoning Diseases of Henan Province, Zhengzhou 450000, China
| | - Fang Yang
- Emergency Department, The First Affiliated Hospital of Zhengzhou University, Medical Key Laboratory of Poisoning Diseases of Henan Province, Zhengzhou 450000, China
| | - Yan Zhang
- Emergency Department, The First Affiliated Hospital of Zhengzhou University, Medical Key Laboratory of Poisoning Diseases of Henan Province, Zhengzhou 450000, China
| | - Yi Li
- Emergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100000, China
| | - Hongyi Yan
- Emergency Department, The First Affiliated Hospital of Zhengzhou University, Medical Key Laboratory of Poisoning Diseases of Henan Province, Zhengzhou 450000, China
| | - Cuicui Meng
- Emergency Department, The First Affiliated Hospital of Zhengzhou University, Medical Key Laboratory of Poisoning Diseases of Henan Province, Zhengzhou 450000, China
| | - Yuqi Du
- Emergency Department, The First Affiliated Hospital of Zhengzhou University, Medical Key Laboratory of Poisoning Diseases of Henan Province, Zhengzhou 450000, China
| | - Huanzhou Zhu
- Emergency Department, The First Affiliated Hospital of Zhengzhou University, Medical Key Laboratory of Poisoning Diseases of Henan Province, Zhengzhou 450000, China
| | - Ding Yuan
- Emergency Department, The First Affiliated Hospital of Zhengzhou University, Medical Key Laboratory of Poisoning Diseases of Henan Province, Zhengzhou 450000, China.
| | - Yanxia Gao
- Emergency Department, The First Affiliated Hospital of Zhengzhou University, Medical Key Laboratory of Poisoning Diseases of Henan Province, Zhengzhou 450000, China.
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Li C, Cai H, Meng F, Meng F, Tang Z, Tang Y, Chen Y, Cui Y, Li Y. Case report: Lung transplantation for treatment of paraquat intoxication: timing of transplantation. Front Pharmacol 2023; 14:1205689. [PMID: 37529697 PMCID: PMC10387547 DOI: 10.3389/fphar.2023.1205689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/07/2023] [Indexed: 08/03/2023] Open
Abstract
Objective: To analyze the optimal timing of lung transplantation and summarize postoperative complications and their management after paraquat poisoning. Methods: Here, we present the clinical course of a 17-year-old boy with paraquat poisoning, in whom bilateral lung transplantation (LT) was performed. We reviewed the eight previously published articles relevant to LT after paraquat poisoning to summarize the therapeutic strategy. Results: A 17-year-old boy was admitted to the hospital after ingestion of 30-50 mL 25% paraquat. Mechanical ventilation was initiated on the 25th day after intoxication. Venovenous extracorporeal membrane oxygenation was initiated on the 26th day. Sequential bilateral LT was performed on the 27th day. Several complex postoperative complications occurred and the patient was discharged on the 50th day postoperatively. Eight case reports were included in the literature review, including 11 patients with paraquat poisoning undergoing LT. Three patients died due to paraquat poisoning leading to fibrosis in the transplanted lungs or postoperative complications. Eight patients survived during follow-up. Conclusion: LT after herbicide poisoning should be planned when hepatorenal function starts to recover, and waiting for complete recovery is unnecessary. Prevention of infection before surgery is important to reduce the incidence of postoperative infection. Complex perioperative complications caused by the herbicide itself or the late timing of transplantation can be successfully managed by a multidisciplinary team.
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Affiliation(s)
- Congcong Li
- Department of Surgery, The First Hospital of Jilin University, Changchun, China
| | - Hongfei Cai
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Fanyu Meng
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Fanjie Meng
- Department of Surgery, The First Hospital of Jilin University, Changchun, China
| | - Ze Tang
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Ying Tang
- Department of Respiratory and Critical Care Medicine, The First Hospital of Jilin University, Changchun, China
| | - Ying Chen
- Department of Critical Medicine, The First Hospital of Jilin University, Changchun, China
| | - Youbin Cui
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, China
| | - Yang Li
- Department of Thoracic Surgery, Organ Transplantation Center, The First Hospital of Jilin University, Changchun, China
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