Journal
ARHIV ZA HIGIJENU RADA I TOKSIKOLOGIJU-ARCHIVES OF INDUSTRIAL HYGIENE AND TOXICOLOGY
Volume 66, Issue 4, Pages 291-298Publisher
INST MEDICAL RESEARCH & OCCUPATIONAL HEALTH
DOI: 10.1515/aiht-2015-66-2740
Keywords
acetylcholinesterase; antidotes; butyrylcholinesterase; K048; nerve agents; pharmacokinetics; tissue-specific activity
Funding
- NATO Reintegration Grant [EAP.RIG.981791]
- Ministry of Science, Education and Sports of the Republic of Croatia [022-0222148-2889]
- Croatian-Slovenian bilateral grant [BI-HR/07-08-020]
- Croatian Science Foundation [4307]
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Even if organophosphorus (OP) nerve agents were banned entirely, their presence would remain a problem as weapons of terror (like in Syria). Oxime antidotes currently used in medical practice still fall short of their therapeutic purpose, as they fail to fully restore the activity of cholinesterases, the main target for OPs. As orphan drugs, these antidotes are tested too seldom for anybody's benefit. Over the last few decades, search for improved reactivators has reached new levels, but the translation of data obtained in vitro to in vivo application is still a problem that hinders efficient therapy. In this study, we tested the strengths and weaknesses of extrapolating pyridinium oxime antidotes reactivation efficiency from in vitro to in vivo application. Our results show that this extrapolation is possible with well-determined kinetic constants, but that it also largely depends on oxime circulation time and its tissue-specific distribution. This suggests that pharmacokinetic studies should be planned at the early stages of antidote development. Special attention should also be given to improving oxime distribution throughout the organism to overcome this major constraint in improving overall OP therapy.
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