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2016 ; 53
(ä): 64-73
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Intranasal delivery of obidoxime to the brain prevents mortality and CNS damage
from organophosphate poisoning
#MMPMID26751814
Krishnan JKS
; Arun P
; Appu AP
; Vijayakumar N
; Figueiredo TH
; Braga MFM
; Baskota S
; Olsen CH
; Farkas N
; Dagata J
; Frey WH 2nd
; Moffett JR
; Namboodiri AMA
Neurotoxicology
2016[Mar]; 53
(ä): 64-73
PMID26751814
show ga
Intranasal delivery is an emerging method for bypassing the blood brain barrier
(BBB) and targeting therapeutics to the CNS. Oximes are used to counteract the
effects of organophosphate poisoning, but they do not readily cross the BBB.
Therefore, they cannot effectively counteract the central neuropathologies caused
by cholinergic over-activation when administered peripherally. For these reasons
we examined intranasal administration of oximes in an animal model of severe
organophosphate poisoning to determine their effectiveness in reducing mortality
and seizure-induced neuronal degeneration. Using the paraoxon model of
organophosphate poisoning, we administered the standard treatment (intramuscular
pralidoxime plus atropine sulphate) to all animals and then compared the
effectiveness of intranasal application of obidoxime (OBD) to saline in the
control groups. Intranasally administered OBD was effective in partially reducing
paraoxon-induced acetylcholinesterase inhibition in the brain and substantially
reduced seizure severity and duration. Further, intranasal OBD completely
prevented mortality, which was 41% in the animals given standard treatment plus
intranasal saline. Fluoro-Jade-B staining revealed extensive neuronal
degeneration in the surviving saline-treated animals 24h after paraoxon
administration, whereas no detectable degenerating neurons were observed in any
of the animals given intranasal OBD 30min before or 5min after paraoxon
administration. These findings demonstrate that intranasally administered oximes
bypass the BBB more effectively than those administered peripherally and provide
an effective method for protecting the brain from organophosphates. The addition
of intranasally administered oximes to the current treatment regimen for
organophosphate poisoning would improve efficacy, reducing both brain damage and
mortality.