Organophosphorus (OP) compounds have been widely available for decades in agriculture for crop protection and as cheap pest controllers, which increases the rate of exposure and poisoning cases. Using serum cholinesterase as prognostic markers for the acute OP toxicity is controversial; therefore, we aim to find out prognostic biomarkers that best correlate with mortality and outcomes of patients with acute OP toxicity. Levels of serum oxidative stress biomarkers (malondialdehyde (MDA) and total antioxidant capacity (TAC)) and activity of the apoptotic biomarkers (caspase 3 and caspase 9) and pseudo-cholinesterase (p.ChE) were performed. Also, we evaluated the apoptotic capacity through determining the genotoxic effects and chromosomal abnormalities among OP intoxicated patients. We found the activity of caspases and serum MDA and TAC were significantly increased after OP poisoning and decreased after the appropriate atropine and oxime treatment course. The ROC curve suggested caspases as mortality and outcome predictive markers for acute OP poisoning patients. However, OP poisoning cases before treatment showed significant DNA damage, and they did not show any chromosomal aberration. The mentioned results strongly suggest apoptotic-related markers (caspase 3, caspase 9) as prognostic markers for evaluation of the treatment, outcomes, and mortality rate in the acute OP toxicity patients.

中文翻译：

---

胱天蛋白酶作为急性有机磷中毒的预后指标和死亡率预测指标

几十年来，有机磷（OP）化合物已在农业中广泛用于作物保护和作为廉价的害虫控制剂，这增加了接触率和中毒病例。使用血清胆碱酯酶作为急性OP毒性的预后指标是有争议的；因此，我们旨在寻找与OP急性毒性患者的死亡率和预后最相关的预后生物标志物。进行血清氧化应激生物标志物（丙二醛（MDA）和总抗氧化能力（TAC））的水平以及凋亡生物标志物（胱天蛋白酶3和胱天蛋白酶9）和假胆碱酯酶（p.ChE）的活性。此外，我们通过确定OP感染患者的遗传毒性作用和染色体异常来评估其凋亡能力。我们发现半胱氨酸蛋白酶的活性和血清中的MDA和TAC在OP中毒后显着增加，在适当的阿托品和肟治疗过程中降低。ROC曲线提示胱天蛋白酶是急性OP中毒患者的死亡率和预后指标。但是，治疗前的OP中毒病例显示出明显的DNA损伤，并且未显示任何染色体畸变。提到的结果强烈提示凋亡相关的标志物（胱天蛋白酶3，胱天蛋白酶9）作为评估急性OP毒性患者的治疗，预后和死亡率的预后标志物。治疗前的OP中毒病例显示出明显的DNA损伤，且未显示任何染色体畸变。提到的结果强烈提示凋亡相关的标志物（胱天蛋白酶3，胱天蛋白酶9）作为评估急性OP毒性患者的治疗，预后和死亡率的预后标志物。治疗前的OP中毒病例显示出明显的DNA损伤，且未显示任何染色体畸变。提到的结果强烈提示凋亡相关的标志物（胱天蛋白酶3，胱天蛋白酶9）作为评估急性OP毒性患者的治疗，预后和死亡率的预后标志物。