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Pathological changes induced by phosphine poisoning: a study on 8 children

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Abstract

Aluminum phosphide (ALP) has been extensively used as an economical and effective insecticide, rodenticide, and fumigant. The active ingredient of ALP is phosphine (PH3), the use of which can lead to accidental inhalation and mass poisoning with high mortality. Exposure to PH3 will give rise to global damage in the human body. This study reviewed 4 fatal accidents including 8 children with PH3 poisoning and aimed to determine the pathological changes that resulted from exposure to PH3 and, secondly, aimed to determine whether oxidative stress was involved in PH3-induced neurotoxicity using histopathological and immunohistochemistry (IHC) methods. After focusing on the pathological changes on the major organs, we found severe damage induced by PH3 in many systems, especially the neurological system, including neuronal, axonal, and vascular injuries as well as oxidative damage with increased expression of 4-hydroxy-2-trans-nonenal (4HNE), 8-hydroxy-2’-deoxyguanosine (8-OH-dG), and 3-nitrotyrosine (3-NT) in the brain, which indicated that oxidative stress was a crucial mechanism for neuronal death in PH3 toxicity. Moreover, we observed severe myocardial and hepatocellular fatty degeneration in the tissues of the heart and liver. We considered that these characteristic changes are a suggestive sign of PH3 poisoning and partly explained the toxic mechanism of PH3 (inhibition of mitochondrial oxidative phosphorylation). We hope that this research could improve the understanding of the toxicity of PH3 in both forensic and clinical practice.

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Funding

This work was supported by National Key Research and Development Program of China (No. 2018YFC0807203) and the Fundamental Research Funds for the Central Universities, HUST (No. 2016JCTD117).

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  1. Yue Liang and Fang Tong contributed equally to this work.

Authors and Affiliations

  1. Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Hankou, Wuhan, 430030, People’s Republic of China

    Yue Liang, Fang Tong, Fang Huang, Yuluo Liu, Longlong Zhu & Yiwu Zhou

  2. The First Clinical College, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, People’s Republic of China

    Jehane Michael Le Grange

  3. Institute of Forensic Science, Ministry of Public Security People’s Republic of China, No. 17 Nanli Mulidi, Beijing, 100038, People’s Republic of China

    Guanglong He

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  1. Yue Liang
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Liang, Y., Tong, F., Huang, F. et al. Pathological changes induced by phosphine poisoning: a study on 8 children. Int J Legal Med 134, 217–228 (2020). https://doi.org/10.1007/s00414-019-02169-z

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