Abstract
Organophosphates (OPs) are one of the main classes of insecticides, in use since the mid 1940s. OPs can exert significant adverse effects in non-target species including humans. Because of the phosphorylation of acetylcholinesterase, they exert primarily a cholinergic toxicity, however, some can also cause a delayed polyneuropathy. Currently debated and investigated issues in the toxicology of OPs are presented in this review. These include: 1) possible long-term effects of chronic low-level exposures; 2) genetic susceptibility to OP toxicity; 3) developmental toxicity and neurotoxicity; 4) common mechanism of action; 5) mechanisms of delayed neurotoxicity; and 6) possible additional OP targets. Continuing and recent debates, and molecular advances in these areas, and their contributions to our understanding of the toxicology of OPs are discussed.
Keywords
Organophosphates;
Acetylcholinesterase;
Neuropathy target esterase;
Low chronic exposure;
Genetic susceptibility;
Developmental neurotoxicity;
Common mechanism of action;
Non-acetylcholinesterase targets
1. Organophosphorus: insecticides
Although a number of organic phosphorus (OP) compounds were synthesized in the 1800s, their development as insecticides only occurred in the late 1930s and early 1940s. The German chemist Gerhard Schrader is credited for the discovery of the general chemical structure of anticholinesterase OP compounds and for the synthesis of the first commercialized OP insecticide [Bladan, containing TEPP (tetraethyl pyrophosphate) as an active ingredient], and for one of the most known, parathion, in 1944 [1]. Since then, hundreds of OP compounds have been made and commercialized worldwide in a variety of formulations.
The chemistry of OPs, which leads to their classification in several subclasses, has been thoroughly investigated [2]. The general structure of OP insecticides can be represented by
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Where X is the so-called “leaving group”, that is displaced when the OP phosphorylates acetylcholinesterase (AChE), and is most sensitive to hydrolysis; R1 and R2 are most commonly alkoxy groups, through other chemical substitutes are also possible; either an oxygen or sulfur atom are also attached to the phosphorus with a double bond.
The complex array of reactions involved in the biotransformation of OPs in target and non-target species has also been the subject of extensive investigations [3]. For compounds that contain a sulfur bound to the phosphorus, a metabolic bioactivation is necessary for their main biological activity to be manifest, as only compounds with a P = O moiety are effective inhibitors of AChE. This bioactivation thus consists in an oxidative desulfuration mediated, mostly but not exclusively in the liver, by cytochromes P450 enzymes (CYPs), and leading to the formation of an “oxon” or oxygen analog of the parent insecticide (Fig. 1). Though this reaction has been known for several decades, the exact CYP isoforms(s) involved are still elusive, but available data suggests that the overall picture is quite complex. Multiple CYPs have shown to bioactivate organophosphorothioates to their oxons, with different substrate specificities. For example, diazinon is activated by human hepatic CYP2C19 [4], while parathion is activated primarily by CYP3A4/5 and CYP2C8 [5]. The CYPs can also catalyze several oxidation, and a few reduction, reactions that lead to detoxication of OP compounds. Some of these are shown in Fig. 1 for the OP insecticide parathion. Differences between CYPs exist also in the detoxication process. For example, while CYP2B6 metabolizes chlorpyrifos primarily to the oxon, it metabolizes parathion primarily to p-nitrophenol [6].
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Fig. 1.
Main metabolic pathways involved in the biotransformation of parathion. Reaction (1) is a bioactivating reaction, the other are detoxifying reactions. (1) Oxidative desulfuration; (2) oxidative dearylation; (3) oxidative deethylation; (4) reduction of the nitro group; (5) hydrolysis. CYP, cytochrome P450; PON1, paraoxonase.
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Catalytic hydrolysis of the OPs by phosphotriesterases known as A-esterases (which are not inhibited by OPs) also plays an important role in the detoxication of certain OPs. One example is the enzyme paraoxonase (PON1) which hydrolyzes the oxons of chlorpyrifos and diazinon, and, at least in vitro, also of parathion [7] (see also Fig. 1). Noncatalytic hydrolysis of OPs also occurs when these compounds phosphorylate serine esterases classified as B-esterases, that are inhibited by OPs but cannot catalytically hydrolyze them. Examples are the carboxylesterases and butyrylcholinesterase (BChE), in addition to the OP target, AChE (see Fig. 2). The carboxylesterases also perform a catalytic hydrolysis of the carboxylic esters of malathion and are believed to be major determinant of its low toxicity in mammals.
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Fig. 2.
Schematic representation of biochemical interactions between OPs and AChE. Reaction 1 leads to phosphorylated AChE. Reaction 2 is spontaneous reactivation of AChE. The rate of this reaction can be accelerated by oximes. Reaction 3 is the aging and leads to a stable, negatively charged phosphorylated AChE. E-OH, active site of the enzyme.
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2. AChE and NTE as primary targets
The primary target for OPs is AChE, a B-esterase whose physiological role is that of hydrolyzing acetylcholine, a major neurotransmitter in the peripheral (autonomic and motor–somatic) and central nervous systems. OPs with a P = O moiety phosphorylate an hydroxyl group on serine in the active (esteratic) site of the enzyme, thus impeding its action on the physiological substrate (Fig. 2). The bond between the phosphorus atom and the esteratic site of the enzyme is much more stable than the bond between the carbonyl carbon of acetate (in acetylcholine) at the same enzyme site. While breaking of the carbon–enzyme bond is complete in a few microseconds, breaking the phosphorus–enzyme bond can take from a few hours to several days, depending on the chemical structure of the OP [1]. Phosphorylated AChE is hydrolyzed by water at a very slow rate, depending, as said, from the chemical nature of the R substituents (e.g., reactivation decreases in the order demethoxy > diethoxy ≫ diisopropoxy). While water is a weak nucleophilic agent, certain hydroxylamine derivatives, known as oximes, contain a positively charged atom capable of attaching to the anionic site of AChE, and facilitate desphosphorylation of the enzyme. These reactivators are utilized in the therapy of OP poisoning.
Reactivation of phosphorylated AChE does not occur once the enzyme–inhibitor complex has “aged” (Fig. 2). Aging consists in the loss (by nonenzymatic hydrolysis) of one of the two alkoxy (R) groups, and the rate of aging depends on the nature of the alkoxy group (e.g., AChE phosphorylated by an isopropoxy phosphate ages most rapidly). When phosphorylated AChE has aged, the enzyme can be considered to be irreversibly inhibited, and the only means of replacing its activity is through synthesis of new enzyme, a process that could take days.
Acetylcholine released from cholinergic nerve terminals is disposed of solely through hydrolysis by AChE. In fact, differently from other neurotransmitters (e.g., noradrenaline), it is the product of acetylcholine hydrolysis by AChE, choline, that is taken up by the presynaptic terminal. Hence, inhibition of AChE by OPs causes accumulation of acetylcholine at cholinergic synapses, with over-stimulation of muscarinic and nicotinic receptors. This “cholinergic syndrome” includes increased sweating and salivation, profound bronchial secretion, bronchoconstriction, miosis, increased gastrointestinal motility, diarrhea, tremors, muscular twitching and various central nervous system effects. When death occurs, this is believed to be due to respiratory failure due to inhibition of respiratory centers in the brainstem, bronchoconstriction and increased bronchial secretion, and flaccid paralysis of the respiratory muscles [8] and [9]. In addition to the aforementioned oximes, which reactivate phosphorylated AChE before aging has occurred, pharmacological treatment of OP poisoning involves the use of atropine, an acetylcholine antagonist that prevents the action of acetylcholine on muscarinic receptors. Additional pharmacological (e.g., diazepam) and supportive (e.g., artificial ventilation) treatments are also utilized in case of severe poisoning [9].
The early discovery of AChE inhibition by OP compounds has led to their development primarily as insecticides, but also as nerve agents and to a limited extent, as drugs. OPs are potent and effective insecticides and still represent the largest group of insecticides sold worldwide. Given the strong similarities of the insect and mammalian cholinergic nervous system, these compounds are, however, responsible for the million of poisonings and thousands of deaths occurring annually as a result of pesticide exposures, particularly in third world countries. Certain OPs, in particular those containing isopropoxy substituents, have also been developed, and some have been used, as nerve agents for chemical warfare. Examples of such compounds are soman, sarin, tabun and VX. A few OPs were also developed as pharmaceutical drugs. Examples are metrifonate (trichlorfon), used on anthelmintic in schistosamiasis, or echothiophate, used for the treatment of glaucoma. However, use of AChE inhibitors for treatment of these and other conditions (e.g., myasthenia gravis, termination of the effects of competitive neuromuscular blockers, Alzheimer's disease) relies mostly on carbamates or other compounds [10].