Mitochondrial Bioenergetics and Neuromuscular Weakness of Acute Organophosphate Poisoning

Pesticides are indispensable to modern day agriculture. In a report by Cai in 2008 global pesticide use was estimated to prevent 78% loss of fruit, 54% loss of vegetable and 32% loss of cereal. Gain in yield of food was associated with an annual use of 4.6 million tons of pesticides and sales of 300 billion dollars during the 1990s. There are currently 500 pesticides with mass applications, of which organophosphate pesticides are in large and widespread use across the world. The large use of pesticides coupled with inadequate regulation in their sale of pesticides, lack of training in their use and handling and insufficient information on pesticide containers leads to significant human toxicity from pesticides in agricultural based populations especially of Asia. This study indicates a role for non-cholinergic pathology involving the mitochondria and oxidative stress in muscle weakness that develops on OPP poisoning. Treatment for this pathology should explore early delivery of high levels of antioxidants to muscle to protect AChE from severe inhibition and prevent mitochondrial disruption to prevent prolonged severe muscle weakness. N-acetylcysteine is a drug that could be tried for treatment of these non-cholinergic pathogenic mechanisms of OPP poisoning