Toxicology Reports最新文献

{"title":"Individualized support for breastfeeding in a case of elevated blood lead levels: A case report","authors":"Ashley Wallace Wu,&nbsp;Joann Mercedes,&nbsp;Morri Markowitz","doi":"10.1016/j.toxrep.2024.101761","DOIUrl":"10.1016/j.toxrep.2024.101761","url":null,"abstract":"<div><h3>Introduction</h3><div>Lead is a known toxicant that affects all tissues in the body, most notably the brains of developing children. However, there are limited data on the dynamics of lead transfer via breastmilk and its short-term and long-term consequences. Much of the available data come from areas of the world where numerous sources of lead complicate our understanding of the effects of lead exposure via breast milk.</div></div><div><h3>Case Presentation</h3><div>We present trends in blood lead levels in a breastfeeding dyad, where the only source of lead exposure identified was prior to pregnancy, without other known ongoing lead exposures for the lactating parent or infant.</div></div><div><h3>Discussion and Conclusions</h3><div>In this case, all lead exposure in the infant was presumed to come from in utero transmission and breastfeeding; and infant blood lead levels varied significantly with initiation and interruption of breastfeeding. This case is discussed in the context of current models for predicting transfer of lead in breastmilk and highlights pathophysiologic considerations for understanding lead transfer in the breastfeeding dyad.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"13 ","pages":"Article 101761"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating quackery formulations: LC-MS/MS based method for detecting glucocorticoid content","authors":"Hafiza Monaza Batool ,&nbsp;Muhammad Irfan Jalees ,&nbsp;Madeeha Batool","doi":"10.1016/j.toxrep.2024.101763","DOIUrl":"10.1016/j.toxrep.2024.101763","url":null,"abstract":"<div><div>Glucocorticoids are widely used as highly effective drugs for treating inflammatory diseases. In this study, a method was developed and validated using liquid chromatography-tandem mass spectrometry (LC-MS/MS) to simultaneously determine four glucocorticoids, including betamethasone, dexamethasone, hydrocortisone, and prednisolone in unauthorized or unregulated medicinal powders often associated with quackery formulations. Commercially available standards were used for method development and glucocorticoid detection. Glucocorticoids were extracted from the samples with methanol, which were then chromatographically separated using two mobile phases (0.1 % formic acid in water and 0.1 % formic acid in acetonitrile) in an isocratic flow on an Agilent Poroshel 120 C18 column (2.1 mm x 75 mm x 2.7 m). The validated analytical measuring range (AMR) of betamethasone and dexamethasone was 7.8–500 ng/mL, whereas, for hydrocortisone and prednisolone, AMR was 7.8–1000 ng/mL. The method showed an excellent coefficient of determination (r2) &gt;0.990 for betamethasone, hydrocortisone, and prednisolone, while for dexamethasone 0.986. Accuracy and precision (intra/inter days) of these glucocorticoids showed a bias of 6–15 % (&lt;20 %) and a coefficient of variation (CV) of &lt;15 %. For each dilution factor, the integrity of samples was maintained after dilution. The developed method is sensitive and valuable for detecting, quantifying, and confirming the selected glucocorticoids in various quackery formulation powders commonly used in Pakistani setups.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"13 ","pages":"Article 101763"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142537897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemical analysis of Alliin-Rich Allium sativum (Garlic) extract and its safety evaluation in Drosophila melanogaster","authors":"Zeniat Emike Oyaluna ,&nbsp;Amos Olalekan Abolaji ,&nbsp;Olusola Bodede ,&nbsp;John Oludele Olanlokun ,&nbsp;Gerhard Prinsloo ,&nbsp;Paul Steenkamp ,&nbsp;Chinedum Peace Babalola","doi":"10.1016/j.toxrep.2024.101760","DOIUrl":"10.1016/j.toxrep.2024.101760","url":null,"abstract":"<div><div>Garlic (<em>Allium sativum</em>) has been traditionally valued for its medicinal properties attributed to the presence of organosulfur compounds. Despite its benefits, concerns about herbal extract toxicity have arisen, necessitating safety assessment<em><strong>.</strong></em> This study was designed to evaluate the chemical analysis and safety profile of Alliin-Rich Garlic Extract (ARGE) using <em>Drosophila melanogaster</em> as a model organism. The ARGE was extracted from garlic cloves (<em>Allium sativum</em> Linn: UIH-23262) using a microwave-assisted method and characterized using UPLC-ESI-MS, ¹H NMR, HPLC and IR. Its safety evaluation was determined using <em>D. melanogaster</em> (Harwich strain), and various assays were conducted on 1–3-day-old flies. Toxicological markers and oxidative stress were assessed to understand the impact of ARGE on the flies. Chemical profiling of ARGE using UPLC-ESI-MS, confirmed the presence of alliin (S-ally-L-cysteine-S-oxide), L-arginine, γ-glutamylmethionine, S-(2-carboxypropyl) glutathione, N-γ-glutamyl-S-(1-propenyl) cysteine, N-γ-glutamyl-S-(2-propenyl) cysteine, N-γ-glutamylphenylalanine, S-(allylthio) cysteine, γ-glutamyl-S-allylthiocysteine and eruboside B. HPLC confirmed an alliin content of 0.073 mg/g. Toxicological assessment in <em>D. melanogaster</em> revealed that ARGE enhanced antioxidant defenses by increasing total thiol levels and GST activity, while reducing acetylcholinesterase activity. No significant alteration was observed in catalase activity and cellular metabolic rate. Histological examination revealed no alterations in the histoarchitecture of the brain, fat body or gut of <em>D. melanogaster</em>. The study demonstrated the safety of ARGE in <em>D. melanogaster</em>, supporting its potential as a safe herbal remedy.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"13 ","pages":"Article 101760"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ameliorating effect of S-Allyl cysteine (Black Garlic) on 6-OHDA mediated neurotoxicity in SH-SY5Y cell line","authors":"Yesim Yeni ,&nbsp;Betul Cicek ,&nbsp;Serkan Yildirim ,&nbsp;İsmail Bolat ,&nbsp;Ahmet Hacimuftuoglu","doi":"10.1016/j.toxrep.2024.101762","DOIUrl":"10.1016/j.toxrep.2024.101762","url":null,"abstract":"<div><div>Therapeutic approaches based on isolated compounds derived from natural products are more common in preventing diseases involving inflammation and oxidative stress at present. S-allyl cysteine (SAC) is a promising garlic-derived organosulfur compound with many positive effects in cell models and living systems. SAC has biological activity in various fields, enclosing healing in learning and memory disorders, neurotrophic effects, and antioxidant activity. In this study, we purposed to identify the neuroprotective activity of SAC toward 6-OHDA-induced cell demise in the SH-SY5Ycell line. For this purpose, 6-OHDA-induced cytotoxicity, and biochemical, and gene expression changes were evaluated in SH-SY5Y cells. SH-SY5Y cells grown in cell culture were treated with SAC 24 h before and after 6-OHDA application. Then, cell viability, antioxidant parameters, and gene expressions were measured. Finally, immunofluorescence staining analysis was performed. Our results showed that SAC increased cell viability by 144 % at 80 µg/mL with pre-incubation (2 h). It was observed that antioxidant levels were significantly increased and oxidative stress marker levels were decreased in cells exposed to 6-OHDA after pre-treatment with SAC (<em>p&lt;0.05</em>). SAC supplementation also suppressed the increase in pro-inflammation levels (TNF-α/IL1/IL8) caused by 6-OHDA <em>(p &lt; 0.05).</em> While 8-OHdG and Nop10 expressions were observed at a mild level in SAC pretreatment depending on the dose, 8-OHdG, and Nop10 expressions were observed at a moderate level in SAC treatment after 6-OHDA application <em>(p&lt;0.05)</em>. Our findings demonstrate the positive effect of pretreatment with SAC on SH-SY5Y cells injured by 6-OHDA, suggesting that SAC may be beneficial for neuroprotection in regulating oxidative stress and neuronal survival in an in vitro model of Parkinson's disease.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"13 ","pages":"Article 101762"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular effects and clinical outcomes in acute opioid toxicity: A case-control study from Port Said and Damietta Governorates Egypt","authors":"Heba Youssef Sayed,&nbsp;Rawan M. Ghaly,&nbsp;Amany A. Mostafa,&nbsp;Mohamed S. Hemeda","doi":"10.1016/j.toxrep.2024.101756","DOIUrl":"10.1016/j.toxrep.2024.101756","url":null,"abstract":"<div><div>Substance abuse, particularly opioid intoxication, presents a significant public health challenge, leading to severe cardiovascular complications. This case-control study assessed the cardiac profile and clinical outcomes of 51 patients with confirmed acute opioid toxicity, compared to 51 control participants, in general hospitals across Port Said and Damietta governorates, Egypt. The study revealed that opioid-intoxicated patients exhibited significant cardiovascular abnormalities, including hypotension (39.2 %) and electrocardiogram (ECG) changes (72.5 %), with sinus bradycardia (51 %) being the most common. Additionally, echocardiographic abnormalities were found in 40 % of cases, with abnormal regional wall motion and valvular defects observed in several patients. Elevated levels of cardiac enzymes, such as Troponin-I and CK-MB, were significantly correlated with increased ICU stay length and higher mortality rates. The most common morbidities included coma (64.7 %) and shock (39.2 %). The study underscores the critical need for early cardiac assessment in opioid-intoxicated patients to predict clinical outcomes and guide therapeutic interventions.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"13 ","pages":"Article 101756"},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterocyclic phytometabolites formononetin and arbutin prevent in vitro oxidative and alkylation-induced mutagenicity","authors":"Lizandra Vitoria de Souza Santos ,&nbsp;Barbara Verena Dias Galvão ,&nbsp;Lays Souza ,&nbsp;Andreia da Silva Fernandes ,&nbsp;Carlos Fernando Araujo-Lima ,&nbsp;Israel Felzenszwalb","doi":"10.1016/j.toxrep.2024.101753","DOIUrl":"10.1016/j.toxrep.2024.101753","url":null,"abstract":"<div><div>Phenolic phytometabolites are promising bioactive compounds for management of genomic instability related diseases. Formononetin (FMN) and arbutin (ARB) are found in several plant sources. Our goal was to investigate the safety and efficacy of FMN and ARB using <em>in vitro</em> both standardized and alternative toxicogenetic methods. FMN and ARB were evaluated through the OECD’S guidelines No. 471 (Bacterial Reverse Mutation Test –<em>Salmonella</em>/microsome) and No. 487 (<em>In vitro</em> Mammalian Micronucleus Test – CBMN assay), accordingly to the mentioned recommendations. Also, antimutagenicity of FMN and ARB was assessed in <em>S</em>. Typhimurium strains TA98, TA100 and TA1535, following pre-, co- and post- treatment protocols. Liver human lineages HepG2 and F C3H were assayed for cytotoxicity after exposure to FMN and ARB (24, 48 and 72 h) using <em>in vitro</em> WST-1 test. ARB showed no mutagenicity in the <em>Salmonella</em>/microsome test under both metabolic conditions (in presence or absence of 4 % S9 mix), but FMN was cytotoxic to the TA97 and TA100 strains after metabolic activation. Under this same condition, FMN induced an increase in the mutagenic index of strain TA1535 at two of the highest tested concentrations. Even so, ARB and FMN exhibited protection against the induced alkylation of DNA in multiple action modes. In the antimutagenicity assay, FMN reached the maximum of 80 % of oxidative-provoked mutagenicity reduction in TA98 strain in co-treatment with known mutagen, besides 69 % of reduction in TA100 in the same exposure condition. ARB showed up to reduce induced mutagenicity in strains TA100 and TA1535, reaching percentages from 55 % to 100 % of antimutagenicity in all of the tested exposure models against alkylating agent. In the CBMN assay, no increase in micronuclei formation was observed. The results suggest that FMN and ARB prevent DNA from mutation using multi-targeted antimutagenic roles. Finally, our data suggests that FMN and ARB are not genotoxic and presented encouraging antimutagenicity action <em>in vitro</em>, being promising compounds for use in genomic instability-related diseases therapeutics.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"13 ","pages":"Article 101753"},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluorescent nanoplastics increase the toxic effects of Graphene oxide nanoparticles in freshwater algae Scenedesmus obliquus","authors":"Soupam Das,&nbsp;Sampriti Giri,&nbsp;Janmey Shah,&nbsp;Amitava Mukherjee","doi":"10.1016/j.toxrep.2024.101759","DOIUrl":"10.1016/j.toxrep.2024.101759","url":null,"abstract":"<div><div>The increased usage of Graphene oxide (GO) in various industrial applications led to their entry into freshwater systems. Other secondary contaminants like nanoplastics (NPs) often co-exist with GO in the environment. This study examines the possible role of fluorescent nanoplastics (FNPs) in modifying the toxic effects of GO on freshwater algae <em>Scenedesmus obliquus</em>. Selected concentrations of GO (0.1, 1, and 10 mg L⁻¹) were combined with a fixed concentration of FNPs (1 mg L⁻¹) to perform combinational toxicity tests on algae. FNPs significantly enhanced the toxic effects of GO in the mixtures in comparison with the pristine GO. In addition to the cytotoxic effects, oxidative stress parameters like total ROS generation and malondialdehyde (MDA) production also increased in the case of the combined pollutants. The antioxidant enzymatic activities like catalase (CAT) and superoxide dismutase (SOD) in the cells were also assessed. Algal exposure to the pristine pollutants and their mixture led to a notable decrease in photosynthetic activities in the cells, with the mixed pollutants aggravating the loss of activity. The interactive toxic effects of the contaminants when present in mixtures were evaluated using Abbotts' Independent action modelling. Furthermore, optical microscopic images revealed the morphological changes in the algal cells after exposure to the contaminants both in the pristine and combined forms.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"13 ","pages":"Article 101759"},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interaction of cannabis cultural use and health: A case of acute myocardial infarction following consumption of cannabis beverage (Bhang)","authors":"Barun Kumar ,&nbsp;Omna Chawla ,&nbsp;Abhimanyu Nigam ,&nbsp;Pankaj Kumar Singh ,&nbsp;Anupam Singh","doi":"10.1016/j.toxrep.2024.101755","DOIUrl":"10.1016/j.toxrep.2024.101755","url":null,"abstract":"<div><div>Cannabis is a psychoactive substance consumed worldwide in the form of smoking, vapors, food additives, or beverages. Delta 9 tetrahydrocannabinol (THC) is a primary component responsible for short and long-term effects on various cognitive and motor functions in a dose-dependent manner. The legal status of cannabis has shifted significantly in recent decades. Some regions maintain strict penalties, but others have legalized them for medicinal use. In India, the use of cannabis in any form is illegal; however, the use of bhang, a cannabis beverage made from leaves, is acceptable due to cultural reasons and thus permitted in some places. We report the case of a 28-year-old male who developed massive anterior wall myocardial infarction after consuming bhang during the Holi festival. He presented with sudden retrosternal chest pain, which was initially ignored till it intensified enough, prompting him to seek emergency medical help approximately 24 hours after symptom onset. Cannabis intoxication impaired attention and information processing, leading to delayed presentation. The patient was managed successfully by timely cardiac intervention. The evolving landscape of cannabis regulations necessitates heightened awareness among health authorities about potential cardiovascular risks associated with its consumption, particularly in forms like Bhang, where concentrations are unregulated and variable.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"13 ","pages":"Article 101755"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term exposure of human U87 glioblastoma cells to polyethylene microplastics: Investigating the potential cancer progression","authors":"Parisasadat Rafazi ,&nbsp;Zeinab Bagheri ,&nbsp;Hamed Haghi-Aminjan ,&nbsp;Mahban Rahimifard ,&nbsp;Akram Ahvaraki","doi":"10.1016/j.toxrep.2024.101757","DOIUrl":"10.1016/j.toxrep.2024.101757","url":null,"abstract":"<div><div>Precancerous cells are present in all human bodies. Various environmental triggers can promote the development of cancer. Microplastics, an emerging concern, may potentially act as one such trigger, contributing to cancer initiation or progression. Studies have confirmed the presence of microplastics within the human body. This raises concerns about their potential toxicity and health risks. In the present study, we aimed to investigate the impact of polyethylene microplastics (PE-MPs) within the size range of 37–75 microns on glioblastoma cancer cells. Initially, we assessed the short-term effects of six different concentrations of PE-MPs (20 mg/mL, 10 mg/mL, 5 mg/mL, 2.5 mg/mL, 1.25 mg/mL, and 0.62 mg/mL) on the U87 glioblastoma cell line. The results demonstrated that PE-MPs exposure led to an increase in cell proliferation compared to the untreated control group. Based on these findings, we decided to further explore the long-term effects of PE-MPs on U87 cancer cells. To evaluate the long-term effects, U87 glioblastoma cells were continuously exposed to 0.005 g of PE-MPs over an extended period of 26 days. Chronic exposure to PE-MPs significantly increased the proliferative and migratory capacities of U87 cells compared to the unexposed control group. Furthermore, continuous PE-MPs exposure altered the behavior and morphological characteristics of U87 cells. These cells exhibited a propensity to aggregate and form colonies within the culture flask. The formation of spheroid structures was also observed in the PE-MPs-exposed cell population. The results of this research indicate that polyethylene microplastics can promote the progression of glioblastoma cancer.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"13 ","pages":"Article 101757"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deadly shades of green: A cautionary tale of an organic biopesticide poisoning","authors":"Anas Mohammed Muthanikkatt ,&nbsp;Mohammed Najeebuddin ,&nbsp;Saravanan Muthu ,&nbsp;Arun A. Mohanan ,&nbsp;Vishwanath Balassoundaram ,&nbsp;S Surendar","doi":"10.1016/j.toxrep.2024.101750","DOIUrl":"10.1016/j.toxrep.2024.101750","url":null,"abstract":"<div><h3>Introduction</h3><div>Methemoglobinemia is a potentially life-threatening condition characterized by the reduced oxygen-carrying capacity of hemoglobin. With the increasing popularity of natural and herbal biopesticides, there is a growing risk of exposure to substances that can induce this dyshemoglobinemia. This case report highlights the importance of recognizing and promptly treating methemoglobinemia in the context of biopesticide exposure, a concern relevant to various healthcare professionals.</div></div><div><h3>Case description</h3><div>A 70-year-old male presented to the emergency department (ED) in an unresponsive state following suspected ingestion of an unknown quantity of an organic biopesticide labeled \"Bull Fight\". Initial management included fluid resuscitation, endotracheal intubation and mechanical ventilation. The patient developed significant hypoxia and hypotension. Abnormal blood color and a saturation gap raised suspicion of methemoglobinemia, which was confirmed by co-oximetry (68.7 % MetHb). Treatment with methylene blue was initiated, leading to initial improvement. However, the patient experienced rebound methemoglobinemia, requiring additional doses of methylene blue. Despite treatment, the patient ultimately succumbed to pneumonia.</div></div><div><h3>Discussion</h3><div>This case underscores the potential dangers of organic biopesticides and the importance of considering methemoglobinemia in patients with unexplained cyanosis, saturation gap, and abnormal blood color. The increasing use of natural and herbal products in agriculture may expose individuals to undisclosed ingredients capable of inducing methemoglobinemia. Healthcare professionals across various specialities, including emergency medicine, critical care, toxicology, and primary care, must remain vigilant and maintain a high index of suspicion for this condition, especially in cases of biopesticide exposure.</div></div><div><h3>Conclusion</h3><div>Awareness of methemoglobinemia and its association with biopesticide exposure is crucial for all healthcare providers who may encounter such cases. Prompt recognition and treatment can be lifesaving. As natural biopesticide use increases, clinicians should be prepared to diagnose and manage methemoglobinemia effectively. Careful monitoring is crucial to detect and prevent rebound methemoglobinemia. Ongoing education and preparedness are essential to address risks associated with emerging agricultural practices and products.</div></div>","PeriodicalId":23129,"journal":{"name":"Toxicology Reports","volume":"13 ","pages":"Article 101750"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}