Diagnosis of carbon monoxide (CO) poisoning is done traditionally by
detecting carboxyhemoglobin (COHb) level. However, the severity of clinical
manifestations is unrelated to the absolute levels of COHb. Netrin-1 (Net-1) is a
protein with anti-inflammatory and anti-apoptotic properties while asymmetric
dimethylarginine (ADMA) is an oxidative stress indicator. This study aimed at
assessing and comparing between Net-1, ADMA and COHb as biomarkers in
CO poisoning. This cross-sectional clinical study was carried out on 30 acutely
CO poisoned adults admitted to Benha Poisoning Control Unit, Benha University
Hospitals; 30 chronic CO exposed workers at four different car service centres,
plus 30 healthy controls. Results showed a positive correlation between serum
levels of Net-1 and ADMA and the severity of acute CO poisoning both on
admission, and after oxygen therapy. There was a positive correlation between
COHb level and both serum levels of Net-1 and ADMA in chronic cases. In
conclusion: COHb level can only support the initial diagnosis of acute CO
poisoning. Both ADMA and Net-1 are better biomarkers in assessing the severity
of acute CO poisoning, where ADMA is better than Net-1. In diagnosis of
chronic CO poisoning, both ADMA and Net-1 are as dependable as COHb.
Introduction
Carbon monoxide (CO) is an odorless,
colorless, nonirritant gas, it is lighter than air,
and produced by partial combustion of carbon
containing compounds. It is often called the
“silent killer” as victims of CO poisoning lose
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(1) Forensic Medicine and Clinical Toxicology Department,
Faculty of Medicine, Benha University, Egypt
(2) Community, Environmental and Occupational Medicine
Department, Faculty of Medicine, Benha University,
Egypt
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