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1.  Exposure to tri-o-cresyl phosphate detected in jet airplane passengers 
Toxicology and applied pharmacology  2011;256(3):337-347.
The aircraft cabin and flight deck ventilation are supplied from partially compressed unfiltered bleed air directly from the engine. Worn or defective engine seals can result in the release of engine oil into the cabin air supply. Aircrew and passengers have complained of illness following such “fume events”. Adverse health effects are hypothesized to result from exposure to tricresyl phosphate mixed esters, a chemical added to jet engine oil and hydraulic fluid for its anti-wear properties. Our goal was to develop a laboratory test for exposure to tricresyl phosphate. The assay was based on the fact that the active-site serine of butyrylcholinesterase reacts with the active metabolite of tri-o-cresyl phosphate, cresyl saligenin phosphate, to make a stable phosphorylated adduct with an added mass of 80 Da. No other organophosphorus agent makes this adduct in vivo on butyrylcholinesterase. Blood samples from jet airplane passengers were obtained 24–48 hours after completing a flight. Butyrylcholinesterase was partially purified from 25 ml serum or plasma, digested with pepsin, enriched for phosphorylated peptides by binding to titanium oxide, and analyzed by mass spectrometry. Of 12 jet airplane passengers tested, 6 were positive for exposure to tri-o-cresyl phosphate that is, they had detectable amounts of the phosphorylated peptide FGEpSAGAAS. The level of exposure was very low. No more than 0.05 to 3% of plasma butyrylcholinesterase was modified. None of the subjects had toxic symptoms. Four of the positive subjects were retested 3 to 7 months following their last airplane trip and were found to be negative for phosphorylated butyrylcholinesterase. In conclusion, this is the first report of an assay that detects exposure to tri-o-cresyl phosphate in jet airplane travelers.
doi:10.1016/j.taap.2011.06.016
PMCID: PMC3205265  PMID: 21723309
aerotoxic syndrome; butyrylcholinesterase; mass spectrometry; tricresyl phosphate; CBDP; titanium oxide
2.  REACTION OF CRESYL SALIGENIN PHOSPHATE, THE ORGANOPHOSPHORUS AGENT IMPLICATED IN THE AEROTOXIC SYNDROME, WITH HUMAN CHOLINESTERASES: MECHANISTIC STUDIES EMPLOYING KINETICS, MASS SPECTROMETRY AND X-RAY STRUCTURE ANALYSIS 
Chemical research in toxicology  2011;24(6):797-808.
The aerotoxic syndrome is assumed to be caused by exposure to tricresyl phosphate (TCP), an anti-wear additive in jet engine lubricants and hydraulic fluids. CBDP (2-(ortho-cresyl)-4H-1,2,3-benzodioxaphosphoran-2-one) is the toxic metabolite of tri-ortho-cresylphosphate, a component of TCP. Human butyrylcholinesterase (BChE; EC 3.1.1.8) and human acetylcholinesterase (AChE; EC 3.1.1.7) are irreversibly inhibited by CBDP. The bimolecular rate constants of inhibition (ki), determined under pseudo first-order conditions, displayed a biphasic time course of inhibition with ki 1.6×108 M−1min−1 and 2.7×107 M−1min−1 for E and E′ forms of BChE. The inhibition constants for AChE were one to two orders of magnitude slower than for BChE. CBDP-phosphorylated cholinesterases are non-reactivatable due to ultra fast “aging”. Mass spectrometry analysis showed an initial BChE adduct with an added mass of 170 Da from cresylphosphate, followed by dealkylation to a structure with an added mass of 80 Da. Mass spectrometry in 18O–water showed that 18O was incorporated only during the final aging step to form phospho-serine as the final “aged” BChE adduct. The crystal structure of CBDP-inhibited BChE confirmed that the phosphate adduct is the ultimate aging product. CBDP is the first organophosphorus agent that leads to a fully dealkylated phospho-serine BChE adduct.
doi:10.1021/tx100447k
PMCID: PMC3118852  PMID: 21438623
Acetylcholinesterase; butyrylcholinesterase; aerotoxic syndrome; organophosphate; CBDP; inhibition kinetics; aging; MALDI-TOF; X-ray crystallography; OPIDN; saligenin
3.  EXPERIMENTAL STUDY OF DIPHTHERITIC POLYNEURITIS IN THE RABBIT AND GUINEA PIG  
Diphtheritic neuritis was produced in rabbits and guinea pigs by injection of underneutralized toxin-antitoxin mixtures. The disease is a progressive, ataxic paresis related in severity to the dose of injected toxin-antitoxin. Cerebrospinal fluids of rabbits with this disease showed "albuminocytologic dissociation" similar to that found in the same disease in man. Histologically the disease is a progressive demyelination of the peripheral nervous system, un-accompanied by axis cylinder damage or inflammation. It involves the spinal roots and sensory ganglia in the rabbit, the peripheral nerves in the guinea pig. Diphtheritic neuritis can be distinguished from experimental allergic neuritis in the rabbit and guinea pig on both clinical and histological grounds. The rabbit disease is however an excellent model of diphtheritic neuritis in man. In the animals with diphtheritic neuritis, studied in the present work, there was vigorous production of circulating antitoxin and infrequently complement-fixing antibody to horse serum proteins. No antibody against rabbit spinal cord or sciatic nerve was demonstrated. Skin reactivity to both rabbit nerve suspension and diphtheria toxoid was present at 1 to 2 weeks following inoculation and reached a maximum well before the peak of antitoxin response. These reactions did not seem to be typical delayed reactions. No correlation existed between the development of diphtheritic polyneuritis and any of these immunologic events or the circulating complement level, either in time or in degree. Treatment of rabbits with 400 r whole body irradiation 48 hours before inoculation resulted in severe leukopenia lasting about 3 weeks, delay of antitoxin formation with considerable reduction of peak titers, and some decreased skin reactivity to toxoid. It had no effect on the disease process. It is concluded that diphtheritic polyneuritis is produced by a non-immunologic mechanism, e.g., direct toxicity.
PMCID: PMC2136720  PMID: 13428927
4.  Polyneuritis cranialis: clinical and electrophysiological findings. 
A 13 year old boy, developed bilateral facial weakness, dysphonia and dysphagia acutely after a febrile illness. Neurological examination and MRI of the brain were normal. The CSF protein level increased. Blink reflex monitoring during clinical recovery was consistent with demyelination of the lower cranial nerves innervating the branchial arch musculature, a rare variant of Guillain-Barré syndrome.
PMCID: PMC489084  PMID: 1318358
5.  Identification and Characterization of Biomarkers of Organophosphorus Exposures in Humans 
Over 1 billion pounds of organophosphorus (OP) chemicals are manufactured worldwide each year, including 70 million pounds of pesticides sprayed in the US. Current methods to monitor environmental and occupational exposures to OPs such as chlorpyrifos (CPS) have limitations, including low specificity and sensitivity, and short time windows for detection. Biomarkers for the OP tricresyl phosphate (TCP), which can contaminate bleed air from jet engines and cause an occupational exposure of commercial airline pilots, crewmembers and passengers, have not been identified.
The aim of our work has been to identify, purify, and characterize new biomarkers of OP exposure. Butyrylcholinesterase (BChE) inhibition has been a standard for monitoring OP exposure. By identifying and characterizing molecular biomarkers with longer half-lives, we should be able to clinically detect TCP and OP insecticide exposure after longer durations of time than are currently possible.
Acylpeptide hydrolase (APH) is a red blood cell (RBC) cytosolic serine proteinase that removes N-acetylated amino acids from peptides and cleaves oxidized proteins. Due to its properties, it is an excellent candidate for a biomarker of exposure. We have been able to purify APH and detect inhibition by both CPS and metabolites of TCP. The 120-day lifetime of the RBC offers a much longer window for detecting exposure. The OP-modified serine conjugate in the active site tryptic peptide has been characterized by mass spectrometry.
This research uses functional proteomics and enzyme activities to identify and characterize useful biomarkers of neurotoxic environmental and occupational OP exposures.
doi:10.1007/978-1-60761-350-3_7
PMCID: PMC2878371  PMID: 20221871
Butyryl cholinesterase; Acylpeptide hydrolase; Biomarkers of OP exposure; Mass spectrometry; Affinity purification; Immunomagnetic beads
6.  Exposure to triaryl phosphates: metabolism and biomarkers of exposure 
Journal of biological physics and chemistry : JBPC  2011;11:10.4024/28FU11A.jbpc.11.04.
The leakage of tricresyl phosphate-containing engine lubricants into aircraft cabin air, either from worn or defective engine seals or under normal operating conditions, is a serious concern for both the health and safety of the cabin occupants, since the oil contains one to five percent tricresyl phosphate (TCP) esters, known neurotoxins. The exposure of pilots is a particular concern since their impairment can affect their safe operation of the aircraft. Mass spectrometric (MS)-based protocols for documenting exposures of individuals are described that entail a rapid purification of the TCP-modified plasma enzyme butyrylcholinesterase (BChE). Following protease digestion of BChE, the modified active site peptide is characterized by MS analysis. Approaches for identifying safer engine oil additives are also described. Some general comments regarding the necessity of improving the quality and safety of the cabin air supply are presented.
doi:10.4024/28FU11A.jbpc.11.04
PMCID: PMC3839637  PMID: 24285929
butyrylcholinesterase; cabin air safety; fume event; mass spectrometry; tricresyl phosphates
7.  Aircraft Recirculation Filter for Air-Quality and Incident Assessment 
Journal of aircraft  2014;51(1):320-326.
The current research examines the possibility of using recirculation filters from aircraft to document the nature of air-quality incidents on aircraft. These filters are highly effective at collecting solid and liquid particulates. Identification of engine oil contaminants arriving through the bleed air system on the filter was chosen as the initial focus. A two-step study was undertaken. First, a compressor/bleed air simulator was developed to simulate an engine oil leak, and samples were analyzed with gas chromatograph-mass spectrometry. These samples provided a concrete link between tricresyl phosphates and a homologous series of synthetic pentaerythritol esters from oil and contaminants found on the sample paper. The second step was to test 184 used aircraft filters with the same gas chromatograph-mass spectrometry system; of that total, 107 were standard filters, and 77 were nonstandard. Four of the standard filters had both markers for oil, with the homologous series synthetic pentaerythritol esters being the less common marker. It was also found that 90% of the filters had some detectable level of tricresyl phosphates. Of the 77 nonstandard filters, 30 had both markers for oil, a significantly higher percent than the standard filters.
doi:10.2514/1.C032458
PMCID: PMC4308957  PMID: 25641977
8.  Biomarkers of organophosphorus (OP) exposures in humans 
Neurotoxicology  2011;32(5):656-660.
There are ongoing events where aircraft engine lubricant containing tricresyl phosphates (TCPs) contaminates aircraft cabins. Some individuals have experienced tremors or other neurological symptoms that may last for many months following exposures. Mass spectrometric (MS) protocols are being developed to determine the percentage of “biomarker proteins” that are modified by such exposures, specifically on active site serines. Both plasma butyrylcholinesterase (BChE) and red cell acylpeptide hydrolase (APH) are readily inhibited by 2-(o-cresyl)-4H-1:3:2:benzodioxaphosphoran-2-one (CBDP) or phenyl saligenin cyclic phosphate (PSP) and have the potential to provide information about the level of exposure of an individual. We have developed immunomagnetic bead-based single-step purification protocols for both BChE and APH and have characterized the active site serine adducts of BChE by MS.
doi:10.1016/j.neuro.2011.06.005
PMCID: PMC3279568  PMID: 21767566
Biomarkers; Tricresyl phosphate; CBDP; Butyrylcholinesterase; Acylpeptide hydrolase; Aerotoxic syndrome
9.  Cresyl saligenin phosphate makes multiple adducts on free histidine, but does not form an adduct on histidine 438 of human butyrylcholinesterase 
Chemico-biological interactions  2012;203(1):103-107.
Cresyl saligenin phosphate (CBDP) is a suspected causative agent of “aerotoxic syndrome”, affecting pilots, crew members and passengers. CBDP is produced in vivo from ortho-containing isomers of tricresyl phosphate (TCP), a component of jet engine lubricants and hydraulic fluids. CBDP irreversibly inhibits butyrylcholinesterase (BChE) in human plasma by forming adducts on the active site serine (Ser-198). Inhibited BChE undergoes aging to release saligenin and o-cresol. The active site histidine (His-438) was hypothesized to abstract o-hydroxybenzyl moiety from the initial adduct on Ser-198. Our goal was to test this hypothesis. Mass spectral analysis of CBDP-inhibited BChE digested with Glu-C showed an o-hydroxybenzyl adduct (+106 amu) on lysine 499, a residue far from the active site, but not on His-438. Nevertheless, the nitrogen of the imidazole ring of free L-histidine formed a variety of adducts upon reaction with CBDP, including the o-hydroxybenzyl adduct, suggesting that histidine-CBDP adducts may form on other proteins.
doi:10.1016/j.cbi.2012.07.006
PMCID: PMC3513658  PMID: 22898212
butyrylcholinesterase; histidine; TCP; CBDP; aging; o-hydroxybenzyl
10.  Voltammetric Determination of the Herbicide Linuron Using a Tricresyl Phosphate-Based Carbon Paste Electrode 
Sensors (Basel, Switzerland)  2011;12(1):148-161.
This paper summarises the results of voltammetric studies on the herbicide 3-(3,4-dichlorophenyl)-1-methoxy-1-methylurea (Linuron), using a carbon paste electrode containing tricresyl phosphate (TCP-CPE) as liquid binder. The principal experimental conditions, such as the pH effect, investigated in Britton-Robinson buffer solutions (pH 2.0–7.0), the peak characteristics for the analyte of interest, or instrumental parameters for the differential pulse voltammetric mode were optimized for the method. As found out, the best electroanalytical performance of the TCP-CPE was achieved at pH 2.0, whereby the oxidation peak of Linuron appeared at ca. +1.3 V vs. SCE. The analytical procedure developed offers good linearity in the concentration range of 1.25–44.20 μg mL−1 (1.77 × 10−4–5.05 × 10−6 mol L−1), showing—for the first time—the applicability of the TCP-CPE for anodic oxidations in direct voltammetry (without accumulation). The method was then verified by determining Linuron in a spiked river water sample and a commercial formulation and the results obtained agreed well with those obtained by the reference HPLC/UV determination.
doi:10.3390/s120100148
PMCID: PMC3279205  PMID: 22368461
Linuron; herbicide; carbon paste electrode; tricresyl phosphate; differential pulse voltammetry
14.  Miller-Fisher polyneuritis. 
PMCID: PMC1863910  PMID: 1240634
16.  Polyneuritis: For Diagnosis 
PMCID: PMC2081378  PMID: 15412954
21.  Acute Infective Polyneuritis 
Images
PMCID: PMC2081042  PMID: 18115530
23.  Case of Dermato-Polyneuritis 
Proceedings of the Royal Society of Medicine  1922;15(Sect Study Dis Child):53-54.
PMCID: PMC2102463  PMID: 19982587
24.  Dermato-polyneuritis (Acrodynia: Erythrœdema) 
Proceedings of the Royal Society of Medicine  1922;15(Sect Study Dis Child):27-29.
PMCID: PMC2102440  PMID: 19982567

Results 1-25 (395360)