Human and experimental toxicology of diquat poisoning: Toxicokinetics, mechanisms of toxicity, clinical features, and treatment

Hum Exp Toxicol. 2018 Nov;37(11):1131-1160. doi: 10.1177/0960327118765330. Epub 2018 Mar 23.

Abstract

Diquat (1,1'-ethylene-2,2'-bipyridinium ion; DQ) is a nonselective quick-acting herbicide, which is used as contact and preharvest desiccant to control terrestrial and aquatic vegetation. Several cases of human poisoning were reported worldwide mainly due to intentional ingestion of the liquid formulations. Its toxic potential results from its ability to produce reactive oxygen and nitrogen species through redox cycling processes that can lead to oxidative stress and potentially cell death. Kidney is the main target organ due to DQ toxicokinetics and redox cycling. There is no antidote against DQ intoxications, and the efficacy of treatments currently applied is still unsatisfactory. The aim of this work was to review the most relevant human and experimental findings related to DQ, characterizing its chemistry, activity as herbicide, mechanisms of toxicity, consequences of poisoning, and potential therapeutic approaches taking into account previous experience in developing antidotes for paraquat, a more toxic bipyridinium herbicide.

Keywords: 1,1′-Ethylene-2,2′-bipyridinium; herbicide; human poisoning; oxidative stress; treatment.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Child
  • Child, Preschool
  • Defoliants, Chemical / pharmacokinetics
  • Defoliants, Chemical / poisoning*
  • Diquat / pharmacokinetics
  • Diquat / poisoning*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Necrosis
  • Oxidative Stress / drug effects*
  • Poisoning / diagnosis
  • Poisoning / metabolism
  • Poisoning / mortality
  • Poisoning / therapy*
  • Risk Assessment
  • Toxicokinetics
  • Treatment Outcome
  • Young Adult

Substances

  • Defoliants, Chemical
  • Diquat