Brain cyanide toxicity

Ibrahim et al. 1963). Aiken and Braitman (1989) determined that cyanide has a direct effect on neurons not mediated by its inhibition of metabolism. Consistent with the view that cyanide toxicity is due to the inability of tissue to utilize oxygen is a report that in cyanide-intoxicated rats, arterial p02 levels rose, while carbon dioxide levels fell (Brierley et al. 1976). The authors suggested that the low levels of carbon dioxide may have led to vasoconstriction and reduction in brain blood flow therefore, brain damage may have been due to both histotoxic and anoxic effects. Partial remyelination after cessation of exposure has been reported, but it is apparent that this process, unlike that in the peripheral nervous system, is slow and incomplete (Hirano et al. 1968). The topographic selectivity of cyanide-induced encephalopathy may be related to the depth of acute intoxication and distribution of blood flow, which may result in selected regions of vascular insufficiency (Levine 1969). 

Linamurin is the principal cyanogenic glycoside in cassava its toxicity is due to hydrolysis by intestinal microflora releasing free cyanide (Padmaja and Panikkar 1989). Rabbits (Oryctolagus cuniculus) fed 1.43 mg linamurin/kg BW daily (10 mg/kg BW weekly) for 24 weeks showed effects similar to those of rabbits fed 0.3 mg KCN/kg BW weekly. Specihc effects produced by linamurin and KCN included elevated lactic acid in heart, brain, and liver reduced glycogen in liver and brain and marked depletion in brain phospholipids (Padmaja and Panikkar 1989). 

Organic cyanide compounds, or nitriles, have been implicated in numerous human fatalities and signs of poisoning — especially acetonitrile, acrylonitrile, acetone cyanohydrin, malonitrile, and succinonitrile. Nitriles hydrolyze to carboxylic acid and ammonia in either basic or acidic solutions. Mice (Mus sp.) given lethal doses of various nitriles had elevated cyanide concentrations in liver and brain the major acute toxicity of nitriles is CN release by liver processes (Willhite and Smith 1981). In general, alkylnitriles release CN much less readily than aryl alkylnitriles, and this may account for their comparatively low toxicity (Davis 1981). 

HCN is a systemic poison toxicity is due to inhibition of cytochrome oxidase, which prevents cellular utilization of oxygen. Inhibition of the terminal step of electron transport in cells of the brain results in loss of consciousness, respiratory arrest, and ultimately, death. Stimulation of the chemoreceptors of the carotid and aortic bodies produces a brief period of hyperpnea cardiac irregularities may also occur. The biochemical mechanisms of cyanide action are the same for all mammalian species. HCN is metabolized by the enzyme rhodanese which catalyzes the transfer of sulfur from thiosulfate to cyanide to yield the relatively nontoxic thiocyanate. 

The toxic effect is known as histotoxic hypoxia. Cyanide also directly stimulates chemoreceptors, causing hyperpnea. Lack of ATP will affect all cells, but heart muscle and brain are particularly susceptible. Therefore, cardiac arrythmias and other changes often occur, resulting in circulatory failure and delayed tissue ischemic anoxia. Death is usually due to respiratory arrest resulting from damage to the CNS, as the nerve cells of the respiratory control center are particularly sensitive to hypoxia. The susceptibility of the brain to pathological damage may reflect the lower concentration of cytochrome oxidase in white matter. 

Cyanide has many sources natural (plant-Cassava), industrial (cyanide salts and nitriles), and accidental (fires). The target organ is the brain death is from respiratory arrest. Cyanide blocks cytochrome a-a3 (cytochrome oxidase) in mitochondria. The toxic level is 1 mg mL-1 in blood. Treatment involves giving dicobalt edetate (chelation). Alternatively, by giving NaNCb, levels of methemoglobin are increased, and this binds cyanide. Detoxication is catalyzed by the enzyme rhodanese, and this pathway may be increased by giving NaS207. 

The basic reaction involves transfer of sulfane sulfur from the donor (SCN) to the enzyme, forming a persulhde intermediate. The persulfide sulfur is transferred from the enzyme to a nucleophilic receptor (CN) to yield SCN. For most species, this enzyme activity is high in liver, kidney, brain, muscle, and olfactory mucosa (Himwich and Saunders, 1948 Dahl, 1989 Aminlari et al., 1994). The nasal metabolism of CN may have relevance to the toxicity of inhaled HCN. (3-Mercaptopymvate-cyanide transulfurases are present in blood, liver, and kidney, and catalyze the reaction ... 

Vamell, R.M., Stimac, G.K., and Fligner, C.L., CT diagnosis of toxic brain injury in cyanide poisoning considerations for forensic medicine. Am. J. NeuroradioL, 8, 1063-1066, 1987. 

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