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Relationship: 450

Title

A descriptive phrase which clearly defines the two KEs being considered and the sequential relationship between them (i.e., which is upstream, and which is downstream). More help

AchE Inhibition leads to Respiratory distress/arrest

Upstream event
The causing Key Event (KE) in a Key Event Relationship (KER). More help
AchE Inhibition
Downstream event
The responding Key Event (KE) in a Key Event Relationship (KER). More help
Respiratory distress/arrest

Key Event Relationship Overview

The utility of AOPs for regulatory application is defined, to a large extent, by the confidence and precision with which they facilitate extrapolation of data measured at low levels of biological organisation to predicted outcomes at higher levels of organisation and the extent to which they can link biological effect measurements to their specific causes.Within the AOP framework, the predictive relationships that facilitate extrapolation are represented by the KERs. Consequently, the overall WoE for an AOP is a reflection in part, of the level of confidence in the underlying series of KERs it encompasses. Therefore, describing the KERs in an AOP involves assembling and organising the types of information and evidence that defines the scientific basis for inferring the probable change in, or state of, a downstream KE from the known or measured state of an upstream KE. More help

AOPs Referencing Relationship

AOP Name Adjacency Weight of Evidence Quantitative Understanding Point of Contact Author Status OECD Status
Acetylcholinesterase inhibition leading to acute mortality non-adjacent Moderate Low Cataia Ives (send email) Under Development: Contributions and Comments Welcome Under Development

Taxonomic Applicability

Latin or common names of a species or broader taxonomic grouping (e.g., class, order, family) that help to define the biological applicability domain of the KER.In general, this will be dictated by the more restrictive of the two KEs being linked together by the KER.  More help

Sex Applicability

An indication of the the relevant sex for this KER. More help

Life Stage Applicability

An indication of the the relevant life stage(s) for this KER.  More help

Key Event Relationship Description

Provides a concise overview of the information given below as well as addressing details that aren’t inherent in the description of the KEs themselves. More help

  • Acetylcholinesterase (AchE) inhibition leads to respiratory distress and arrest via increased cholinergic signalling. AchE inhibition leads to accumulation of acetylcholine (Ach) within neural synaptic clefts and neuromuscular junctions. Respiratory failure follows as a consequence of a multifactor process resulting from physiological functions associated with both muscarinic and nicotinic cholinergic signalling. This process includes a direct depressant effect on the brain stem respiratory center, airway constriction, increased mucus secretion in the airways, and respiratory musculature paralysis (review in Carey, 2013).

Evidence Collection Strategy

Include a description of the approach for identification and assembly of the evidence base for the KER. For evidence identification, include, for example, a description of the sources and dates of information consulted including expert knowledge, databases searched and associated search terms/strings.  Include also a description of study screening criteria and methodology, study quality assessment considerations, the data extraction strategy and links to any repositories/databases of relevant references.Tabular summaries and links to relevant supporting documentation are encouraged, wherever possible. More help

Evidence Map 2.0

ID Experimental Design Species Upstream Observation Downstream Observation Citation (first author, year) Notes

Evidence Map

Addresses the scientific evidence supporting KERs in an AOP setting the stage for overall assessment of the AOP. More help
Title First Author
Biological Plausibility
Dose Concordance
Temporal Concordance
Incidence Concordance
Biological Plausibility
Dose Concordance Evidence
Temporal Concordance Evidence
Incidence Concordance Evidence
Uncertainties and Inconsistencies
Addresses inconsistencies or uncertainties in the relationship including the identification of experimental details that may explain apparent deviations from the expected patterns of concordance. More help

Known modulating factors

This table captures specific information on the MF, its properties, how it affects the KER and respective references.1.) What is the modulating factor? Name the factor for which solid evidence exists that it influences this KER. Examples: age, sex, genotype, diet 2.) Details of this modulating factor. Specify which features of this MF are relevant for this KER. Examples: a specific age range or a specific biological age (defined by...); a specific gene mutation or variant, a specific nutrient (deficit or surplus); a sex-specific homone; a certain threshold value (e.g. serum levels of a chemical above...) 3.) Description of how this modulating factor affects this KER. Describe the provable modification of the KER (also quantitatively, if known). Examples: increase or decrease of the magnitude of effect (by a factor of...); change of the time-course of the effect (onset delay by...); alteration of the probability of the effect; increase or decrease of the sensitivity of the downstream effect (by a factor of...) 4.) Provision of supporting scientific evidence for an effect of this MF on this KER. Give a list of references.  More help

Domain of Applicability

A free-text section of the KER description that the developers can use to explain their rationale for the taxonomic, life stage, or sex applicability structured terms. More help

  • The effects of anticholinesterase drugs on respiratory response varied by species. In rabbits, respiratory failure resulted from a combined central respiratory response with neuromuscular block at the diaphragm, while bronchoconstriction was less severe. Cats showed immediate bronchoconstriction and consequent anoxia, followed by central respiratory effects. In monkeys, respiratory failure was almost entirely caused by inhibition of central respiratory mechanism (De Candole).

  •  Studies across multiple species show that the relative role of local pulmonary effects, central respiratory depression, and respiratory muscle paralysis may vary, but the central effects predominate in nonhuman primates (and by extension humans).  Maintenance of ventilation and treatment with muscarinic blockers and reactivating agents are shown to reduce mortality in animal studies and continue to be the standard clinical treatment (Hulse et al., 2014).

  • In fish, the mechanism for respiratory-cardiovascular response in fish is likely explained by a decrease in respiratory surface area of the gills, or vasoconstriction. AChE inhibition in the gills would result in continuous stimulation at neuromuscular junctions, causing arterial sphincters to constrict and reduced blood flow to secondary lamellae. Oxygen utilization decreased as a result (McKim).

  • In birds, respiratory failure occurs after continued cholinergic stimulation exhausts the respiratory muscles. Other respiratory symptoms include muscle tremors and increased respiratory tract secretions (Blackwell's Five-Minute Veterinary Consult: Avian).