Delayed poisoning cases pose a major challenge to clinical toxicologists due to the multifold complications that can arise in addition to the primary clinical impact. One example is pesticide poisoning, which can lead to delayed cholinergic syndrome, intermediate syndrome, organophosphate-induced delayed polyneuropathy, and chronic organophosphate-induced neuropsychiatric disorder. The major problem with delayed presentation of poisoning cases is that these complications can significantly impact patient outcomes. However, the advancements in clinical toxicology, particularly in the field of nanotoxicology, have greatly improved our capacity to diagnose and treat poisoning cases. This editorial aims to emphasize the remarkable progress made in nanotoxicology technology and its application in treating delayed poisoning cases.

Nanotechnology has revolutionized various fields, including medicine, by providing tools for targeted drug delivery, imaging, and diagnostics. Nano-toxicology is a field of study that assesses the potential toxicity of nanoparticles and nanomaterials on living organisms and the environment. In the context of toxicology, nanotechnology offers novel approaches to detect and mitigate the effects of toxic substances in the body. Nanoscale materials, such as nanoparticles and nanosensors, exhibit unique properties that can be exploited for the detection and treatment of poisoning. The detection methods used in nano-toxicology research are crucial for understanding the safety and risks associated with nanomaterials. In this study, the author will discuss several commonly employed detection methods in nano-toxicology research.

Traditional methods for detecting toxic substances often suffer from limitations such as low sensitivity and specificity, especially in cases of delayed poisoning where the concentration of the toxin may be low. Nanotechnology-based sensors have emerged as powerful tools for the highly sensitive and selective detection of toxicants in biological samples. These sensors can detect even trace amounts of toxins, enabling early diagnosis and intervention. Some nanotechnology techniques that have wide potential are listed below:

Oxidative stress analysis

• Reactive Oxygen Species (ROS) assays: Assays like 2',7'-Dichlorodihydrofluorescein diacetate (DCFH-DA) and dihydroethidium (DHE) are employed to detect and quantify intracellular ROS levels, e.g. superoxide anions, hydroxyl radicals, etc.
• Glutathione (GSH) Assays: GSH is an important antioxidant and defense mechanism against oxidative stress. GSH assays, such as the DTNB-GSH reductase recycling assay, can assess the alterations in GSH levels caused by toxic exposure.

Genotoxicity assessment

• Comet assay: The comet assay determines DNA damage in individual cells exposed to protoplasmic toxins like phosphides, phosphorous, etc. It involves electrophoresis of cells embedded in agarose gel, allowing for the visualization and quantification of DNA breaks.
• Micronucleus assay: The micronucleus assay measures the formation of micronuclei, small extra-nuclear bodies, resulting from chromosomal damage caused by genotoxins.

Biodistribution and elimination studies

• Inductively Coupled Plasma-Mass Spectrometry (ICP-MS): ICP-MS is a highly sensitive analytical technique used for quantitative analysis of elemental composition in biological samples. It allows the determination of toxin biodistribution in various organs and tissues.
• Poison elimination studies: Clearance studies involve monitoring the elimination of toxins or poison levels from the body, often through feces, urine, or exhaled breath, to understand their biocompatibility and potential accumulation.

Once poisoning is diagnosed, prompt and targeted treatment is essential to prevent further harm to the patient. Nanotechnology offers innovative approaches for delivering antidotes and therapeutic agents directly to the affected tissues or organs. Nanocarriers, such as liposomes and nanoparticles, can encapsulate drugs and facilitate their controlled release, improving efficacy while minimizing systemic side effects. Additionally, nanomaterials can be engineered to adsorb or neutralize toxins in the body, providing a novel approach to detoxification.

The application of nanotoxicology technology in clinical practice holds great promise for managing delayed poisoning cases. For instance, nanoscale sensors integrated into wearable devices could enable real-time monitoring of environmental toxins or occupational exposures, allowing for early intervention. Similarly, nanomaterial-based antidote delivery systems could revolutionize the treatment of acute poisoning by enhancing the pharmacokinetics and bioavailability of antidotes.

Despite the significant progress in nanotoxicology technology, several challenges remain unaddressed. These include concerns regarding the safety and biocompatibility of nanomaterials, as well as regulatory hurdles associated with their clinical translation. Furthermore, the cost-effectiveness and scalability of nanotechnology-based approaches need to be carefully evaluated to ensure widespread adoption. The more concerning is that there is a lack of information about the environmental and biological impacts of nano-waste generated from nanomaterials.

In conclusion, recent advances in nanotoxicology technology offer promising opportunities for improving the diagnosis and treatment of delayed poisoning cases. By leveraging the unique properties of nanomaterials, clinicians and researchers can develop innovative strategies for detecting toxins with high sensitivity and delivering targeted therapies to affected individuals. Continued research and collaboration are essential to overcome existing challenges and realize the full potential of nanotechnology in clinical toxicology.