Novichok – an old “novice” among poisons

We recently witnessed the death of Alexei Navalny, a critic of Russian President Vladimir Putin. For years, he pointed out the negatives related to the Russian government and ultimately ended up in a penal colony 60 km from the Arctic Circle, where he died tragically. It is known that Navalny fell ill after a walk and was immediately given emergency medical assistance. Unfortunately, the resuscitation measures did not succeed, which ended the life of the 47-year-old. What must be taken into account when it comes to Navalny’s death is also the fact that he was poisoned with the Soviet nerve agent Novichok in 2020. After this tragedy, the question arises whether this poison is responsible for his death despite the significant time gap between poisoning and death

The poison route: from insects to humans

Since there have been people, there have been conflicts and wars. When you read the word “war”, images of soldiers with helmets, tanks, rifles and other weapons probably appeared before your eyes. But you certainly didn’t think of chemical weapons, which are one of the main arsenals of modern conflicts. Among them is the infamous Novichok, already mentioned in the introduction. It is actually the name of a family of nerve agents, some of which are also used as chemical weapons.

The story of war poisons begins before the start of the Second World War when German scientists were developing compounds in order to obtain new insecticides. They synthesized over 2,000 compounds that belong to the group of organophosphates, based on which war poisons were also synthesized. Novichok also belongs to the referred group. As was stated, Novichok is not a substance, but a two-component mixture of chemical agents, one of which is, for example, A-242 (Novichok-5).

Novichok is believed to have been developed in the 1970s in Soviet Russia, which, of course, was not allowed to be discussed until the collapse of the Soviet Union. Vil Mirzayanov, who participated in the development of this poison at the Soviet State Institute of Organic Chemistry and Technology (GosNIIOKAT), published the project documentation in 1992. It is interesting that Novichok has never been used as a chemical weapon in wars. However, it has become very popular in the media since cases of terrorism were recorded using it.

Watch out, the ‘novice’ is attacking!

Novichok (Russian: novice, newbie) is an irreversible inhibitor of acetylcholinesterase and other cholinesterases. This means that it prevents the normal functioning of acetylcholinesterase, responsible for breaking down acetylcholine, which transmits nerve impulses between nerve cells and muscles. As acetylcholine cannot be broken down, it accumulates in the synaptic space and increases the stimulation of nerve receptors. However, this poison can also enter the body through breathing. When the respiratory tract is exposed to small amounts of the poison, symptoms such as runny and stuffy nose, difficulty breathing, contraction of the bronchi and burning in the chest occur.

The first sign of local or systemic poisoning is the narrowing of the pupils of the eye, followed by eye pain. Digestive symptoms that occur after oral ingestion of a small amount of poison are typical as with other poisonings: nausea, vomiting, abdominal pain. It is important to emphasize the effect of Novichok on the central nervous system. There are a number of symptoms that occur when taking lower doses of poison: anxiety, restlessness, nightmares, insomnia.

On the other hand, severe poisoning also causes dilated pupils, as well as tachycardia (rapid heart rate) and increased blood pressure. The poison has a strong effect on the muscles, causing spasms, therefore it also affects the diaphragm muscle that we associate with breathing. Finally, death itself occurs as a result of respiratory arrest due to paralysis of the diaphragm, but also due to a weakened breathing center in the central nervous system.

The case of Dr. Andrei Zheleznyakov, who worked on the development of novichok-5 and was exposed to this poison via aerosol, is interesting. Symptoms of severe poisoning appeared rapidly. Physicians reacted in time and the doctor was saved, but he died 5 years later due to advanced cirrhosis of the liver and epilepsy.

If there is a quick reaction, salvation is possible

In the case of poisoning by organophosphates, including Novichok, it is important to take immediate treatment measures. The most important thing is to maintain airway patency, breath control and normal blood circulation. The use of antidotes such as oximes and atropine is an indispensable step in the treatment. Depending on the dose of the poison, it is important to use laboratory tests to determine how much of it is actually present in the body so that the appropriate amount of antidote can be administered. Likewise, acetylcholinesterase and butyrylcholinesterase inhibition tests are performed to determine whether organophosphate poisoning is present.

The poisons don’t let up

The death of Alexei Navalny is one of the most controversial death cases in recent years. Considering that he was poisoned with Novichok, it is not surprising why an apparently healthy man said farewell to this world so suddenly. Today, poisons have never been more available and have become a common weapon in terrorism and wars. When the body is exposed to a bullet, it can easily miss, but poisons do not miss. Once they enter the body, it is usually over. Also, poisons are invisible unlike weapons. They can get into food and drink or ventilation systems and harm a large number of people. In the case of Novichok, we could see how it does not kill immediately, but with a delay of several years. That is why we can only talk about a temporary cure. It is important to raise awareness about the availability and uncontrolled use of poisons and to understand how by killing one person we affect not only them, but also all those who love and respect them.

Translated by: Nina Šlopar