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Highly toxic organophosphorus based (OP) nerve agents have been developed by different countries for use as chemical warfare agents (CWAs) since the 1930s.1  Nerve agents have been repeatedly used during military conflicts,2  against civilian populations3  and by terrorists.4  In the meantime, the production, storage and use of CWAs have been banned by the international community and compliance with the regulations of the Chemical Weapons Convention is controlled by the Organisation for the Prohibition of Chemical Weapons. However, the nerve agent sarin was repeatedly used against civilians in Syria in 2013,5,6  emphasizing the continuing threat CWAs pose.

Exposure to nerve agents can result in life threatening toxic effects and requires rapid diagnosis and treatment. Typical signs of poisoning enable clinical diagnosis in cases of nerve agent exposure with rapid onset of toxic signs; however, these may be delayed in scenarios with low level and percutaneous exposure to nerve agents. This demands the development and availability of laboratory tools for supporting the clinical diagnosis of nerve agent exposure and to provide decisive information for the initiation and optimization of specific antidotal treatment.

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