Nerve agents have been used extensively in chemical warfare in the past. However, recent
use of Novichok agents have reignited the debate on the threat posed by Organophosphorus
Nerve Agents (OPNAs). The currently available therapy for OPNA toxicity is only symptomatic
and is potentially ineffective in neutralizing OPNAs. Hence, there is a dire need to develop a prophylactic
therapy for counteracting OPNA toxicity. In this regard, human paraoxonase 1 has
emerged as the enzyme of choice. In this review, we have focussed upon the recent and past events
of OPNA use, their mechanism of action and toxicity. Further, we have emphasized upon the potential
of enzyme based therapy and the various advances in the development of paraoxonase 1 as a
countermeasure for OPNA poisoning. Finally, we have elaborated the shortcomings of paraoxonase
1 and the work that needs to be undertaken in order to develop human paraoxonase 1 as a prophylactic
against OPNA poisoning.