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Human & Experimental Toxicology Aug 19971 Dimercaprol (BAL), 2,3-dimercaptopropanesulphonate sodium (DMPS) and meso-2,3-dimercaptosuccinic acid (DMSA) are effective arsenic antidotes, but the question which... (Review)
Review
1 Dimercaprol (BAL), 2,3-dimercaptopropanesulphonate sodium (DMPS) and meso-2,3-dimercaptosuccinic acid (DMSA) are effective arsenic antidotes, but the question which one is preferable for optimal therapy of arsenic poisoning is still open to discussion. Major drawbacks of BAL include (a) its low therapeutic index, (b) its tendency to redistribute arsenic to brain and testes, for example, (c) the need for (painful) intramuscular injection and (d) its unpleasant odour. 2 The newer antidotes DMPS and DMSA feature low toxicity and high therapeutic index. They can be given orally or intravenously due to their high water solubility. While these advantages make it likely that DMPS and DMSA will replace BAL for the treatment of chronic arsenic poisoning, acute intoxication-especially with lipophilic organoarsenicals-may pose a problem for the hydrophilic antidotes, because their ionic nature can adversely affect intracellular availability. 3 This article focuses on aspects dealing with the power of BAL, DMPS, and DMSA to mobilize tissue-bound arsenic in various experimental models, such as monolayers of MDCK (= Madin-Darby canine kidney) cells from dog kidney, isolated perfused liver from guinea-pigs, and perfused jejunal segments from rat small intestine. 4 The results show that hydrophilic DMPS and DMSA may fail to rapidly and completely remove arsenic that has escaped from the extracellular space across tight epithelial barriers. However, owing to their low toxicity, which allows larger doses to be applied, and the potential modification of their pharmacokinetics by means of inert oral anion-exchange resins, DMPS and DMSA may advantageously replace BAL whenever intervention time is not critical. With severe intoxication by organic arsenicals, when the point-of-no-return is a limiting factor, BAL may still have a place as an arsenic antidote.
Topics: Animals; Antidotes; Arsenic Poisoning; Dimercaprol; Dogs; Guinea Pigs; Humans; Mice; Poisoning; Rats; Succimer; Unithiol
PubMed: 9292286
DOI: 10.1177/096032719701600807 -
Journal of Neurochemistry Jun 2017Acrolein is one of the most toxic byproducts of lipid peroxidation, and it has been shown to be associated with multiple pathological processes in trauma and diseases,...
Acrolein is one of the most toxic byproducts of lipid peroxidation, and it has been shown to be associated with multiple pathological processes in trauma and diseases, including spinal cord injury, multiple sclerosis, and Alzheimer's disease. Therefore, suppressing acrolein using acrolein scavengers has been suggested as a novel strategy of neuroprotection. In an effort to identify effective acrolein scavengers, we have confirmed that dimercaprol, which possesses thiol functional groups, could bind and trap acrolein. We demonstrated the reaction between acrolein and dimercaprol in an abiotic condition by nuclear magnetic resonance spectroscopy. Specifically, dimercaprol is able to bind to both the carbon double bond and aldehyde group of acrolein. Its acrolein scavenging capability was further demonstrated by in vitro results that showed that dimercaprol could significantly protect PC-12 cells from acrolein-mediated cell death in a dose-dependent manner. Furthermore, dimercaprol, when applied systemically through intraperitoneal injection, could significantly reduce acrolein contents in spinal cord tissue following a spinal cord contusion injury in rats, a condition known to have elevated acrolein concentration. Taken together, dimercaprol may be an effective acrolein scavenger and a viable candidate for acrolein detoxification.
Topics: Acrolein; Animals; Body Weight; Cell Death; Dimercaprol; Disease Models, Animal; Dose-Response Relationship, Drug; Drug Interactions; Free Radical Scavengers; L-Lactate Dehydrogenase; Magnetic Resonance Spectroscopy; Male; PC12 Cells; Rats; Spinal Cord; Spinal Cord Injuries
PubMed: 28301040
DOI: 10.1111/jnc.14025 -
Lancet (London, England) Jan 1952
Topics: Dimercaprol; Hepatolenticular Degeneration
PubMed: 14889814
DOI: No ID Found -
Bulletin. American Society of Hospital... 1946
Topics: Dimercaprol; Sulfhydryl Compounds
PubMed: 20247093
DOI: No ID Found -
Annals of Emergency Medicine Mar 2003Emergency physicians are familiar with British anti-Lewisite (BAL) because it is a heavy metal-chelating agent that is recommended in some cases of metal poisoning,...
Emergency physicians are familiar with British anti-Lewisite (BAL) because it is a heavy metal-chelating agent that is recommended in some cases of metal poisoning, especially arsenic. Although there are more modern chelating agents, the fact that BAL is still recommended and stocked by hospital pharmacies more than 60 years after its initial synthesis is itself remarkable. During World War II, BAL minimized the risk to the Allied infantry of injury or death from Lewisite, a very potent arsenic-based chemical warfare agent. Once developed, BAL revolutionized the treatment of heavy metal poisonings, both accidental and iatrogenic (eg, toxicity from treatment of arthritis with gold salts). In 1951, BAL was used to treat Wilson's disease with striking success. Today, BAL might again become prominent should terrorists or governments use Lewisite against civilians or military forces.
Topics: Arsenicals; Chelating Agents; Chemical Warfare Agents; Dimercaprol; England; Heavy Metal Poisoning, Nervous System; Hepatolenticular Degeneration; History, 20th Century; Humans; United States
PubMed: 12605205
DOI: 10.1067/mem.2003.72 -
Acta Pharmacologica Et Toxicologica 1955
Topics: Cadmium; Cadmium Poisoning; Dimercaprol; Poisoning
PubMed: 13248567
DOI: 10.1111/j.1600-0773.1955.tb00203.x -
British Journal of Pharmacology and... Sep 1949
Topics: Animals; Dimercaprol; Hepatobiliary Elimination; Lagomorpha; Lead; Rabbits
PubMed: 18141088
DOI: 10.1111/j.1476-5381.1949.tb00547.x -
Journal of Neurology, Neurosurgery, and... Feb 1954
Topics: Databases, Genetic; Dimercaprol; Hepatolenticular Degeneration; Humans
PubMed: 13131080
DOI: 10.1136/jnnp.17.1.70 -
The Journal of Pharmacology and... Nov 1953
Topics: Animals; Barbiturates; Dimercaprol; Mice; Pentobarbital
PubMed: 13109689
DOI: No ID Found -
British Medical Journal Mar 1957
Topics: Dermatitis; Dimercaprol; Humans; Mercury; Tattooing
PubMed: 13404275
DOI: 10.1136/bmj.1.5020.687