Abstract:SM was first used during the First World War and it is still considered one of the major chemical weapons recently used by non-state actors in Syria and Iraq. In case of SM exposure, medical treatment of SM-induced lesions is symptomatic because no antidote or causal therapy does exist even though SM is very well known for over 100 years. However, clinical management in intensive care medicine of SM victims have improved since the 1980s, this study which is one of the largest recent SM-exposed case series sinc… Show more
“…The world has witnessed the indiscriminate use of chemical weapons for more than a century, from the First World War to the recent Syrian Civil War (32). Unfortunately, despite an intensive quest for strategies against their acute toxicity, the pharmacopeia has no effective choices for preventing the appearance of chronic disabilities.…”
Section: Immune-inflammation and Oxidative Stress Induced By Vesicantmentioning
In this review we focused our attention on sulfur mustard [bis(2-chloroethyl) sulphide], the main vesicant chemical warfare agent (CWA), which has been widely used in different military conflicts, including World War I and the Iran-Iraq war. Moreover, the evolution of the recent Iraq and Syria conflicts suggests that terrorist groups are aware of the significant psychological and media effects that would be produced by the mere attempt to use CWAs. Sulfur mustard can produce the alkylation of macromolecules bearing sulfhydryl groups, such as DNA and proteins. This vesicant can also generate free radicals which can develop toxicity in the areas exposed, such as the eyes, skin, respiratory tract (inhalation) and gastrointestinal tract (ingestion). In this respect, we advance and propose three salvage mechanisms through which a broad-spectrum multipotent molecule, melatonin, could facilitate neutralization of the toxic damage induced by sulfur mustard radical scavenging. We also speculate that the long-term effects of varying severity can appear after acute poisoning. Besides, melatonin-based therapy strategies can modulate of epigenetic mechanisms and become very suitable for the clinical treatment of victimized patients. However, the utilization of melatonin as a “therapeutic bullet” addressed to counteract the vesicant CWAs needs much additional in vitro research as well as systematic animal studies and controlled translational trials.
“…The world has witnessed the indiscriminate use of chemical weapons for more than a century, from the First World War to the recent Syrian Civil War (32). Unfortunately, despite an intensive quest for strategies against their acute toxicity, the pharmacopeia has no effective choices for preventing the appearance of chronic disabilities.…”
Section: Immune-inflammation and Oxidative Stress Induced By Vesicantmentioning
In this review we focused our attention on sulfur mustard [bis(2-chloroethyl) sulphide], the main vesicant chemical warfare agent (CWA), which has been widely used in different military conflicts, including World War I and the Iran-Iraq war. Moreover, the evolution of the recent Iraq and Syria conflicts suggests that terrorist groups are aware of the significant psychological and media effects that would be produced by the mere attempt to use CWAs. Sulfur mustard can produce the alkylation of macromolecules bearing sulfhydryl groups, such as DNA and proteins. This vesicant can also generate free radicals which can develop toxicity in the areas exposed, such as the eyes, skin, respiratory tract (inhalation) and gastrointestinal tract (ingestion). In this respect, we advance and propose three salvage mechanisms through which a broad-spectrum multipotent molecule, melatonin, could facilitate neutralization of the toxic damage induced by sulfur mustard radical scavenging. We also speculate that the long-term effects of varying severity can appear after acute poisoning. Besides, melatonin-based therapy strategies can modulate of epigenetic mechanisms and become very suitable for the clinical treatment of victimized patients. However, the utilization of melatonin as a “therapeutic bullet” addressed to counteract the vesicant CWAs needs much additional in vitro research as well as systematic animal studies and controlled translational trials.
“…It has been used subsequently in a number of smaller conflicts [ [2] , [3] , [4] ], culminating in the Iran/Iraq War (1980-1988) where over 100,000 Iranian and Iraqi-Kurdish civilians and soldiers were exposed to this chemical agent [ 5 ]. Almost thirty years later, evidence of H use by non-state actors during the Syrian Civil War has also been reported [ [6] , [7] , [8] , [9] , [10] ]. Figure 1 Chemical structures of sulphur mustard (H), 2-chloroethyl ethyl sulphide (CEES) and mechlorethamine (HN-2).…”
In the long and intensive search for effective treatments to counteract the toxicity of the chemical warfare (CW) agent sulphur mustard (H; bis(2-chloroethyl) sulphide), the most auspicious and consistent results have been obtained with the drug N-acetylcysteine (NAC), particularly with respect to its therapeutic use against the effects of inhaled H. It is a synthetic cysteine derivative that has been used in a wide variety of clinical applications for decades and a wealth of information exists on its safety and protective properties against a broad range of toxicants and disease states. Its primary mechanism of action is as a pro-drug for the synthesis of the antioxidant glutathione (GSH), particularly in those circumstances where oxidative stress has exhausted intracellular GSH stores. It impacts a number of pathways either directly or through its GSH-related antioxidant and anti-inflammatory properties, which make it a prime candidate as a potential treatment for the wide range of deleterious cellular effects that H is acknowledged to cause in exposed individuals. This report reviews the available literature on the protection afforded by NAC against the toxicity of H in a variety of model systems, including its efficacy in treating the long-term chronic lung effects of H that have been demonstrated in Iranian veterans exposed during the Iran-Iraq War (1980-1988). Although there is overwhelming evidence supporting this drug as a potential medical countermeasure against this CW agent, there is a requirement for carefully controlled clinical trials to determine the safety, efficacy and optimal NAC dosage regimens for the treatment of inhaled H.
“…-наглядно продемонстрировал, что сернистый иприт (далее -иприт) сохранил за собой статус «короля газов», приобретенный им еще в период Первой мировой войны [2][3][4]. В последние годы были документально подтверждены многочисленные случаи применения иприта различными террористическими организациями на территории стран Ближнего Востока [1,10,13]. Вместе с тем высокоэффективных антидотов и средств патогенетической терапии поражений ипритом до сих пор не разработано, что в совокупности с аналитическими выводами о высокой вероятности использования этого токсиканта в качестве поражающего агента предопределяет актуальность поиска и разработки перспективных медицинских средств защиты.…”
The present work describes the currently existing experimental models of sulphur mustard gas inhalation injury. These models were analysed in terms of their suitability for the development of medical protective equipment. It is proposed to use micro-sprayers, which provide the possibility of transferring mustard gas from a liquid state to an aerosol form while exhibiting an increased ergonomic simplicity and safety.
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