Chronic inorganic mercury poisoning treated with N-acetyl-D-penicillamine

Gledhill, R. F.; Hopkins, Alex

doi:10.1136/oem.29.2.225

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…NAP is a well-known heavy metal chelator that is used clinically in the treatment of methyl-mercury and copper poisoning [59–61]. Indeed, NAP has been used for almost half a century [62–65]. Its medical uses have been widely taught in Medical Pharmacology courses as part of heavy metal poisoning treatments [60, 61] and it has also been used to protect against free radical induced organ injuries [66].…”

Section: Resultsmentioning

confidence: 99%

Long-term nitric oxide release and elevated temperature stability with S-nitroso-N-acetylpenicillamine (SNAP)-doped Elast-eon E2As polymer

et al. 2013

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Nitric oxide (NO) is known to be a potent inhibitor of platelet activation and adhesion. Healthy endothelial cells that line the inner walls of all blood vessels exhibit a NO flux of 0.5~4×10−10 mol cm−2 min−1 that helps prevent thrombosis. Materials with a NO flux that is equivalent to this level are expected to exhibit similar anti-thrombotic properties. In this study, five biomedical grade polymers doped with S-nitroso-N-acetylpenicillamine (SNAP) were investigated for their potential to control the release of NO from the SNAP within the polymers, and further control the release of SNAP itself. SNAP in the Elast-eon E2As polymer creates an inexpensive, homogeneous coating that can locally deliver NO (via thermal and photochemical reactions) as well slowly release SNAP. Furthermore, SNAP is surprisingly stable in the E2As polymer, retaining 82% of the initial SNAP after 2 months storage at 37°C. The E2As polymer containing SNAP was coated on the walls of extracorporeal circuits (ECC) and exposed to 4 h blood flow in a rabbit model of extracorporeal circulation to examine the effects on platelet count, platelet function, clot area, and fibrinogen adsorption. After 4 h, platelet count was preserved at 100±7% of baseline for the SNAP/E2As coated loops, compared to 60±6% for E2As control circuits (n=4). The SNAP/E2As coating also reduced the thrombus area when compared to the control (2.3±0.6 and 3.4±1.1 pixels/cm2, respectively). The results suggest that the new SNAP/E2As coating has potential to improve the thromboresistance of intravascular catheters, grafts, and other blood contacting medical devices, and exhibits excellent storage stability compared to previously reported NO release polymeric materials.

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Section: Resultsmentioning

confidence: 99%

Long-term nitric oxide release and elevated temperature stability with S-nitroso-N-acetylpenicillamine (SNAP)-doped Elast-eon E2As polymer

et al. 2013

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“…The figure of 300 ,ug mercury per litre of urine, suggested by Noe (1960), has received some acceptance (Gledhill and Hopkins, 1972;Smith et al, 1970) and, indeed, most cases of overt toxicity due to mercury reported in the literature have had concentrations exceeding this value (Kark et al, 1971;Gledhill and Hopkins, 1972). However, toxic symptoms undoubtedly occur in patients with urinary mercury excretions substantially below this figure.…”

Section: Discussionmentioning

confidence: 95%

Measurement of urinary mercury excretion by atomic absorption in health and disease

Taylor

1973

Occupational and Environmental Medicine

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“…D-Penicillamine has been used as an oral chelating agent in inorganic Hg toxicity (adult dose: 250 mg qid, pediatric dose: 20-30 mg/kg/day for 1-2 weeks), but has no role in MeHg exposure. 67,68 Hypersensitivity and nephrotoxicity are the commonest side effects of penicillamine. Similarly, dimercaprol or British anti-Lewisite (BAL) has also been used successfully mainly in inorganic and elemental mercury poisoning (deep intramuscular injection of 5 mg/kg for every 4 h for 1-2 days, then 2.5 mg/kg one-two times/day for 10 days).…”

Section: Chelation Therapymentioning

confidence: 99%

Mercury and Movement Disorders: The Toxic Legacy Continues

Ganguly

Kulshreshtha

Jog

2021

Can. J. Neurol. Sci.

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Mercury (Hg) exists in the environment as inorganic (metallic Hg vapor, mercurous and mercuric salts) or organic (bonded to a structure containing carbon atoms) forms. Neurotoxic effect of Hg is known for years. While the organic form (methylmercury (meHg)) led to the Minamata incidence in Japan and “wonder-wheat” disaster in Iraq, the “mad hatters” and “Danbury shakes” were related to the inorganic elemental form (Hg vapor). Human exposure to toxic Hg continues in the modern world to a large extent by artisanal gold mining, biomass combustion, chloralkali production, and indigenous medicine use to name a few. Heavy industrial use of Hg contaminates air and landfills, affecting the aquatic ecosystem and marine food chain. A detailed social and occupational history with a high index of clinical suspicion is required to not miss this toxic etiology for movement disorders like ataxia, tremor, or myoclonus. In this review, we have discussed the past and present global health impact of Hg from a movement disorder perspective. The connection of Hg with neurodegeneration and autoimmunity has been highlighted. We have also discussed the role of chelating agents and the preventive strategies to combat the neurotoxic effects of Hg in the modern world.

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Chronic inorganic mercury poisoning treated with N-acetyl-D-penicillamine

Cited by 6 publications

References 10 publications

Long-term nitric oxide release and elevated temperature stability with S-nitroso-N-acetylpenicillamine (SNAP)-doped Elast-eon E2As polymer

Long-term nitric oxide release and elevated temperature stability with S-nitroso-N-acetylpenicillamine (SNAP)-doped Elast-eon E2As polymer

Measurement of urinary mercury excretion by atomic absorption in health and disease

Mercury and Movement Disorders: The Toxic Legacy Continues

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