Current status of the acquired immune system of Iranian patients with long-term complications of sulfur mustard poisoning

Balali‐Mood, Mahdi; Riahi-Zanjani, Bamdad; Mahmoudi, Mahmoud; Sadeghi, Mahmood

doi:10.1007/s40199-019-00239-6

Cited by 7 publications

(3 citation statements)

References 27 publications

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“…Military conflicts were the primary cause of SM exposure, with the highest incidence rates reported during the Iran–Iraq war in the 1980s. According to a study published in 2019, the prevalence of SM-induced tissue injuries among Iranian veterans was 42.3%, with most cases being mild or moderate in severity [ 30 , 31 ].…”

Section: Incidence Rate Of Sm-induced Tissue Injurymentioning

confidence: 99%

Therapeutic Benefits of Stem Cells and Exosomes for Sulfur-Mustard-Induced Tissue Damage

Bosholm,

Zhu,

et al. 2023

IJMS

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Sulfur mustard (SM) is a highly toxic chemical agent that causes severe tissue damage, particularly to the eyes, lungs, and skin. Despite advances in treatment, there is a need for more effective therapies for SM-induced tissue injury. Stem cell and exosome therapies are emerging as promising approaches for tissue repair and regeneration. Stem cells can differentiate into multiple cell types and promote tissue regeneration, while exosomes are small vesicles that can deliver therapeutic cargo to target cells. Several preclinical studies demonstrated the potential of stem cell, exosome, or combination therapy for various tissue injury, showing improvements in tissue repairing, inflammation, and fibrosis. However, there are also challenges associated with these therapies, such as the requirement for standardized methods for exosome isolation and characterization, the long-term safety and efficacy and reduced SM-induced tissue injury of these therapies. Stem cell or exosome therapy was used for SM-induced eye and lung injury. Despite the limited data on the use for SM-induced skin injury, this therapy is a promising area of research and may offer new treatment options in the future. In this review, we focused on optimizing these therapies, evaluating their safety and efficacy, and comparing their efficacy to other emerging therapeutic approaches potentially for SM-induced tissue injury in the eye, lung, and skin.

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Section: Incidence Rate Of Sm-induced Tissue Injurymentioning

confidence: 99%

Therapeutic Benefits of Stem Cells and Exosomes for Sulfur-Mustard-Induced Tissue Damage

Bosholm,

Zhu,

et al. 2023

IJMS

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“…Sulfur mustard (SM), an oily and hydrophobic agent, was used as a chemical warfare agent in World War I, the Iran-Iraq War 1980-1988, and the recent Syria civil war (Sezigen et al, 2019). SM can severely damage tissues or organs due to the result of an acute or long term effect (Balali-Mood et al, 2019;Khazdair and Boskabady, 2019). The severe damage by SM is hard to repair since the toxicity mechanism of SM is complex and not fully known (Panahi et al, 2018;Rose et al, 2018;Shakarjian et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Phospholipid and Triglyceride keep vortex-dispersed sulfur mustard analog as undissolved droplets which induce necrosis from nearby cells via declining mitochondrial membrane potential

Dan

Zeng³

et al. 2019

Fundam. Toxicol. Sci.

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-SM (Sulfur mustard) is an oily, hydrophobic, and lipophilic chemical agent that damages cells with intricate patterns. CEES (2-chloroethyl ethyl sulfide soluble) is a standard SM analog commonly employed in the toxicity mechanism study. To obtain ideal results in vitro, researchers should disperse CEES well in the medium, avoiding the presence of undissolved droplets. However, such a purpose is not easy to reach under the conventional solution preparation, and the information about droplet formation and function is little available. Here, we showed that phospholipid and triglyceride, two essential components of serum lipids, could prevent CEES from dissolving in water after vortex, which kept partial CEES as small droplets. By detecting CEES level, we proved that residual droplets slowed CEES hydrolysis and conversion. Under the microscope, CEES droplets were observed to degrade and diffuse with time to induce the necrosis and mitochondrial membrane potential decline from nearby cells. In conclusion, the damage pattern of CEES droplets is quite different from that of dissolved CEES, and a low level of phospholipid and triglyceride is beneficial for preventing droplets formation in preparing CEES solution.

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“…Proteases such as MMP-9 are induced that contribute to edema formation, tissue destruction and blistering (6). Sulfur mustard wound often shows incomplete healing, with patients burdened by chronic skin inflammation and pruritus even decades after exposure (2, 7).…”

Section: Introductionmentioning

confidence: 99%

Accelerating Inflammation Resolution to Counteract Chemical Cutaneous Injury

Achanta¹,

Chintagari

Balakrishna

et al. 2019

Preprint

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Running title: Lipid mediators mitigate chemical skin injury Abbreviations:RvD1 (Resolvin D1); RvD2 (Resolvin D2); CS (2-Chlorobenzalmalononitrile); CEES (2-chloroethylethyl-sulfide); SM (sulfur mustard); HD (sulfur mustard); MMP-9 (matrix metallo protein-9), IL-1β (Interleukin-1 beta), KC/CXCL1 (keratinocyte chemoattractant)/(chemokine (C-X-C motif) ligand 1); CXCL2 (chemokine (C-X-C motif) ligand 2); IL-6 (interleukin-6); ELISA (enzyme linked immune sorbent assay); PBS (phosphate buffer saline); MEVM (mouse ear vesicant model); i.p (intraperitoneal); i.v (intravenous); NSAIDs (nonsteroidal anti-inflammatory drugs) AbstractChemical exposure to vesicants such as sulfur mustard (SM), and electrophilic riot control agents such as 2-chlorobenzalmalononitrile (CS) tear gas agent, cause strong cutaneous inflammation. Classical antiinflammatory treatments have focused on interference with target initiation and maintenance of inflammation, with mixed outcomes. Inflammation is broadly classified into three temporal phases, initiation, amplification and maintenance, and resolution. Resolution of inflammation was thought to be a passive process but the recent body of literature shows that resolution is an active process and is mediated by fatty acid-derived mediators (specialized pro-resolving mediators, SPMs). We hypothesized that accelerating resolution phase of inflammation may attenuate the exaggerated inflammatory response following chemical threat exposure, leading to decreased morbidity and improved recovery. In this study, SPMs, such as Resolvin D1 (RvD1) and Resolvin D2 (RvD2), were administered to mice at nanogram doses post-exposure to an SM analog, 2-chloroethyl-ethyl-sulfide (CEES) or CS tear gas agent.SPMs decreased edema (ear thickness and punch biopsy weights), pro-inflammatory cytokines (IL-1β, CXCL1/KC, MIP2) and protease marker (MMP-9), and vascular leakage (determined by IRDye 800 CW PEG) while improving histopathology in cutaneous chemical injury mouse models. These results support our hypothesis and pave the way for SPMs for further development as potential medical countermeasures for chemical threat agents-induced skin injuries.A new area of inflammation research has focused on the process of inflammation resolution (29-32). Resolution of inflammation was thought to occur due to the lack of inflammatory drive when concentrations of inflammation-initiating and -maintaining mediators are removed or in decline.However, new studies show that the resolution of inflammation is an active mechanism involving the activation of signaling pathways during inflammation initiation, and the later generation of fatty-acidderived specialized pro-resolving mediators (SPMs) that activate resolution mechanisms. These mediators include resolvins, lipoxins, protectins, and maresins. Resolvins and protectins are omega-3 fatty acids derived from docosahexaenoic acid (DHA; C22:6) or eicosapentaenoic acid (EPA; C20:5),We appreciate thoughtful discussions of Drs. Conflict of interestAuthors do not have any conflicts of interes...

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Current status of the acquired immune system of Iranian patients with long-term complications of sulfur mustard poisoning

Cited by 7 publications

References 27 publications

Therapeutic Benefits of Stem Cells and Exosomes for Sulfur-Mustard-Induced Tissue Damage

Therapeutic Benefits of Stem Cells and Exosomes for Sulfur-Mustard-Induced Tissue Damage

Phospholipid and Triglyceride keep vortex-dispersed sulfur mustard analog as undissolved droplets which induce necrosis from nearby cells via declining mitochondrial membrane potential

Accelerating Inflammation Resolution to Counteract Chemical Cutaneous Injury

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