Rationale for the Successful Management of EDTA Chelation Therapy in Human Burden by Toxic Metals

Ferrero, Maria Elena

doi:10.1155/2016/8274504

Cited by 58 publications

(51 citation statements)

References 84 publications

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“…First, to assess mercury poisoning in our patient, we decided to quantify the serum mercury concentration with ICP-MS technology because this is the method currently used to evaluate toxic-metal levels in blood and/or urine samples in humans [ 14 , 15 , 16 ].…”

Section: Discussion and Literature Revisionmentioning

confidence: 99%

“…A common chelating agent is CaNa 2 ·EDTA [ 30 ]. It is the most commonly used chelating agent in poisoning lead and cadmium [ 15 ]. However, this drug was selected because, in addition to forming complexes that allow the elimination of mercury, several benefits have been reported on the vascular and cardiac systems [ 31 ].…”

Section: Discussion and Literature Revisionmentioning

confidence: 99%

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Full Atrioventricular Block Secondary to Acute Poisoning Mercury: A Case Report

Peregrina-Chávez

Ramírez-Galindo

Chávez-Martínez

et al. 2018

IJERPH

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Background: The biological behaviour and clinical significance of mercury toxicity vary according to its chemical structure. Mercury differs in its degree of toxicity and in its effects on the nervous, digestive and immune systems as well as on organs such as the lungs, kidneys, skin, eyes and heart. Human exposure occurs mainly through inhalation of elemental mercury vapours during industrial and artisanal processes such as artisanal and small-scale gold mining. Case presentation: A 52-years-old female, housewife, with a body mass index of 25.3 kg/cm2, without smoking or alcohol habits or any important clinical or chronic cardiovascular history, was admitted to the emergency room due to probable accidental poisoning by butane gas. Clinical manifestations with a headache, dizziness, cough, and dyspnoea of medium to small efforts. An initial physical exploration with Glasgow scored at 15, with arrhythmic heart sounds, pulmonary fields with bilateral subcrepitant rales and right basal predominance. Electrocardiographic findings were as follows: a cardiac frequency of 50 beats per minute and atrioventricular dissociation. Laboratory parameters were: white blood cells at 15.8 × 109/L; aspartate aminotransferase at 38 U/L; lactate dehydrogenase at 1288 U/L; creatine-kinase at 115 U/L; CK-MB fraction at 28 U/L; and other biochemical parameters were within the reference values. A radiographic evaluation showed flow cephalization, diffuse bilateral infiltrates with right basal predominance. In addition, the patient presented data of low secondary expenditure to third-degree atrioventricular (AV) block for which the placement of a transvenous pacemaker was decided, substantially improving the haemodynamic parameters. Subsequently, after a family interrogation, the diagnosis of mercury inhalation poisoning was established. An initial detection of mercury concentration (Hg(0)) was carried out, reporting 243.5 µg/L. In view of this new evidence, mercury chelation therapy with intravenous calcium disodium ethylenediamine tetraacetic acid (CaNa2·EDTA) was initiated. After 8-days of hospital stay, she presented a favourable evolution with both clinical and radiological improvements, so that the mechanical ventilation progressed to extubating. Subsequently, she was referred for cardiology because of her persistent 3rd-degree atrioventricular block, deciding to place a definitive bicameral pacemaker. The patient was discharged from the hospital 14 days after admission due to clinical improvements with mercury plasma levels at 5 µmol/L and a heart rhythm from the pacemaker. Conclusions: We show evidence that acute exposure to elemental mercury can affect the heart rhythm, including a complete atrioventricular blockage.

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Section: Discussion and Literature Revisionmentioning

confidence: 99%

Section: Discussion and Literature Revisionmentioning

confidence: 99%

Full Atrioventricular Block Secondary to Acute Poisoning Mercury: A Case Report

Peregrina-Chávez

Ramírez-Galindo

Chávez-Martínez

et al. 2018

IJERPH

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“…However, the serious side effects that may occur during the chelation therapy such as depletion of essential minerals, prooxidant effects, hepatic and renal toxicity, and no removal of heavy metals from intracellular compartments are the major drawbacks of this treatment [3]. Since oxidative stress plays a pivotal role in the pathogenesis of metal toxicity, the use of antioxidants as a supplementary therapy to conventional chelation treatment has been proposed [3,4].…”

Section: Introductionmentioning

confidence: 99%

Protective Effects of Dietary Antioxidants against Vanadium-Induced Toxicity: A Review

Zwolak

2020

Oxidative Medicine and Cellular Longevity

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Vanadium (V) in its inorganic forms is a toxic metal and a potent environmental and occupational pollutant and has been reported to induce toxic effects in animals and people. In vivo and in vitro data show that high levels of reactive oxygen species are often implicated in vanadium deleterious effects. Since many dietary (exogenous) antioxidants are known to upregulate the intrinsic antioxidant system and ameliorate oxidative stress-related disorders, this review evaluates their effectiveness in the treatment of vanadium-induced toxicity. Collected data, mostly from animal studies, suggest that dietary antioxidants including ascorbic acid, vitamin E, polyphenols, phytosterols, and extracts from medicinal plants can bring a beneficial effect in vanadium toxicity. These findings show potential preventive effects of dietary antioxidants on vanadium-induced oxidative stress, DNA damage, neurotoxicity, testicular toxicity, and kidney damage. The relevant mechanistic insights of these events are discussed. In summary, the results of studies on the role of dietary antioxidants in vanadium toxicology appear encouraging enough to merit further investigations.

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“…Previous studies have shown that the divalent cation chelator ethylenediaminetetraacetic acid (EDTA) can destabilize the biofilm structure by interfering with the ionic attractive forces among the biofilm matrix components [13,14]. EDTA is prescribed in a number of clinical conditions demonstrating high tolerability (up to 2 g once a week, intravenously injected) and efficacy [15]. Recently, we demonstrated that the optimized semi-synthetic antimicrobial peptide lin-SB056-1 in combination with EDTA is able to exert a synergistic bactericidal effect against P. aeruginosa in an artificial sputum medium resembling CF sputum [16].…”

Section: Introductionmentioning

confidence: 99%

Targeting Pseudomonas aeruginosa in the Sputum of Primary Ciliary Dyskinesia Patients with a Combinatorial Strategy Having Antibacterial and Anti-Virulence Potential

Maisetta

Grassi

Esin

et al. 2019

IJMS

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In primary ciliary dyskinesia (PCD) patients, Pseudomonas aeruginosa is a major opportunistic pathogen, frequently involved in chronic infections of the lower airways. Infections by this bacterial species correlates with a worsening clinical prognosis and recalcitrance to currently available therapeutics. The antimicrobial peptide, lin-SB056-1, in combination with the cation chelator ethylenediaminetetraacetic acid (EDTA), was previously demonstrated to be bactericidal against P. aeruginosa in an artificial sputum medium. The purpose of this study was to validate the anti-P. aeruginosa activity of such a combination in PCD sputum and to evaluate the in vitro anti-virulence effects of EDTA. In combination with EDTA, lin-SB056-1 was able to significantly reduce the load of endogenous P. aeruginosa ex vivo in the sputum of PCD patients. In addition, EDTA markedly reduced the production of relevant bacterial virulence factors (e.g., pyocyanin, proteases, LasA) in vitro by two representative mucoid strains of P. aeruginosa isolated from the sputum of PCD patients. These results indicate that the lin-SB056-1/EDTA combination may exert a dual antimicrobial and anti-virulence action against P. aeruginosa, suggesting a therapeutic potential against chronic airway infections sustained by this bacterium.

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Rationale for the Successful Management of EDTA Chelation Therapy in Human Burden by Toxic Metals

Cited by 58 publications

References 84 publications

Full Atrioventricular Block Secondary to Acute Poisoning Mercury: A Case Report

Full Atrioventricular Block Secondary to Acute Poisoning Mercury: A Case Report

Protective Effects of Dietary Antioxidants against Vanadium-Induced Toxicity: A Review

Targeting Pseudomonas aeruginosa in the Sputum of Primary Ciliary Dyskinesia Patients with a Combinatorial Strategy Having Antibacterial and Anti-Virulence Potential

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