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Laskin JD, Ozkuyumcu K, Zhou P, Croutch CR, Heck DE, Laskin DL, Joseph LB. Skin Models Used to Define Mechanisms of Action of Sulfur Mustard. Disaster Med Public Health Prep 2023; 17:e551. [PMID: 37849329 DOI: 10.1017/dmp.2023.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Sulfur mustard (SM) is a threat to both civilian and military populations. Human skin is highly sensitive to SM, causing delayed erythema, edema, and inflammatory cell infiltration, followed by the appearance of large fluid-filled blisters. Skin wound repair is prolonged following blistering, which can result in impaired barrier function. Key to understanding the action of SM in the skin is the development of animal models that have a pathophysiology comparable to humans such that quantitative assessments of therapeutic drugs efficacy can be assessed. Two animal models, hairless guinea pigs and swine, are preferred to evaluate dermal products because their skin is morphologically similar to human skin. In these animal models, SM induces degradation of epidermal and dermal tissues but does not induce overt blistering, only microblistering. Mechanisms of wound healing are distinct in these animal models. Whereas a guinea pig heals by contraction, swine skin, like humans, heals by re-epithelialization. Mice, rats, and rabbits are also used for SM mechanistic studies. However, healing is also mediated by contraction; moreover, only microblistering is observed. Improvements in animal models are essential for the development of therapeutics to mitigate toxicity resulting from dermal exposure to SM.
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Affiliation(s)
- Jeffrey D Laskin
- Department of Environmental and Occupational Health and Justice, Rutgers University School of Public Health, Piscataway, NJ, USA
| | - Kevin Ozkuyumcu
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Piscataway, NJ, USA
| | - Peihong Zhou
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Piscataway, NJ, USA
| | | | - Diane E Heck
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Piscataway, NJ, USA
| | - Debra L Laskin
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Piscataway, NJ, USA
| | - Laurie B Joseph
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Piscataway, NJ, USA
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Dalton C, Watkins R, Pritchard S, Graham S. Skin decontamination of Carfentanil in vitro. Toxicol Lett 2023; 388:56-63. [PMID: 37806367 DOI: 10.1016/j.toxlet.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/28/2023] [Accepted: 10/05/2023] [Indexed: 10/10/2023]
Abstract
Skin decontamination of Chemical Biological Radioactive and Nuclear (CBRN) materials involves the timely and effective removal of the contaminants from the skin surface. The current work evaluated Fuller's Earth & The Reactive Skin Decontaminant Lotion Kit (RSDL®) to investigate whether they were as efficacious against free base Carfentanil skin contamination as they are against chemical warfare agents. The in vitro methodology used allowed for evaluation of decontamination regimens as specified by the decontaminant manufacturer rather than as an application of a bolus dose left in situ for the study duration. A selection of novel decontaminants, including Dermal Decontamination Gel (DDGel), Trivorex®, itaconic acid (IA), N,N'-methylenebisacrylamide (MBA), 2-trifluoromethylacrylic acid (TFMAA) and NanoSan Sorb were also tested for efficacy. All the evaluated decontaminants were successful at removing the majority of the Carfentanil skin surface contamination. The current work has shown that the Fuller's Earth decontamination kit, removes as much (or more) free base carfentanil from the skin surface in comparison to other products tested in this study series.
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Affiliation(s)
- Christopher Dalton
- Chemical Biological and Radiological Division, Dstl Porton Down, Salisbury SP4 0JQ, UK.
| | - Rachel Watkins
- Chemical Biological and Radiological Division, Dstl Porton Down, Salisbury SP4 0JQ, UK
| | - Sarah Pritchard
- Chemical Biological and Radiological Division, Dstl Porton Down, Salisbury SP4 0JQ, UK
| | - Stuart Graham
- Chemical Biological and Radiological Division, Dstl Porton Down, Salisbury SP4 0JQ, UK
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Nandamuri S, Feschuk AM, Maibach HI. A Review of the Efficacy of Easily Accessible Dry Decontaminants for Human Chemical Contamination. J Appl Toxicol 2022; 42:950-960. [PMID: 35275408 DOI: 10.1002/jat.4315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/07/2022] [Accepted: 03/02/2022] [Indexed: 11/09/2022]
Abstract
Soap and water are often considered the gold standard for dermal decontamination. However, recent systematic reviews have shown that these methods often result in incomplete decontamination and may even induce contaminant absorption due to the "wash-in" effect. Therefore, it is important to gain insight on other decontamination methods. A literature search was done using PubMed to find experimental studies relating to dry decontamination performed with readily available items. Seven studies met eligibility criteria, and the study model, dry decontaminant, method of dry decontamination, method of analyzing decontamination, and main conclusions from each study were extracted, summarized and compared. Important conclusions include that all studies investigated found that dry decontamination yielded decreases in contamination. In addition, it was shown by multiple studies that not only the decontaminant, but the manner in which it is used (method used (blotting, rubbing, etc.), amount used, and whether decontamination instructions are provided to exposed individuals) is vital to success. Finally, in all four studies that investigated wet and dry decontamination combination protocols, combinations were more efficacious than dry decontamination alone. However, this means that dry improvised decontamination can be performed while waiting for the deployment and arrival of further formal decontaminants. These conclusions deserve consideration in the event that universal decontamination guidelines are designed. However, more studies are required in order to draw definitive conclusions regarding the important topic of dermal decontamination.
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Affiliation(s)
- Saisha Nandamuri
- University of California San Francisco, San Francisco, California, United States
| | - Aileen M Feschuk
- Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland & Labrador, Canada
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, California, United States
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Nair A, Yadav P, Behl A, Sharma RK, Kulshrestha S, Butola BS, Sharma N. Toxic blister agents: Chemistry, mode of their action and effective treatment strategies. Chem Biol Interact 2021; 350:109654. [PMID: 34634268 DOI: 10.1016/j.cbi.2021.109654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 08/11/2021] [Accepted: 09/09/2021] [Indexed: 11/19/2022]
Abstract
Since their use during the First World War, Blister agents have posed a major threat to the individuals and have caused around two million casualties. Major incidents occurred not only due to their use as chemical warfare agents but also because of occupational hazards. Therefore, a clear understanding of these agents and their mode of action is essential to develop effective decontamination and therapeutic strategies. The blister agents have been categorised on the basis of their chemistry and the biological interactions that entail post contamination. These compounds have been known to majorly cause blisters/bullae along with alkylation of the contaminated DNA. However, due to the high toxicity and restricted use, very little research has been conducted and a lot remains to be clearly understood about these compounds. Various decontamination solutions and detection technologies have been developed, which have proven to be effective for their timely mitigation. But a major hurdle seems to be the lack of proper understanding of the toxicological mechanism of action of these compounds. Current review is about the detailed and updated information on physical, chemical and biological aspects of various blister agents. It also illustrates the mechanism of their action, toxicological effects, detection technologies and possible decontamination strategies.
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Affiliation(s)
- Ashrit Nair
- Department of Textile and Fibre Engineering, Indian Institute of Technology, New Delhi-110016, India
| | - Pooja Yadav
- Department of Medical Elementology and Toxicology, Jamia Hamdard, New Delhi, 110062, India
| | - Amanpreet Behl
- Department of Textile and Fibre Engineering, Indian Institute of Technology, New Delhi-110016, India
| | - Rakesh Kumar Sharma
- Saveetha Institute of Medical & Technical Sciences, 162, Poonamallee High Road Chennai, Tamil Nadu 600077, India
| | - Shweta Kulshrestha
- Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi-110029, India
| | - Bhupendra Singh Butola
- Department of Textile and Fibre Engineering, Indian Institute of Technology, New Delhi-110016, India.
| | - Navneet Sharma
- Department of Textile and Fibre Engineering, Indian Institute of Technology, New Delhi-110016, India.
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Skin decontamination procedures against potential hazards substances exposure. Chem Biol Interact 2021; 344:109481. [PMID: 34051209 DOI: 10.1016/j.cbi.2021.109481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/20/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
Decontamination of unprotected skin areas is crucial to prevent excessive penetration of chemical contaminants after criminal or accidental release. A review of literature studies was performed to identify the available decontamination methods adopted to treat skin contamination after chemical, radiological and metal exposures. In this bibliographic review, an overview of the old and recent works on decontamination procedures followed in case of potential hazards substances contaminations with a comparison between these systems are provided. Almost all data from our 95 selected studies conducted in vitro and in vivo revealed that a rapid skin decontamination process is the most efficient way to reduce the risk of intoxication. The commonly-used or recommended conventional procedures are simple rinsing with water only or soapy water. However, this approach has some limitations because an easy removal by flushing may not be sufficient to decontaminate all chemical deposited on the skin, and skin absorption can be enhanced by the wash-in effect. Other liquid solutions or systems as adsorbent powders, mobilizing agents, chelation therapy are also applied as decontaminants, but till nowadays does not exist a decontamination method which can be adopted in all situations. Therefore, there is an urgent need to develop more efficient and successful decontaminating formulations.
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Matar H, Price SC, Chilcott RP. Further studies of the efficacy of military, commercial and novel skin decontaminants against the chemical warfare agents sulphur Mustard, Soman and VX. Toxicol In Vitro 2018; 54:263-268. [PMID: 30347232 DOI: 10.1016/j.tiv.2018.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 09/25/2018] [Accepted: 10/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND/AIMS Following an incident involving toxic chemicals, deployment of countermeasures before the arrival of specialised services at the scene may provide a "therapeutic" window in which to mitigate skin absorption. METHODS Five potential candidates (itaconic acid, N,N'-methylenebisacrylamide, 2-trifluoromethylacrylic acid, fuller's earth and Fast-Act®) previously found effective against a simulant (methyl salicylate) were evaluated against a 10 μL droplet of 14C-sulphur mustard (HD), soman (GD) or VX applied to the surface of porcine skin mounted on static skin diffusion cells. RESULTS All the decontaminants applied to the skin 5 min post exposure achieved a marked reduction in the amount of 14C contaminant remaining within the skin at 24 h. Itaconic acid significantly (p < .05) reduced the amount of 14C-HD, GD and VX remaining in the skin at 24 h. Additionally, 2-trifluoromethylacrylic acid significantly reduced the amount of 14C-HD, whilst fuller's earth significantly reduced the amounts of 14C-HD and VX recovered within the skin at 24 h. CONCLUSION All of the products evaluated in this study performed well in reducing the dermal absorption of all the chemical warfare agents tested.
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Affiliation(s)
- Hazem Matar
- Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency (now Public Health England), Chilton, Oxfordshire OX11 0RQ, United Kingdom; Research Centre for Transdermal Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, Hatfield, United Kingdom
| | - Shirley C Price
- Vice Provost Office, Senate House, University of Surrey, Guildford, United Kingdom
| | - Robert P Chilcott
- Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency (now Public Health England), Chilton, Oxfordshire OX11 0RQ, United Kingdom; Research Centre for Transdermal Drug Delivery and Toxicology, Department of Pharmacy, University of Hertfordshire, Hatfield, United Kingdom..
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Lydon H, Hall C, Matar H, Dalton C, Chipman JK, Graham JS, Chilcott RP. The percutaneous toxicokinetics of VX in a damaged skin porcine model and the evaluation of WoundStat™ as a topical decontaminant. J Appl Toxicol 2017; 38:318-328. [PMID: 29023806 DOI: 10.1002/jat.3542] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 08/31/2017] [Accepted: 08/31/2017] [Indexed: 11/06/2022]
Abstract
This study used a damaged skin, porcine model to evaluate the in vivo efficacy of WoundStat™ for the decontamination of superficial, nerve agent-contaminated wounds. Anaesthetized animals were randomly assigned to either control (n = 7), no decontamination (n = 12) or WoundStat™ (n = 12) treatment groups. Pigs were exposed to a 5× LD50 dose of neat, radiolabelled S-[2-(diisopropylamino)ethyl]-O-ethyl methyl-phosphonothioate (VX; or equivalent volume of sterile saline for the control group) via an area of superficially damaged skin on the ear. WoundStat™ was applied at 30 seconds post-exposure to assigned animals. The VX contaminant (or saline) and decontaminant remained in place for the duration of the study (up to 6 hours). Physiological parameters and signs of intoxication were recorded during the exposure period. Skin and organ samples were taken post mortem for 14 C-VX distribution analyses. Blood samples were taken periodically for toxicokinetic and whole-blood acetylcholinesterase (AChE) activity analyses. VX exposure was accompanied by a rapid decrease in AChE activity in all animals, regardless of decontamination. However, decontamination significantly improved survival rate and time and reduced the severity of signs of intoxication. In addition, the distribution of 14 C-VX in key internal organs and post mortem blood samples was significantly lower in the WoundStat™ treatment group. This study demonstrates that WoundStat™ may be a suitable medical countermeasure for increasing both survival rate and time following VX exposure. The results also suggest that AChE activity is not a useful prognostic indicator.
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Affiliation(s)
- Helen Lydon
- CBRN & Chemical Toxicological Research Group, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency (now Public Health England), Chilton, UK.,School of Biosciences, University of Birmingham, Edgbaston, UK
| | - Charlotte Hall
- CBRN & Chemical Toxicological Research Group, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency (now Public Health England), Chilton, UK.,School of Biosciences, University of Birmingham, Edgbaston, UK
| | - Hazem Matar
- CBRN & Chemical Toxicological Research Group, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency (now Public Health England), Chilton, UK.,Research Centre for Topical Drug Delivery and Toxicology, University of Hertfordshire, Hatfield, UK
| | - Christopher Dalton
- School of Biosciences, University of Birmingham, Edgbaston, UK.,Defence Science & Technology Laboratory, Porton, UK
| | - J Kevin Chipman
- School of Biosciences, University of Birmingham, Edgbaston, UK
| | - John S Graham
- Medical Toxicology Branch Analytical Toxicology Division, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, 21010, USA
| | - Robert P Chilcott
- CBRN & Chemical Toxicological Research Group, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency (now Public Health England), Chilton, UK.,Research Centre for Topical Drug Delivery and Toxicology, University of Hertfordshire, Hatfield, UK
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Dalton C, Hall C, Lydon H, Jenner J, Chipman JK, Graham JS, Chilcott RP. The percutaneous absorption of soman in a damaged skin porcine model and the evaluation of WoundStat™ as a topical decontaminant. Cutan Ocul Toxicol 2017; 37:172-179. [DOI: 10.1080/15569527.2017.1365883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Christopher Dalton
- CBR Division, Dstl Porton Down, Salisbury, UK
- School of Biosciences, University of Birmingham, Birmingham, UK
| | - Charlotte Hall
- School of Biosciences, University of Birmingham, Birmingham, UK
- CBRN & Chemical Toxicological Research Group, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency, Chilton, UK
| | - Helen Lydon
- School of Biosciences, University of Birmingham, Birmingham, UK
- CBRN & Chemical Toxicological Research Group, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency, Chilton, UK
| | - John Jenner
- CBR Division, Dstl Porton Down, Salisbury, UK
| | | | - John S. Graham
- Medical Toxicology Branch, USAMRICD, Aberdeen Proving Ground, MD, USA
| | - Robert P. Chilcott
- CBRN & Chemical Toxicological Research Group, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency, Chilton, UK
- Department of Pharmacy, Research Centre for Topical Drug Delivery and Toxicology, University of Hertfordshire, Hatfield, UK
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