Skin effects of trichothecenes and their amelioration by decontamination

Effective protective agents against the organ toxicity of T-2 toxin and corresponding detoxification mechanisms: A narrative review

T-2 toxin is one of the most widespread and toxic fungal toxins in food and feed. It can cause gastrointestinal toxicity, hepatotoxicity, immunotoxicity, reproductive toxicity, neurotoxicity, and nephrotoxicity in humans and animals. T-2 toxin is physicochemically stable and does not readily degrade during food and feed processing. Therefore, suppressing T-2 toxin-induced organ toxicity through antidotes is an urgent issue. Protective agents against the organ toxicity of T-2 toxin have been recorded widely in the literature, but these protective agents and their molecular mechanisms of detoxification have not been comprehensively summarized. In this review, we provide an overview of the various protective agents to T-2 toxin and the molecular mechanisms underlying the detoxification effects. Targeting appropriate targets to antagonize T-2 toxin toxicity is also an important option. This review will provide essential guidance and strategies for the better application and development of T-2 toxin antidotes specific for organ toxicity in the future.

Preliminary evaluation of military, commercial and novel skin decontamination products against a chemical warfare agent simulant (methyl salicylate)

Rapid decontamination is vital to alleviate adverse health effects following dermal exposure to hazardous materials. There is an abundance of materials and products which can be utilised to remove hazardous materials from the skin. In this study, a total of 15 products were evaluated, 10 of which were commercial or military products and five were novel (molecular imprinted) polymers. The efficacies of these products were evaluated against a 10 µl droplet of (14)C-methyl salicylate applied to the surface of porcine skin mounted on static diffusion cells. The current UK military decontaminant (Fuller's earth) performed well, retaining 83% of the dose over 24 h and served as a benchmark to compare with the other test products. The five most effective test products were Fuller's earth (the current UK military decontaminant), Fast-Act® and three novel polymers [based on itaconic acid, 2-trifluoromethylacrylic acid and N,N-methylenebis(acrylamide)]. Five products (medical moist-free wipes, 5% FloraFree™ solution, normal baby wipes, baby wipes for sensitive skin and Diphotérine™) enhanced the dermal absorption of (14)C-methyl salicylate. Further work is required to establish the performance of the most effective products identified in this study against chemical warfare agents.

Differential effects of route of T-2 toxin exposure on hepatic oxidative damage in mice

T-2 toxin is the most toxic among mycotoxins and poses a potential health hazard for both humans and animals. At high doses, T-2 toxin can cause shock-like syndrome that can result in death. We evaluated the effect of time course and route of exposure on hepatic oxidative damage in mice and it is only such study so far to compare the effects of dermal and subcutaneous exposure of T-2 toxin. Mice were exposed to 1 LD50 of T-2 toxin either by percutaneous (5.94 mg/kg body weight) or subcutaneous (1.54 mg/kg body weight) route and sacrificed at 0, 1, 3, and 7 days postexposure. Analysis of a number of serum biochemical variables, antioxidant enzymes activity, gene and protein expression by immunoblot assay showed time and route dependent effects of T-2 induced hepatic oxidative damage. Time dependent increase in protein carbonyl content and protein oxidation was seen in serum and liver. Results of our study may provide possible mechanism for developing medical countermeasures against T-2 toxin.

Evaluation of protective efficacy of CC-2 formulation against topical lethal dose of T-2 toxin in mice

T-2 toxin is the type-A trichothecene and a common contaminant of food and cereals, produced by Fusarium species. T-2 toxin easily penetrates skin due to its lipophilic nature and causes skin irritation and blisters in humans. Physical protection of the skin and airway is the only proven effective method of protection. To date, no chemical antidotes are available to prevent T-2 induced lethality. In the present study, we evaluated the protective efficacy of 20% N,N'-dichloro-bis(2,4,6-trichlorophenyl) urea (CC-2) formulation against lethal topical exposure dose of T-2 toxin in mice. None of the animals exposed to only T-2 toxin at lethal dose of 2 and 4 LD50 (11.8 and 23.76 mg/kg body weight) survived beyond 36 and 16 h, respectively. CC-2 application at 5 and 15 min post-exposure protected mice 100% from lethality at 2 LD50. Survival rate was 100% and 50% at 4LD50 dose if CC-2 was applied dermally within 5 and 15 min post-exposure. Recovery profile of surviving animals after 2LD50 T-2 toxin exposure at 1, 3, 7, and 14 days was assessed in terms of hepatic GSH, lipid peroxidation, serum ALP, ALT and AST. Hepatic lipid peroxidation significantly increased in all groups exposed to T-2 toxin by 3 day but normalized by day 7. A delayed GSH depletion was noted in surviving animals on day 7 but recovered by day 14. ALT and AST levels were elevated in all CC-2 protected mice on day 1 and normalized by day 3. ALP level decreased till day 7 in all protected groups. The biochemical variables recovered to control values by 14th day. GC-MS analysis after in vitro interaction of CC-2 formulation with T-2 toxin had shown that nearly 86% of T-2 toxin is decontaminated in 5 min but 8-10% of T-2 toxin was still present even after 60 min of interaction. Results of our study suggest that CC-2 may be an effective dermal decontaminant against lethal topical exposure of T-2 toxin.

T-2 toxin and HT-2 toxin in grain and grain-based commodities in Europe: occurrence, factors affecting occurrence, co-occurrence and toxicological effects

This paper presents an overview of the occurrence of T-2 toxin and HT-2 toxin in cereals in Europe and derived food products, factors influencing the occurrence, co-occurrence with other trichothecenes, and toxicological effects of T-2 and HT-2 in human. Of all cereals, oats showed to be most susceptible to T-2/HT-2 contamination. Particularly, oats grown in Scandinavia and UK in the period 2003-2007 were highly contaminated. This contamination has reduced in 2008 and 2009. In raw cereals, T-2 and HT-2 levels were highly correlated with each other in most instances, with the HT-2 level being two to seven times higher than the T-2 level. The toxin levels showed not to be correlated with levels of deoxynivalenol and nivalenol. The occurrence of T-2 and HT-2 in the field varied between years, regions, cereal grain varieties, sowing time, and precrop. Organically produced cereals contained lower T-2 and HT-2 levels as compared to conventionally grown cereals. Little or no effects from using fungicides was seen. Processing cereals resulted in low T-2 and HT-2 levels in food products, although oat products contained some T-2 and HT-2. The by-products from food processing, often used for animal feeding, frequently were highly contaminated. T-2 and HT-2 showed to have high acute and subacute toxicity, as they caused haematotoxic, immunotoxic, cytotoxic, and dermal effects. Carcinogenicity of T-2 and HT-2 in human has not been proven. Outbreaks of human toxicosis caused by trichothecenes, including T-2 and HT-2, have been reported. The present overview is deemed to be valuable for risk assessments at the European level, planned to be held by EFSA. It also provides directions for further research, including the ecology of the fungi responsible for T-2 and HT-2, and agronomical practices to reduce the contamination in the field.

Brain oxidative stress after dermal and subcutaneous exposure of T-2 toxin in mice

T-2 toxin belongs to group of mycotoxins and is found as a natural contaminant in cereals, feed and vegetables. In the present study we evaluated acute toxicity of dermal and subcutaneous exposure of T-2 toxin on brain oxidative stress in mice. Mice were exposed to 1 LD50 of T-2 toxin either by dermal (5.94 mg/kg) or subcutaneous (1.54 mg/kg body weight) route and sacrificed at 1, 3 and 7 days post-exposure. T-2 toxin treated animals showed time dependent increase in reactive oxygen species generation, glutathione depletion, lipid peroxidation and protein carbonyl content in brain in both the routes of exposure. Gene expression profile of antioxidant enzymes showed significant increase in superoxide dismutase and catalase in percutaneous route and glutathione reductase and glutathione peroxidase in subcutaneous route. Immunoblot analysis of antioxidant enzymes correlated with gene expression profile. T-2 toxin exposure resulted in down regulation of transcription factor Nrf2 and its downstream target genes of phase II detoxifying enzymes NQO1, Gclc, Gclm and hemeoxygenase-1. Results of our study show that percutaneously and subcutaneously applied T-2 toxin can cause brain oxidative damage possibly after crossing blood-brain barrier by altering its permeability.

Sampling and analytical method development and hand wipe measurements of dermal exposures to polycyclic aromatic hydrocarbons

This article describes the laboratory assessment of a hand and surface wipe sampling method for polycyclic aromatic hydrocarbons (PAHs). The analytical method employed extraction of the wipe samples into dimethyl sulfoxide (DMSO) and high-performance liquid chromatography (HPLC) flourometric detection of pyrene, a predominant PAH in used gasoline engine oils (UGEO). Recovery of pyrene was evaluated for two different sampling media by first contaminating the hands of a small number of volunteers with UGEO, followed by applying a small amount of corn oil to the palms, and by wiping the skin with a Whatman cellulostic filter paper or a polyester fabric wipe (i.e., Alpha wipes). In summary, using either Whatman or Alpha wipes, the mean recovery of pyrene from the UGEO that was applied to the hands and contained within three consecutive wipes was 69% and 54%, respectively. However, the relative recovery of the first to second wipe was on average 47% and 75% for the two media, respectively. These results indicate that the Alpha wipes were more efficient at recovering pyrene in the first wipe but less efficient overall when all three consecutive samples were included. Even though this sampling was performed in a controlled laboratory environment, the minimum and maximum amount of pyrene recovered in the individual composite samples using either method spanned a range of twofold. Overall, intra-and interpersonal variability, as measured by coefficient of variation, were 22% and 19%, respectively, and were not statistically different by type of media used. This method was used in a pilot field survey to sample the hands of 18 automotive repair technicians and 18 office workers. Detectable amounts of pyrene (>0.2 microg/sample) were found on the hands of 61% and 0% of these two groups, respectively, with the highest measured quantity equal to 1.06 microg. Samples from the upper surfaces of automobile motors were generally low to nondetectable (<0.027 microg/sample), while the median value of 0.047 mkcrlg/50 cm(2)(CV = 160%) and up to 0.640 microg were found on the drip pans.

Fungi as Bioweapons

Fungi cause disease directly by infection or indirectly through mycotoxins. Fungi that are used as weapons might be targeted against humans, livestock, or crops. Humans and animals encounter fungi and mycotoxins through inhalation, ingestion, and contact with skin and mucous membranes. Effective fungal bioweapons would require the ability to cause significant destruction and a means of delivery to target populations or farms. Effective counter measures against fungal bioweapons would be able to prevent or treat this damage. This article describes several potential biological warfare or bioterrorism fungal species and mycotoxins in regard to their biology, epidemiology, potential for weaponization, and the clinical features, prevention, and treatment of the diseases that they cause.

Evaluation of barrier creams against sulphur mustard. I. In vitro studies using human skin

The purpose of this study was to assess the effectiveness of a range of passive and reactive barrier cream formulations against the chemical warfare agent sulphur mustard (SM) using an in vitro diffusion cell system containing human skin. In general, proprietary formulations were relatively effective under occluded conditions, but ineffective under unoccluded conditions. For example, SM skin absorption rates through occluded control and Stokoderm pre-treated skin were 538 +/- 193 and 200 +/- 51 microg x cm(-2) x h(-1), respectively (p < 0.05). Under unoccluded conditions, control and Stokoderm pre-treated skin absorption rates were 4.41 +/- 1.90 and 36.84 +/- 15.19 microg x cm(-2) x h(-1) (p < 0.05). Novel (perfluorinated) barrier creams were generally more effective under unoccluded conditions; pre-treatment with one formulation led to an 18-fold reduction in skin absorption rate and reduced the total amount of SM penetrated by 95% of the applied dose. Several proprietary formulations also had adverse effects on the effectiveness of the skin decontaminant fuller's earth. The rate (Jss) and total amount (percentage of dose) of SM absorbed through the skin were deemed to be independent parameters of barrier cream performance. These data indicate that (1) perceived conditions of use, (2) compatibility with existing protective equipment and (3) the rate and extent of SM skin absorption must all be taken into account when evaluating barrier creams in vitro.

In vitro skin absorption and decontamination of sulphur mustard: comparison of human and pig-ear skin

The aim of this study was to evaluate the use of an in vitro skin diffusion cell system as a model for assessing decontaminants against the chemical warfare agent sulphur mustard (SM). The in vitro absorption rates of SM through heat-separated human (157 +/- 66 microg cm(-2) h(-1)) and pig-ear (411 +/- 175 microg cm(-2) h(-1)) epidermal membranes were in agreement with previous in vivo studies that quoted skin absorption rates of 150 and 366 microg cm(-2) h(-1), respectively. Decontaminants (fuller's earth, Ambergard and BDH spillage granules) were ranked in order of effectiveness by measuring the skin absorption rates and the percentage of applied dose of SM that penetrated human and pig-ear epidermal membranes. The effectiveness of fuller's earth measured in this in vitro study using human epidermal membranes was in agreement with a previous in vivo human volunteer study. Similarly, the effectiveness of fuller's earth and Ambergard measured in vitro with pig-ear epidermal membranes was in agreement with a previous in vivo study conducted on rats. However, there was complete disparity in the ranking of decontaminants between human and pig-ear epidermal membranes measured in vitro. Thus, although pig-ear skin may be a relatively good model for predicting the human skin absorption of SM, it is a poor model for testing decontamination systems. The results of this study further validate the use of Franz-type glass diffusion cells containing human epidermal membranes as a model for predicting in vivo human skin absorption.

Mycotoxins, fungus and 'electrohypersensitivity'

'Electrohypersensitivity' is often explained as a psychological syndrome. Our modern environment contains a lot of different substances and some of them are toxic. Mycotoxins are types of toxins that are biologically very active and that affect living organisms. Mycotoxins and fungi capable of producing toxins have been detected in ventilation systems, water damage and in foodstuff. Many of those displaying symptoms caused by electromagnetic fields have fungus infections or have been living in fungus-contaminated environments for long periods. In animal studies mycotoxins have shown the same effects as those seen in the 'electrohypersensitivity' syndrome. Phototoxic reactions are well known in veterinary medicine and in medical science, so the question is whether the 'electrohypersensitivity' syndrome is caused by 'phototoxic' reactions?

Comparison of detection methods for trichothecenes produced by Fusarium sporotrichioides on fodder and grains at different air humidities

Growth and toxin production of a highly toxic strain of Fusarium sporotrichioides Sherb were studied on oat and wheat grains and on straw under experimental conditions, in which relative humidity (RH) of air was regulated. The materials were incubated at three different RH levels at a range of 84-100%. F. sporotrichioides grew well on oat and wheat grains at RH 97-100% but grew less well at RH 84-88% and on straw. Toxin production was measured with three biological toxicity tests (cytotoxicity test, dermotoxicity test, and yeast cell toxicity test), with chemical analysis, and T-2 ELISA assay. Cytotoxicity and production of trichothecene mycotoxins were detected in all the samples incubated at all three RH levels. On oat and wheat grains, T-2 toxin, neosolaniol, and diacetoxyscirpenol were found, and on straw T-2 toxin, HT-2 toxin, neosolaniol, and T-2 tetraol were determined. In the T-2 ELISA assay, all material samples were found to contain T-2 toxin. The cytotoxicity test was the most sensitive method for detecting biological toxicity of samples inoculated with fungus. The T-2 ELISA assay and chemical analysis were about equally sensitive to detect T-2 toxin in samples.

Transdermal delivery of physostigmine. A pretreatment against organophosphate poisoning

Physostigmine absorption through isolated human skin and inhibition of plasma and red blood cell cholinesterases in guinea-pigs have been measured to assess the feasibility of its transdermal delivery as a pretreatment for organophosphate poisoning. Penetration of radiolabelled physostigmine across human epidermis was measured in-vitro using glass diffusion cells and optimization of physostigmine delivery was achieved by changes in vehicle formulation and use of penetration enhancers. Two-component vehicles consisting of propionic acid/isopropyl myristate (50:50) and propionic acid/oleic acid (50:50) produced the highest transdermal delivery of physostigmine. A comparison of formulations containing propionic acid alone with propionic acid plus oleic acid when applied to guinea-pigs, showed that inclusion of oleic acid allowed the amount of physostigmine and the size of the transdermal patch to be substantially reduced, whilst maintaining effective delivery rates. The formulation containing oleic acid was not irritant to guinea-pigs when applied to the skin for 48 h. It is concluded that a mixture of propionic acid and oleic acid containing physostigmine is a good candidate for transdermal delivery of physostigmine as a pretreatment for organophosphate poisoning.

Comparative tissue distribution and excretion of orally administered [3H]diacetoxyscirpenol (anguidine) in rats and mice

A quantitative comparison of tissue distribution and excretion of an orally administered sublethal dose of [3H]diacetoxyscirpenol (anguidine) was made in rats and mice 90 min, 24 hr, and 7 days after treatment. Total recoveries of 95-100% were obtained. Approximately 90% of the dose was excreted in urine and feces during the first 24 hr with a feces:urine ratio of about 1:4.5 in both species. Carcass and tissue radioactivity dropped rapidly during the first 24 hr but remained relatively constant at low, but detectable, levels (1.5-3.5% of dose) over the course of the experiment. Few substantive interspecies differences were noted in tissue distribution. At 90 min the highest percentage of dose was in tissues involved in sequestering diacetoxyscirpenol because of high body water/lipid content (carcass, skin) or the absorption (stomach, small intestine), metabolism (liver), or excretion (kidney) of the toxin. The rank order of these tissues was generally stable over the course of the experiment. When data were expressed as specific radioactivity (dpm/g tissue) instead, the carcass and skin dropped from the top rank tissues at 90 min and were replaced by the spleen and cecum. At 24 hr and 7 days the top-ranked order of tissues shifted to include organs associated with trichothecene-induced toxicity such as the lymphohematopoietic system (spleen, thymus, and femur bone marrow), heart, and testis (in mouse) as well as the cecum and large intestine. In addition, the rate of loss of radioactivity with time generally did not decrease as rapidly in these target organs as observed in liver, kidney, skin, and carcass. Brain radioactivity, though very low, also diminished relatively slowly. Significant differences in specific radioactivity which did occur between the rat and mouse tended to occur in target organs and with the higher levels present in the mouse. These data were discussed in terms of interspecies differences in lethality and target organ toxicity.

Penetration of [3H]T-2 mycotoxin through abraded and intact skin and methods to decontaminate [3H]T-2 mycotoxin from abrasions

Penetration of 50 muCi of [3H]T-2 mycotoxin through abraded and intact skin was studied in anesthetized rats sacrificed at 5, 15, 30, 45, 60 and 90 min post-exposure. The greatest penetration was through abraded skin (49 +/- 7%) at 90 min post-exposure, whereas penetration through intact skin (2 +/- 3%) was substantially less (P less than 0.0015). Methods to decontaminate [3H]T-2 mycotoxin from abraded skin over time were studied. Treatment of [3H]T-2 contaminated abrasions by applying Trau + Medic dressing, applying Charcoal Cloth-Anti-bacterial Field Dressing (Charcoal Dressing), or swabbing with povidone-iodine 30 min post-exposure removed 17-32% of the applied [3H]T-2. Immediate blotting with immediate removal of the dressings absorbed 103 +/- 4% (Trau + Medic) and 87 +/- 4% (Charcoal Dressing) of the applied [3H]T-2, while immediate blotting and leaving the dressing in place for 30 min removed 91 +/- 5% (Trau + Medic) and 76 +/- 3% (Charcoal Dressing). It appears that immediate blotting with either dressing followed by immediate removal before application of a clean dressing is an effective method for decontaminating [3H]T-2 from abrasions.