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Tang SM, Lu GZ, Lei XY, Yang XY, Tang GT, Yu J, Xie ZZ. Sodium thiosulfate: A donor or carrier signaling molecule for hydrogen sulfide? Nitric Oxide 2024; 149:67-74. [PMID: 38897561 DOI: 10.1016/j.niox.2024.06.004] [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: 03/03/2024] [Revised: 06/11/2024] [Accepted: 06/15/2024] [Indexed: 06/21/2024]
Abstract
Sodium thiosulfate has been used for decades in the treatment of calciphylaxis and cyanide detoxification, and has recently shown initial therapeutic promise in critical diseases such as neuronal ischemia, diabetes mellitus, heart failure and acute lung injury. However, the precise mechanism of sodium thiosulfate remains incompletely defined and sometimes contradictory. Although sodium thiosulfate has been widely accepted as a donor of hydrogen sulfide (H2S), emerging findings suggest that it is the executive signaling molecule for H2S and that its effects may not be dependent on H2S. This article presents an overview of the current understanding of sodium thiosulfate, including its synthesis, biological characteristics, and clinical applications of sodium thiosulfate, as well as the underlying mechanisms in vivo. We also discussed the interplay of sodium thiosulfate and H2S. Our review highlights sodium thiosulfate as a key player in sulfide signaling with the broad clinical potential for the future.
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Affiliation(s)
- Si-Miao Tang
- The Hunan Provincial Key Laboratory of Tumor Microenvironment Responsive Drug Research, Institute of Pharmacy & Pharmacology, University of South China, Hengyang, Hunan, 421001, China
| | - Guo-Zhong Lu
- 922th Hospital of Hengyang, Hunan, 421001, China
| | - Xiao-Yong Lei
- The Hunan Provincial Key Laboratory of Tumor Microenvironment Responsive Drug Research, Institute of Pharmacy & Pharmacology, University of South China, Hengyang, Hunan, 421001, China
| | - Xiao-Yan Yang
- The Hunan Provincial Key Laboratory of Tumor Microenvironment Responsive Drug Research, Institute of Pharmacy & Pharmacology, University of South China, Hengyang, Hunan, 421001, China
| | - Guo-Tao Tang
- The Hunan Provincial Key Laboratory of Tumor Microenvironment Responsive Drug Research, Institute of Pharmacy & Pharmacology, University of South China, Hengyang, Hunan, 421001, China
| | - Jia Yu
- The Hunan Provincial Key Laboratory of Tumor Microenvironment Responsive Drug Research, Institute of Pharmacy & Pharmacology, University of South China, Hengyang, Hunan, 421001, China.
| | - Zhi-Zhong Xie
- The Hunan Provincial Key Laboratory of Tumor Microenvironment Responsive Drug Research, Institute of Pharmacy & Pharmacology, University of South China, Hengyang, Hunan, 421001, China.
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Park S, Mukai D, Lee J, Burney T, Boss G, Haouzi P, Lee JA, Kim MT, Fox AM, Philipopoulos G, Brenner M. Intratracheal cobinamide (vitamin B 12 analog) administration increases survivability in rabbits exposed to a lethal dose of inhaled hydrogen sulfide. Clin Toxicol (Phila) 2024; 62:94-100. [PMID: 38512020 DOI: 10.1080/15563650.2024.2314155] [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: 09/20/2023] [Accepted: 01/30/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Hydrogen sulfide is a highly toxic, flammable, and colorless gas. Hydrogen sulfide has been identified as a potential terrorist chemical threat agent in mass-casualty events. Our previous studies showed that cobinamide, a vitamin B12 analog, effectively reverses the toxicity from hydrogen sulfide poisoning. In this study, we investigate the effectiveness of intratracheally administered cobinamide in treating a lethal dose hydrogen sulfide gas inhalation and compare its performance to saline control administration. METHODS A total of 53 pathogen-free New Zealand White rabbits were used for this study. Four groups were compared: (i) received no saline solution or drug intratracheally (n = 15), (ii) slow drip saline intratracheally (n = 15), (iii) fast drip saline intratracheally (n = 15), and (iv) slow drip cobinamide intratracheally (n = 8). Blood pressure was continuously monitored, and deoxy- and oxyhemoglobin concentration changes were monitored in real-time in vivo using continuous wave near-infrared spectroscopy. RESULTS The mean (± standard deviation) weight for all animals (n = 53) was 3.87 ± 0.10 kg. The survival rates of the slow cobinamide and the fast saline groups were 75 percent and 60 percent, respectively, while the survival rates in the slow saline and control groups were 26.7 percent and 20 percent, respectively. A log-rank (Mantel-Cox) test showed that survival in fast saline and slow cobinamide groups were significantly greater than those of no saline control and slow saline groups (P < 0.05). The slow and no saline control groups were not significantly different (P = 0.59). The slow cobinamide group did significantly better than the slow saline group (P = 0.021). DISCUSSION The ability to use intratracheal cobinamide as an antidote to hydrogen sulfide poisoning is a novel approach to mass-casualty care. The major limitations of this study are that it was conducted in a single species at a single inhaled hydrogen sulfide concentration. Repeated investigations in other species and at varying levels of hydrogen sulfide exposure will be needed before any definitive recommendations can be made. CONCLUSIONS We demonstrated that intratracheal cobinamide and fast saline drip improved survival for hydrogen sulfide gas inhalation in rabbit models. Although further study is required, our results suggest that intratracheal administration of cobinamide and fast saline may be useful in hydrogen sulfide mass-casualty events.
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Affiliation(s)
- Seungyong Park
- Beckman Laser Institute, University of CA, Irvine, CA, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, Irvine, CA, USA
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - David Mukai
- Beckman Laser Institute, University of CA, Irvine, CA, USA
| | - Jangweon Lee
- Beckman Laser Institute, University of CA, Irvine, CA, USA
| | - Tanya Burney
- Beckman Laser Institute, University of CA, Irvine, CA, USA
| | - Gerry Boss
- Department of Medicine, University of California, San Diego, CA, USA
| | - Phillipe Haouzi
- Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | | | | | | | - Matthew Brenner
- Beckman Laser Institute, University of CA, Irvine, CA, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, Irvine, CA, USA
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Liposomal methemoglobin as a potent antidote for hydrogen sulfide poisoning. Toxicol Appl Pharmacol 2022; 450:116159. [PMID: 35803436 DOI: 10.1016/j.taap.2022.116159] [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: 06/04/2022] [Revised: 06/30/2022] [Accepted: 07/03/2022] [Indexed: 11/21/2022]
Abstract
Hydrogen sulfide (H2S) induces acute and lethal toxicity at high concentrations. However, no specific antidotes for H2S poisoning have been approved. Liposomal methemoglobin (metHb@Lipo) was developed as an antidote for cyanide poisoning. As the toxic mechanism of H2S poisoning is the same as that of cyanide poisoning, metHb@Lipo could potentially be used as an antidote for H2S poisoning. In this study, we evaluated the antidotal efficacy of metHb@Lipo against H2S poisoning. Stopped-flow rapid-scan spectrophotometry clearly showed that metHb@Lipo scavenged H2S rapidly. Additionally, metHb@Lipo showed cytoprotective effects against H2S exposure in H9c2 cells by maintaining mitochondrial function. MetHb@Lipo treatment also improved the survival rate after H2S exposure in vivo, with the maintenance of cytochrome c oxidase activity and suppression of metabolic acidosis. Moreover, metHb@Lipo therapy maintained significant antidotal efficacy even after 1-year-storage at 4-37 °C. In conclusion, metHb@Lipo is a candidate antidote for H2S poisoning.
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Miyazaki Y, Marutani E, Ikeda T, Ni X, Hanaoka K, Xian M, Ichinose F. A Sulfonyl Azide-Based Sulfide Scavenger Rescues Mice from Lethal Hydrogen Sulfide Intoxication. Toxicol Sci 2021; 183:393-403. [PMID: 34270781 DOI: 10.1093/toxsci/kfab088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Exposure to hydrogen sulfide (H2S) can cause neurotoxicity and cardiopulmonary arrest. Resuscitating victims of sulfide intoxication is extremely difficult, and survivors often exhibit persistent neurological deficits. However, no specific antidote is available for sulfide intoxication. The objective of this study was to examine whether administration of a sulfonyl azide-based sulfide-specific scavenger, SS20, would rescue mice in models of H2S intoxication: ongoing exposure and post-cardiopulmonary arrest. In the ongoing exposure model, SS20 (1,250 µmol/kg) or vehicle was administered to awake CD-1 mice intraperitoneally at 10 minutes after breathing 790 ppm of H2S followed by another 30 minutes of H2S inhalation. Effects of SS20 on survival was assessed. In the post-cardiopulmonary arrest model, cardiopulmonary arrest was induced by an intraperitoneal administration of sodium sulfide nonahydrate (125 mg/kg) in anesthetized mice. After 1 minute of cardiopulmonary arrest, mice were resuscitated with intravenous administration of SS20 (250 µmol/kg) or vehicle. Effects of SS20 on survival, neurological outcomes, and plasma H2S levels were evaluated. Administration of SS20 during ongoing H2S inhalation improved 24-hour survival (6/6 [100%] in SS20 versus 1/6 [17%] in vehicle; P = 0.0043). Post-arrest administration of SS20 improved 7-day survival (4/10 [40%] in SS20 versus 0/10 [0%] in vehicle; P = 0.0038) and neurological outcomes after resuscitation. SS20 decreased plasma H2S levels to pre-arrest baseline immediately after reperfusion and shortened the time to return of spontaneous circulation and respiration. The current results suggest that SS20 is an effective antidote against lethal H2S intoxication, even when administered after cardiopulmonary arrest.
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Affiliation(s)
- Yusuke Miyazaki
- Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA
| | - Eizo Marutani
- Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA
| | - Takamitsu Ikeda
- Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA
| | - Xiang Ni
- Department of Chemistry, Brown University, Providence, RI
| | - Kenjiro Hanaoka
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - Ming Xian
- Department of Chemistry, Brown University, Providence, RI
| | - Fumito Ichinose
- Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA
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Tiopronin as a novel copper depressant for the selective flotation separation of chalcopyrite and molybdenite. Sep Purif Technol 2021. [DOI: 10.1016/j.seppur.2021.118576] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Haouzi P, Sonobe T, Judenherc-Haouzi A. Hydrogen sulfide intoxication induced brain injury and methylene blue. Neurobiol Dis 2019; 133:104474. [PMID: 31103557 DOI: 10.1016/j.nbd.2019.05.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 04/16/2019] [Accepted: 05/15/2019] [Indexed: 02/06/2023] Open
Abstract
Hydrogen sulfide (H2S) remains a chemical hazard in the gas and farming industry. It is easy to manufacture from common chemicals and thus represents a potential threat for the civilian population. It is also employed as a method of suicide, for which incidence has recently increased in the US. H2S is a mitochondrial poison and exerts its toxicity through mechanisms that are thought to result from its high affinity to various metallo-proteins (such as - but not exclusively- the mitochondrial cytochrome c oxidase) and interactions with cysteine residues of proteins. Ion channels with critical implications for the cardiac and the brain functions appear to be affected very early during and following H2S exposure, an effect which is rapidly reversible during a light intoxication. However, during severe H2S intoxication, a coma, associated with a reduction in cardiac contractility, develops within minutes or even seconds leading to death by complete electro-mechanical dissociation of the heart. If the level of intoxication is milder, a rapid and spontaneous recovery of the coma occurs as soon as the exposure stops. The risk, although probably very small, of developing long-term debilitating motor or cognitive deficits is present. One of the major challenges impeding our effort to offer an effective treatment against H2S intoxication after exposure is that the pool of free/soluble H2S almost immediately disappears from the body preventing agents trapping free H2S (cobalt or ferric compounds) to play their protective role. This paper (1) presents and discusses the neurological symptoms and lesions observed in various animals models and in humans following an acute exposure to sub-lethal or lethal levels of H2S, (2) reviews the potential interest of methylene blue (MB), a potent cyclic redox dye - currently used for the treatment of methemoglobinemia - which has potential rescuing effects on the mitochondrial activity, as an antidote against sulfide intoxication.
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Affiliation(s)
- Philippe Haouzi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Takashi Sonobe
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Annick Judenherc-Haouzi
- Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, USA
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Ng PC, Hendry-Hofer TB, Witeof AE, Brenner M, Mahon SB, Boss GR, Haouzi P, Bebarta VS. Hydrogen Sulfide Toxicity: Mechanism of Action, Clinical Presentation, and Countermeasure Development. J Med Toxicol 2019; 15:287-294. [PMID: 31062177 DOI: 10.1007/s13181-019-00710-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/08/2019] [Accepted: 04/10/2019] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Hydrogen sulfide (H2S) is found in various settings. Reports of chemical suicide, where individuals have combined readily available household chemicals to produce lethal concentrations of H2S, have demonstrated that H2S is easily produced. Governmental agencies have warned of potential threats of use of H2S for a chemical attack, but currently there are no FDA-approved antidotes for H2S. An ideal antidote would be one that is effective in small volume, readily available, safe, and chemically stable. In this paper we performed a review of the available literature on the mechanism of toxicity, clinical presentation, and development of countermeasures for H2S toxicity. DISCUSSION In vivo, H2S undergoes an incomplete oxidation after an exposure. The remaining non-oxidized H2S is found in dissolved and combined forms. Dissolved forms such as H2S gas and sulfhydryl anion can diffuse between blood and tissue. The combined non-soluble forms are found as acid-labile sulfides and sulfhydrated proteins, which play a role in toxicity. Recent countermeasure development takes into account the toxicokinetics of H2S. Some countermeasures focus on binding free hydrogen sulfide (hydroxocobalamin, cobinamide); some have direct effects on the mitochondria (methylene blue), while others work by mitigating end organ damage by generating other substances such as nitric oxide (NaNO2). CONCLUSION H2S exists in two main pools in vivo after exposure. While several countermeasures are being studied for H2S intoxication, a need exists for a small-volume, safe, highly effective antidote with a long shelf life to treat acute toxicity as well as prevent long-term effects of exposure.
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Affiliation(s)
- Patrick C Ng
- Denver Health and Hospital Authority, Rocky Mountain Poison and Drug Center, Denver, CO, USA. .,Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Tara B Hendry-Hofer
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alyssa E Witeof
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew Brenner
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA, USA.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, Irvine, CA, USA
| | - Sari B Mahon
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, CA, USA
| | - Philippe Haouzi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Vikhyat S Bebarta
- Denver Health and Hospital Authority, Rocky Mountain Poison and Drug Center, Denver, CO, USA.,Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Cheung JY, Wang J, Zhang XQ, Song J, Davidyock JM, Prado FJ, Shanmughapriya S, Worth AM, Madesh M, Judenherc-Haouzi A, Haouzi P. Methylene Blue Counteracts H 2S-Induced Cardiac Ion Channel Dysfunction and ATP Reduction. Cardiovasc Toxicol 2019; 18:407-419. [PMID: 29603116 DOI: 10.1007/s12012-018-9451-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
We have previously demonstrated that methylene blue (MB) counteracts the effects of hydrogen sulfide (H2S) cardiotoxicity by improving cardiomyocyte contractility and intracellular Ca2+ homeostasis disrupted by H2S poisoning. In vivo, MB restores cardiac contractility severely depressed by sulfide and protects against arrhythmias, ranging from bundle branch block to ventricular tachycardia or fibrillation. To dissect the cellular mechanisms by which MB reduces arrhythmogenesis and improves bioenergetics in myocytes intoxicated with H2S, we evaluated the effects of H2S on resting membrane potential (Em), action potential (AP), Na+/Ca2+ exchange current (INaCa), depolarization-activated K+ currents and ATP levels in adult mouse cardiac myocytes and determined whether MB could counteract the toxic effects of H2S on myocyte electrophysiology and ATP. Exposure to toxic concentrations of H2S (100 µM) significantly depolarized Em, reduced AP amplitude, prolonged AP duration at 90% repolarization (APD90), suppressed INaCa and depolarization-activated K+ currents, and reduced ATP levels in adult mouse cardiac myocytes. Treating cardiomyocytes with MB (20 µg/ml) 3 min after H2S exposure restored Em, APD90, INaCa, depolarization-activated K+ currents, and ATP levels toward normal. MB improved mitochondrial membrane potential (∆ψm) and oxygen consumption rate in myocytes in which Complex I was blocked by rotenone. We conclude that MB ameliorated H2S-induced cardiomyocyte toxicity at multiple levels: (1) reversing excitation-contraction coupling defects (Ca2+ homeostasis and L-type Ca2+ channels); (2) reducing risks of arrhythmias (Em, APD, INaCa and depolarization-activated K+ currents); and (3) improving cellular bioenergetics (ATP, ∆ψm).
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MESH Headings
- Action Potentials
- Adenosine Triphosphate/metabolism
- Animals
- Arrhythmias, Cardiac/chemically induced
- Arrhythmias, Cardiac/metabolism
- Arrhythmias, Cardiac/physiopathology
- Arrhythmias, Cardiac/prevention & control
- Calcium Channels, L-Type/drug effects
- Calcium Channels, L-Type/metabolism
- Calcium Signaling/drug effects
- Energy Metabolism/drug effects
- Heart Rate/drug effects
- Hydrogen Sulfide/toxicity
- Ion Channels/drug effects
- Ion Channels/metabolism
- Membrane Potential, Mitochondrial/drug effects
- Methylene Blue/pharmacology
- Mice
- Mitochondria, Heart/drug effects
- Mitochondria, Heart/metabolism
- Myocardial Contraction/drug effects
- Myocytes, Cardiac/drug effects
- Myocytes, Cardiac/metabolism
- Oxygen Consumption/drug effects
- Potassium Channels, Voltage-Gated/drug effects
- Potassium Channels, Voltage-Gated/metabolism
- Sodium-Calcium Exchanger/drug effects
- Sodium-Calcium Exchanger/metabolism
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Affiliation(s)
- Joseph Y Cheung
- Center of Translational Medicine, Lewis Katz School of Medicine of Temple University, 3500 N. Broad Street, MERB 958, Philadelphia, PA, 19140, USA.
- Department of Medicine, Lewis Katz School of Medicine of Temple University, Philadelphia, PA, 19140, USA.
| | - JuFang Wang
- Center of Translational Medicine, Lewis Katz School of Medicine of Temple University, 3500 N. Broad Street, MERB 958, Philadelphia, PA, 19140, USA
| | - Xue-Qian Zhang
- Center of Translational Medicine, Lewis Katz School of Medicine of Temple University, 3500 N. Broad Street, MERB 958, Philadelphia, PA, 19140, USA
| | - Jianliang Song
- Center of Translational Medicine, Lewis Katz School of Medicine of Temple University, 3500 N. Broad Street, MERB 958, Philadelphia, PA, 19140, USA
| | - John M Davidyock
- Department of Medicine, Lewis Katz School of Medicine of Temple University, Philadelphia, PA, 19140, USA
| | - Fabian Jana Prado
- Center of Translational Medicine, Lewis Katz School of Medicine of Temple University, 3500 N. Broad Street, MERB 958, Philadelphia, PA, 19140, USA
| | - Santhanam Shanmughapriya
- Center of Translational Medicine, Lewis Katz School of Medicine of Temple University, 3500 N. Broad Street, MERB 958, Philadelphia, PA, 19140, USA
| | - Alison M Worth
- Center of Translational Medicine, Lewis Katz School of Medicine of Temple University, 3500 N. Broad Street, MERB 958, Philadelphia, PA, 19140, USA
| | - Muniswamy Madesh
- Center of Translational Medicine, Lewis Katz School of Medicine of Temple University, 3500 N. Broad Street, MERB 958, Philadelphia, PA, 19140, USA
| | - Annick Judenherc-Haouzi
- Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA
| | - Philippe Haouzi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA
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On the Efficacy of Cardio-Pulmonary Resuscitation and Epinephrine Following Cyanide- and H 2S Intoxication-Induced Cardiac Asystole. Cardiovasc Toxicol 2019; 18:436-449. [PMID: 29644580 DOI: 10.1007/s12012-018-9454-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
This study was aimed at determining the efficacy of epinephrine, followed by chest compressions, in producing a return of spontaneous circulation (ROSC) during cyanide (CN)- or hydrogen sulfide (H2S)-induced toxic cardiac pulseless electrical activity (PEA) in the rat. Thirty-nine anesthetized rats were exposed to either intravenous KCN (n = 27) or H2S solutions (n = 12), at a rate that led to a PEA within less than 10 min. In the group intoxicated by CN, 20 rats were mechanically ventilated and received either epinephrine (0.1 mg/kg i.v. n = 10) followed by chest compressions or saline (n = 10, "control CN") when in PEA. PEA was defined as a systolic pressure below 20 mmHg and a pulse pressure of less than 5 mmHg for 1 min. In addition, seven spontaneously breathing rats were also exposed to the same CN protocol, but infusion was stopped when a central apnea occurred; then, as soon as a PEA occurred, epinephrine (0.1 mg/kg IV) was administered while providing manual chest compressions and mechanical ventilation (CPR). Finally, 12 rats were intoxicated with H2S, while mechanically ventilated, and received either saline (n = 6, "control H2S") or epinephrine (n = 6) with CPR when in PEA. None of the control-intoxicated animals resuscitated (10 rats in the control CN group and 6 in the control H2S group). In contrast, all the animals intoxicated with CN or H2S that received epinephrine followed by chest compressions, returned to effective circulation. In addition, half of the spontaneously breathing CN-intoxicated animals that achieved ROSC after epinephrine resumed spontaneous breathing. In all the animals achieving ROSC, blood pressure, cardiac output, peripheral blood flow and [Formula: see text]O2 returned toward baseline, but remained lower than the pre-intoxication levels (p < 0.01) with a persistent lactic acidosis. Epinephrine, along with CPR maneuvers, was highly effective in resuscitating rodents intoxicated with CN or H2S. Since epinephrine is readily available in any ambulance, its place as an important countermeasure against mitochondrial poisons should be advocated. It remains critical to determine whether the systematic administration of epinephrine to any victims found hypotensive following CN or H2S intoxication could prevent PEA, decrease post-ischemic brain injury and increase the efficacy of current antidotes by improving the circulatory status.
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Szabo C, Papapetropoulos A. International Union of Basic and Clinical Pharmacology. CII: Pharmacological Modulation of H 2S Levels: H 2S Donors and H 2S Biosynthesis Inhibitors. Pharmacol Rev 2017; 69:497-564. [PMID: 28978633 PMCID: PMC5629631 DOI: 10.1124/pr.117.014050] [Citation(s) in RCA: 278] [Impact Index Per Article: 39.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Over the last decade, hydrogen sulfide (H2S) has emerged as an important endogenous gasotransmitter in mammalian cells and tissues. Similar to the previously characterized gasotransmitters nitric oxide and carbon monoxide, H2S is produced by various enzymatic reactions and regulates a host of physiologic and pathophysiological processes in various cells and tissues. H2S levels are decreased in a number of conditions (e.g., diabetes mellitus, ischemia, and aging) and are increased in other states (e.g., inflammation, critical illness, and cancer). Over the last decades, multiple approaches have been identified for the therapeutic exploitation of H2S, either based on H2S donation or inhibition of H2S biosynthesis. H2S donation can be achieved through the inhalation of H2S gas and/or the parenteral or enteral administration of so-called fast-releasing H2S donors (salts of H2S such as NaHS and Na2S) or slow-releasing H2S donors (GYY4137 being the prototypical compound used in hundreds of studies in vitro and in vivo). Recent work also identifies various donors with regulated H2S release profiles, including oxidant-triggered donors, pH-dependent donors, esterase-activated donors, and organelle-targeted (e.g., mitochondrial) compounds. There are also approaches where existing, clinically approved drugs of various classes (e.g., nonsteroidal anti-inflammatories) are coupled with H2S-donating groups (the most advanced compound in clinical trials is ATB-346, an H2S-donating derivative of the non-steroidal anti-inflammatory compound naproxen). For pharmacological inhibition of H2S synthesis, there are now several small molecule compounds targeting each of the three H2S-producing enzymes cystathionine-β-synthase (CBS), cystathionine-γ-lyase, and 3-mercaptopyruvate sulfurtransferase. Although many of these compounds have their limitations (potency, selectivity), these molecules, especially in combination with genetic approaches, can be instrumental for the delineation of the biologic processes involving endogenous H2S production. Moreover, some of these compounds (e.g., cell-permeable prodrugs of the CBS inhibitor aminooxyacetate, or benserazide, a potentially repurposable CBS inhibitor) may serve as starting points for future clinical translation. The present article overviews the currently known H2S donors and H2S biosynthesis inhibitors, delineates their mode of action, and offers examples for their biologic effects and potential therapeutic utility.
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Affiliation(s)
- Csaba Szabo
- Department of Anesthesiology, The University of Texas Medical Branch, Galveston, Texas (C.S.); Laboratory of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens, Zografou, Greece (A.P.); and Clinical, Experimental Surgery and Translational Research Center, Biomedical Research Foundation of the Academy of Athens, Athens, Greece (A.P.)
| | - Andreas Papapetropoulos
- Department of Anesthesiology, The University of Texas Medical Branch, Galveston, Texas (C.S.); Laboratory of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens, Zografou, Greece (A.P.); and Clinical, Experimental Surgery and Translational Research Center, Biomedical Research Foundation of the Academy of Athens, Athens, Greece (A.P.)
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11
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Wald PH, Balmes JR. Respiratory Effects of Short-Term, High-Intensity Toxic Inhalations: Smoke, Gases, and Fumes. J Intensive Care Med 2016. [DOI: 10.1177/088506668700200504] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Respiratory insufficiency resulting from inhalation of hot air, smoke, or toxic gas is a common cause of death in fire victims. Toxic gas inhalation in settings other than fires is a less common but still important cause of death and disability. Pulmonary inhalation injury and systemic intoxication from exposure to a variety of agents are discussed with regard to their pathogenesis, pathophysi ology, diagnosis, and treatment. Upper airway obstruc tion and noncardiogenic pulmonary edema are the life- threatening respiratory complications in the immediate postinhalation period. Carbon monoxide and hydrogen cyanide intoxication are frequently associated with in halation injury in fire victims. Early recognition and treatment of inhalation injury and systemic intoxication in victims of fires and industrial and environmental acci dents could well result in improved survival.
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Affiliation(s)
- Peter H. Wald
- Division of Occupational Medicine, Department of Medicine, University of California School of Medicine, San Francisco, CA
| | - John R. Balmes
- Division of Occupational Medicine, Department of Medicine, University of California School of Medicine, San Francisco, CA
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Jiang J, Chan A, Ali S, Saha A, Haushalter KJ, Lam WLM, Glasheen M, Parker J, Brenner M, Mahon SB, Patel HH, Ambasudhan R, Lipton SA, Pilz RB, Boss GR. Hydrogen Sulfide--Mechanisms of Toxicity and Development of an Antidote. Sci Rep 2016; 6:20831. [PMID: 26877209 PMCID: PMC4753484 DOI: 10.1038/srep20831] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 01/08/2016] [Indexed: 12/22/2022] Open
Abstract
Hydrogen sulfide is a highly toxic gas—second only to carbon monoxide as a cause of inhalational deaths. Its mechanism of toxicity is only partially known, and no specific therapy exists for sulfide poisoning. We show in several cell types, including human inducible pluripotent stem cell (hiPSC)-derived neurons, that sulfide inhibited complex IV of the mitochondrial respiratory chain and induced apoptosis. Sulfide increased hydroxyl radical production in isolated mouse heart mitochondria and F2-isoprostanes in brains and hearts of mice. The vitamin B12 analog cobinamide reversed the cellular toxicity of sulfide, and rescued Drosophila melanogaster and mice from lethal exposures of hydrogen sulfide gas. Cobinamide worked through two distinct mechanisms: direct reversal of complex IV inhibition and neutralization of sulfide-generated reactive oxygen species. We conclude that sulfide produces a high degree of oxidative stress in cells and tissues, and that cobinamide has promise as a first specific treatment for sulfide poisoning.
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Affiliation(s)
- Jingjing Jiang
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Adriano Chan
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Sameh Ali
- Department of Anesthesiology, University of California San Diego, La Jolla, California, USA.,VA San Diego Healthcare System, San Diego, California, USA.,Center for Aging and Associated Diseases, Helmy Institute of Medical Sciences, Zewail City of Science and Technology, Giza, Egypt
| | - Arindam Saha
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Kristofer J Haushalter
- Department of Chemistry and Biochemistry, University of California San Diego, La Jolla, California, USA
| | - Wai-Ling Macrina Lam
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Megan Glasheen
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - James Parker
- Neurodegenerative Disease Center, The Scintillon Institute, San Diego, California, USA
| | - Matthew Brenner
- Beckman Laser Institute, University of California Irvine, Irvine, California, USA
| | - Sari B Mahon
- Beckman Laser Institute, University of California Irvine, Irvine, California, USA
| | - Hemal H Patel
- Department of Anesthesiology, University of California San Diego, La Jolla, California, USA.,VA San Diego Healthcare System, San Diego, California, USA
| | - Rajesh Ambasudhan
- Neurodegenerative Disease Center, The Scintillon Institute, San Diego, California, USA
| | - Stuart A Lipton
- Neurodegenerative Disease Center, The Scintillon Institute, San Diego, California, USA.,Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Renate B Pilz
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Gerry R Boss
- Department of Medicine, University of California San Diego, La Jolla, California, USA
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13
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Sonobe T, Chenuel B, Cooper TK, Haouzi P. Immediate and Long-Term Outcome of Acute H2S Intoxication Induced Coma in Unanesthetized Rats: Effects of Methylene Blue. PLoS One 2015; 10:e0131340. [PMID: 26115032 PMCID: PMC4482667 DOI: 10.1371/journal.pone.0131340] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 06/01/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Acute hydrogen sulfide (H2S) poisoning produces a coma, the outcome of which ranges from full recovery to severe neurological deficits. The aim of our study was to 1--describe the immediate and long-term neurological effects following H2S-induced coma in un-anesthetized rats, and 2--determine the potential benefit of methylene blue (MB), a compound we previously found to counteract acute sulfide cardiac toxicity. METHODS NaHS was administered IP in un-sedated rats to produce a coma (n = 34). One minute into coma, the rats received MB (4 mg/kg i.v.) or saline. The surviving rats were followed clinically and assigned to Morris water maze (MWM) and open field testing then sacrificed at day 7. RESULTS Sixty percent of the non-treated comatose rats died by pulseless electrical activity. Nine percent recovered with neurological deficits requiring euthanasia, their brain examination revealed major neuronal necrosis of the superficial and middle layers of the cerebral cortex and the posterior thalamus, with variable necrosis of the caudate putamen, but no lesions of the hippocampus or the cerebellum, in contrast to the typical distribution of post-ischemic lesions. The remaining animals displayed, on average, a significantly less effective search strategy than the control rats (n = 21) during MWM testing. Meanwhile, 75% of rats that received MB survived and could perform the MWM test (P<0.05 vs non-treated animals). The treated animals displayed a significantly higher occurrence of spatial search than the non-treated animals. However, a similar proportion of cortical necrosis was observed in both groups, with a milder clinical presentation following MB. CONCLUSION In conclusion, in rats surviving H2S induced coma, spatial search patterns were used less frequently than in control animals. A small percentage of rats presented necrotic neuronal lesions, which distribution differed from post-ischemic lesions. MB dramatically improved the immediate survival and spatial search strategy in the surviving rats.
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Affiliation(s)
- Takashi Sonobe
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Bruno Chenuel
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Timothy K. Cooper
- Department of Comparative Medicine, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
- Department of Pathology, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Philippe Haouzi
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
- * E-mail:
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14
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Cronican AA, Frawley KL, Ahmed H, Pearce LL, Peterson J. Antagonism of Acute Sulfide Poisoning in Mice by Nitrite Anion without Methemoglobinemia. Chem Res Toxicol 2015; 28:1398-408. [PMID: 25951111 DOI: 10.1021/acs.chemrestox.5b00015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
There are currently no FDA-approved antidotes for H2S/sulfide intoxication. Sodium nitrite, if given prophylactically to Swiss Webster mice, was shown to be highly protective against the acute toxic effects of sodium hydrosulfide (∼LD40 dose) with both agents administered by intraperitoneal injections. However, sodium nitrite administered after the toxicant dose did not detectably ameliorate sulfide toxicity in this fast-delivery, single-shot experimental paradigm. Nitrite anion was shown to rapidly produce NO in the bloodstream, as judged by the appearance of EPR signals attributable to nitrosylhemoglobin and methemoglobin, together amounting to less than 5% of the total hemoglobin present. Sulfide-intoxicated mice were neither helped by the supplemental administration of 100% oxygen nor were there any detrimental effects. Compared to cyanide-intoxicated mice, animals surviving sulfide intoxication exhibited very short knockdown times (if any) and full recovery was extremely fast (∼15 min) irrespective of whether sodium nitrite was administered. Behavioral experiments testing the ability of mice to maintain balance on a rotating cylinder showed no motor impairment up to 24 h post sulfide exposure. It is argued that antagonism of sulfide inhibition of cytochrome c oxidase by NO is the crucial antidotal activity of nitrite rather than formation of methemoglobin.
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Affiliation(s)
- Andrea A Cronican
- Department of Environmental and Occupational Health, Graduate School of Public Health, The University of Pittsburgh, 100 Technology Drive, Pittsburgh, Pennsylvania 15219, United States
| | - Kristin L Frawley
- Department of Environmental and Occupational Health, Graduate School of Public Health, The University of Pittsburgh, 100 Technology Drive, Pittsburgh, Pennsylvania 15219, United States
| | - Humza Ahmed
- Department of Environmental and Occupational Health, Graduate School of Public Health, The University of Pittsburgh, 100 Technology Drive, Pittsburgh, Pennsylvania 15219, United States
| | - Linda L Pearce
- Department of Environmental and Occupational Health, Graduate School of Public Health, The University of Pittsburgh, 100 Technology Drive, Pittsburgh, Pennsylvania 15219, United States
| | - Jim Peterson
- Department of Environmental and Occupational Health, Graduate School of Public Health, The University of Pittsburgh, 100 Technology Drive, Pittsburgh, Pennsylvania 15219, United States
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Belley R, Bernard N, Côté M, Paquet F, Poitras J. Hyperbaric oxygen therapy in the management of two cases of hydrogen sulfide toxicity from liquid manure. CAN J EMERG MED 2015; 7:257-61. [PMID: 17355683 DOI: 10.1017/s1481803500014408] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTHydrogen sulfide is a potent lethal gas. Supportive care, nitrite therapy and hyperbaric oxygen are the treatment modalities reported in the literature in cases of hydrogen sulfide exposure. We describe an industrial exposure in which 6 workers inhaled high concentrations of hydrogen sulfide when they entered a closed spreader tank partially filled with liquid swine manure. Five of the 6 lost consciousness, and 2 were agitated and poorly responsive on arrival to the emergency department despite having already received high-flow oxygen for nearly 1 hour. These 2 patients received nitrite therapy followed by orotracheal intubation and hyperbaric oxygen. All patients were discharged home without sequelae after short stays in hospital. The emergency management of hydrogen sulfide exposure is briefly reviewed.
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Affiliation(s)
- Richard Belley
- Hyperbaric Medicine Service, Emergency Department, Hôtel Dieu de Lévis, Centre Hospitalier Affilié à l'Université Laval, Université Laval, Québec, Québec, Canada
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16
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Chenuel B, Sonobe T, Haouzi P. Effects of infusion of human methemoglobin solution following hydrogen sulfide poisoning. Clin Toxicol (Phila) 2015; 53:93-101. [PMID: 25634666 DOI: 10.3109/15563650.2014.996570] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
RATIONALE We have recently reported that infusion of a solution containing methemoglobin (MetHb) during exposure to hydrogen sulfide results in a rapid and large decrease in the concentration of the pool of soluble/diffusible H2S in the blood. However, since the pool of dissolved H2S disappears very quickly after H2S exposure, it is unclear if the ability of MetHb to "trap" sulfide in the blood has any clinical interest and relevance in the treatment of sulfide poisoning. METHODS In anesthetized rats, repetition of short bouts of high level of H2S infusions was applied to allow the rapid development of an oxygen deficit. A solution containing MetHb (600 mg/kg) or its vehicle was administered 1 min and a half after the end of H2S intoxication. RESULTS The injection of MetHb solution increased methemoglobinemia to about 6%, almost instantly, but was unable to affect the blood concentration of soluble H2S, which had already vanished at the time of infusion, or to increase combined H2S. In addition, H2S-induced O2 deficit and lactate production as well as the recovery of carotid blood flow and blood pressure were similar in treated and control animals. CONCLUSION Our results do not support the view that administration of MetHb or drugs-induced methemoglobinemia during the recovery phase following severe H2S intoxication in sedated rats can restore cellular oxidative metabolism, as the pool of diffusible sulfide, accessible to MetHb, disappears rapidly from the blood after H2S exposure.
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Affiliation(s)
- B Chenuel
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University College of Medicine , Hershey, PA , USA
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17
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Abstract
Hydrogen sulfide (H2S) is a hazard primarily in the oil and gas industry, agriculture, sewage and animal waste handling, construction (asphalt operations and disturbing marshy terrain), and other settings where organic material decomposes under reducing conditions, and in geothermal operations. It is an insoluble gas, heavier than air, with a very low odor threshold and high toxicity, driven by concentration more than duration of exposure. Toxicity presents in a unique, reliable, and characteristic toxidrome consisting, in ascending order of exposure, of mucosal irritation, especially of the eye ("gas eye"), olfactory paralysis (not to be confused with olfactory fatigue), sudden but reversible loss of consciousness ("knockdown"), pulmonary edema (with an unusually favorable prognosis), and death (probably with apnea contributing). The risk of chronic neurcognitive changes is controversial, with the best evidence at high exposure levels and after knockdowns, which are frequently accompanied by head injury or oxygen deprivation. Treatment cannot be initiated promptly in the prehospital phase, and currently rests primarily on supportive care, hyperbaric oxygen, and nitrite administration. The mechanism of action for sublethal neurotoxicity and knockdown is clearly not inhibition of cytochrome oxidase c, as generally assumed, although this may play a role in overwhelming exposures. High levels of endogenous sulfide are found in the brain, presumably relating to the function of hydrogen sulfide as a gaseous neurotransmitter and immunomodulator. Prevention requires control of exposure and rigorous training to stop doomed rescue attempts attempted without self-contained breathing apparatus, especially in confined spaces, and in sudden release in the oil and gas sector, which result in multiple avoidable deaths.
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18
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Salnikov DS, Makarov SV, van Eldik R, Kucherenko PN, Boss GR. Kinetics and mechanism of the reaction of hydrogen sulfide with diaquacobinamide in aqueous solution. Eur J Inorg Chem 2014; 2014:4123-4133. [PMID: 25580081 PMCID: PMC4286256 DOI: 10.1002/ejic.201402082] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Indexed: 11/09/2022]
Abstract
We conducted a detailed kinetic study of the reaction of the vitamin B12 analog diaquacobinamide ((H2O)2Cbi(III)) with hydrogen sulfide in water from pH 3 to 11. The reaction proceeds in three steps: (i) formation of three different complexes between cobinamide and hydrogen sulfide, viz. (HO-)(HS-)Cbi(III), (H2O)(HS-)Cbi(III), and (HS-)2Cbi(III); (ii) inner-sphere electron transfer (ISET) in the two complexes with one coordinated HS- to form the reduced cobinamide complex [(H)S]Cbi(II); and (iii) addition of a second molecule of hydrogen sulfide to the reduced cobinamide. ISET does not proceed in the (HS-)2Cbi(III) complex. The final products of the reaction between cobinamide and hydrogen sulfide were found to be independent of pH, with the main product being a complex of cobinamide(II) with the anion-radical SSH2-.
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Affiliation(s)
- Denis S. Salnikov
- Department of Food Chemistry, Ivanovo State University of Chemistry and Technology, Sheremetevskiy str. 7, 153000 Ivanovo, Russia
- Department of Chemistry and Pharmacy, University of Erlangen – Nuremberg, Egerland strasse 1, 91058 Erlangen, Germany
| | - Sergei V. Makarov
- Department of Food Chemistry, Ivanovo State University of Chemistry and Technology, Sheremetevskiy str. 7, 153000 Ivanovo, Russia
| | - Rudi van Eldik
- Department of Chemistry and Pharmacy, University of Erlangen – Nuremberg, Egerland strasse 1, 91058 Erlangen, Germany
| | - Polina N. Kucherenko
- Department of Food Chemistry, Ivanovo State University of Chemistry and Technology, Sheremetevskiy str. 7, 153000 Ivanovo, Russia
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652, United States
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Haouzi P, Sonobe T, Torsell-Tubbs N, Prokopczyk B, Chenuel B, Klingerman CM. In vivo interactions between cobalt or ferric compounds and the pools of sulphide in the blood during and after H2S poisoning. Toxicol Sci 2014; 141:493-504. [PMID: 25015662 DOI: 10.1093/toxsci/kfu140] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Hydrogen sulphide (H2S), a chemical hazard in oil and gas production, has recently become a dreadful method of suicide, posing specific risks and challenges for the first responders. Currently, there is no proven effective treatment against H2S poisoning and its severe neurological, respiratory or cardiac after-effects. We have recently described that H2S is present in various compartments, or pools, in the body during sulphide exposure, which have different levels of toxicity. The general goals of our study were to (1) determine the concentrations and kinetics of the various pools of hydrogen sulphide in the blood, i.e., gaseous (CgH2S) versus total sulphide, i.e., reacting with monobromobimane (CMBBH2S), during and following H2S exposure in a small and large mammal and (2) establish the interaction between the pools of H2S and a methemoglobin (MetHb) solution or a high dose of hydroxocobalamin (HyCo). We found that CgH2S during and following H2S infusion was similar in sedated sheep and rats at any given rate of infusion/kg and provoked symptoms, i.e., hyperpnea and apnea, at the same CgH2S. After H2S administration was stopped, CgH2S disappeared within 1 min. CMBBH2S also dropped to 2-3μM, but remained above baseline levels for at least 30 min. Infusion of a MetHb solution during H2S infusion produced an immediate reduction in the free/soluble pool of H2S only, whereas CMBBH2S increased by severalfold. HyCo (70 mg/kg) also decreased the concentrations of free/soluble H2S to almost zero; CgH2S returned to pre-HyCo levels within a maximum of 20 min, if H2S infusion is maintained. These results are discussed in the context of a relevant scenario, wherein antidotes can only be administered after H2S exposure.
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Affiliation(s)
- Philippe Haouzi
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Penn State University College of Medicine, Hershey, PA 17033
| | - Takashi Sonobe
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Penn State University College of Medicine, Hershey, PA 17033
| | - Nicole Torsell-Tubbs
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Penn State University College of Medicine, Hershey, PA 17033
| | - Bogdan Prokopczyk
- Department of Pharmacology, Penn State University College of Medicine, Hershey, PA 17033
| | - Bruno Chenuel
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Penn State University College of Medicine, Hershey, PA 17033
| | - Candice M Klingerman
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Penn State University College of Medicine, Hershey, PA 17033 Department of Biological and Allied Health Sciences, Bloomsburg University, Bloomsburg, PA 17815
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20
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Klingerman CM, Trushin N, Prokopczyk B, Haouzi P. H2S concentrations in the arterial blood during H2S administration in relation to its toxicity and effects on breathing. Am J Physiol Regul Integr Comp Physiol 2013; 305:R630-8. [PMID: 23904109 DOI: 10.1152/ajpregu.00218.2013] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Our aim was to establish in spontaneously breathing urethane-anesthetized rats, the relationship between the concentrations of H2S transported in the blood and the corresponding clinical manifestations, i.e., breathing stimulation and inhibition, during and following infusion of NaHS at increasing rates. The gaseous concentration of H2S (CgH2S, one-third of the total soluble form) was computed from the continuous determination of H2S partial pressure in the alveolar gas, while H2S, both dissolved and combined to hemoglobin, was measured at specific time points by sulfide complexation with monobromobimane (CMBBH2S). We found that using a potent reducing agent in vitro, H2S added to the whole blood had little interaction with the plasma proteins, as sulfide appeared to be primarily combined and then oxidized by hemoglobin. In vivo, H2S was undetectable in the blood in its soluble form in baseline conditions, while CMBBH2S averaged 0.7 ± 0.5 μM. During NaHS infusion, H2S was primarily present in nonsoluble form in the arterial blood: CMBBH2S was about 50 times higher than CgH2S at the lowest levels of exposure and 5 or 6 times at the levels wherein fatal apnea occurred. CgH2S averaged only 1.1 ± 0.7 μM when breathing increased, corresponding to a CMBBH2S of 11.1 ± 5.4 μM. Apnea occurred at CgH2S above 5.1 μM and CMBBH2S above 25.4 μM. At the cessation of exposure, CMBBH2S remained elevated, at about 3 times above baseline for at least 15 min. These data provide a frame of reference for studying the putative effects of endogenous H2S and for testing antidotes against its deadly effects.
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Affiliation(s)
- Candice M Klingerman
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Penn State University College of Medicine, Hershey, Pennsylvania; and
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Van de Louw A, Haouzi P. Inhibitory effects of hyperoxia and methemoglobinemia on H(2)S induced ventilatory stimulation in the rat. Respir Physiol Neurobiol 2012; 181:326-34. [PMID: 22490362 DOI: 10.1016/j.resp.2012.03.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 03/26/2012] [Accepted: 03/27/2012] [Indexed: 01/03/2023]
Abstract
The aim of this study was to clarify, using in vitro and in vivo approaches in the rat, the site of mediation of the inhibition of H(2)S induced arterial chemoreceptor stimulation, by hyperoxia and methemoglobinemia. We first determined the ventilatory dose-response curves during intravenous injections of H(2)S. A very high dose of NaHS, i.e. 0.4 μmol (concentration: 800 μM), was needed to stimulate breathing within 1s following i.v. injection. Above this level (and up to 2.4 μmol, with a concentration of 4800 μM), a dose-dependent effect of H(2)S injection was observed. NaHS injection into the thoracic aorta produced the same effect, suggesting that within one circulatory time, H(2)S pulmonary exchange does not dramatically reduce H(2)S concentrations in the arterial blood. The ventilatory response to H(2)S was abolished in the presence of MetHb (12.8%) and was significantly depressed in hyperoxia and, surprisingly, in 10% hypoxia. MetHb per se did not affect the ventilatory response to hypoxia or hyperoxia, but dramatically enhanced the oxidation of H(2)S in vitro, with very fast kinetics. These findings suggest that, the decrease/oxidation of exogenous H(2)S in the blood is the primary effect of MetHb in vivo. In contrast, the in vitro oxidative properties of blood for H(2)S were not affected by the level of [Formula: see text] between 23 and >760 mmHg. This suggests that the inhibition of the ventilatory response to H(2)S by hyperoxia during aortic or venous injection originates within the CB and not in the blood. The implications of these results on the role of endogenous H(2)S in the arterial chemoreflex are discussed.
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Affiliation(s)
- Andry Van de Louw
- Pennsylvania State University, College of Medicine, Division of Pulmonary and Critical Care Medicine, Penn State Hershey Medical Center, 500 University Dr., Hershey, PO Box 850, MC H047, PA 17033-0850, USA
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Abstract
INTRODUCTION Access to genetically engineered mice has opened many new opportunities to address questions relevant to the pathophysiology and treatment of patients in critical conditions. However, the results of studies in mice cannot disregard the unique ability of small rodents to adjust their temperature and high metabolic rate and the corresponding respiratory and circulatory requirements in response to hypoxia. POINT OF VIEW Studies performed in mice on questions related to metabolic, circulatory, and respiratory regulation should always be considered in light of the ability of mice to rapidly drop their nonshivering thermogenesis-related metabolism. As an example, it has been recently argued that a moderate level of inhaled hydrogen sulfide may have a potential benefit in patients in coma or shock or during an anoxic or ischemic insult, as this toxic gas dramatically reduces the metabolic rate in resting mice. However, acute hypometabolism has long been described in small mammals in response to hypoxia and is not specific to hydrogen sulfide. More importantly, mice have a specific metabolic rate that is 15-20 times higher than the specific metabolic level of a resting human. This difference can be accounted for by the large amount of heat produced by mice through nonshivering thermogenesis, related to the activity of uncoupling proteins. This mechanism, which is essential for maintaining homeothermia in small mammals, is virtually absent in larger animals, including in adult humans. Accordingly, no direct metabolic effect of hydrogen sulfide is observed in large mammals. We present the view that similar reasoning should be applied when the circulatory or respiratory response to hypoxic exposure is considered. This leads us to question whether a similar strategy could occur in mice in critical conditions other than hypoxia, such as in hypovolemic, septic, or cardiogenic shock. CONCLUSION Mouse models developed to understand the mechanisms of protection against hypoxia or ischemia or to propose new therapeutic approaches applicable in critical care patients should be understood in light of the specificity of the metabolic, respiratory, and circulatory responses of mice to a hypoxic insult, since many of these adaptations have no clear equivalent in humans.
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Haouzi P, Bell H, Van de Louw A. Hypoxia-induced arterial chemoreceptor stimulation and hydrogen sulfide: too much or too little? Respir Physiol Neurobiol 2011; 179:97-102. [PMID: 22001444 DOI: 10.1016/j.resp.2011.09.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Revised: 09/16/2011] [Accepted: 09/19/2011] [Indexed: 11/28/2022]
Abstract
This brief review presents and discusses some of the important issues surrounding the theory which asserts that endogenous hydrogen sulfide (H(2)S) is the mediator of, or at least an important contributor to, hypoxia-induced arterial chemorereceptor stimulation. The view presented here is that before H(2)S can seriously be considered as a candidate for transducing the O(2)-signal in the carotid bodies (CB), fundamental contradictions need to be resolved. One of these major contradictions is certainly the discrepancy between the levels of H(2)S endogenously present in the CB during hypoxia compared to the levels required to stimulate the arterial chemoreceptors in vitro. Very small amounts of H(2)S are thought to be produced endogenously during a given level of hypoxia, yet the partial pressure of tissue H(2)S which is needed to produce an effect commensurate with that of hypoxia is thousands to millions of times higher. This review discusses this and other contradictions in light of what is known about H(2)S concentration and production in various tissues, the lessons we have learnt from the response to exogenous sulfide and the ability of the blood and the mitochondria to oxidize very large amounts of sulfide. These considerations suggest that the increased production of H(2)S in hypoxia and exogenous sulfide cannot produce the same effect on the carotid bodies and breathing. While the effects of the endogenous H(2)S on breathing remains to be established, the effects exogenous sulfide can be accounted for by its long established toxicity on cytochrome C oxidase.
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Affiliation(s)
- Philippe Haouzi
- Division of Pulmonary and Critical Care Medicine, Pennsylvania State University, College of Medicine, Hershey, PA 17033, United States.
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Haouzi P, Bell H, Philmon M. Hydrogen sulfide oxidation and the arterial chemoreflex: effect of methemoglobin. Respir Physiol Neurobiol 2011; 177:273-83. [PMID: 21569867 DOI: 10.1016/j.resp.2011.04.025] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 04/27/2011] [Accepted: 04/28/2011] [Indexed: 01/01/2023]
Abstract
Endogenous H(2)S has been proposed to transduce the effects of hypoxia in the carotid bodies (CB). To test this hypothesis, we created a sink for endogenously produced H(2)S by inducing ∼10% methemoglobinemia via the injection of 250 mg of sodium nitrite in spontaneously breathing anaesthetized sheep. Methemoglobinemia has been shown to catalyze the oxidation of large quantities of sulfide in the blood and tissues. We found that the presence of metHb completely abolished the ventilatory stimulation induced by 10 mg NaHS (i.v.), which in control conditions mimicked the effects of breathing 6-7 tidal volumes of nitrogen, confirming the dramatic increase in the oxidative power of the blood for sulfide. The ventilatory responses to hypoxia (10% O(2)), nitrogen and hyperoxia were in no way depressed by the metHb. Our results demonstrate that the ventilatory chemoreflex is not depressed in the presence of a high oxidative capacity for sulfide and challenge the view that H(2)S transduces the effects of hypoxia in the CB.
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Affiliation(s)
- Philippe Haouzi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University, College of Medicine, Penn State Milton Hershey Medical Centre, Hershey, PA, USA.
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25
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Lee E, Kwan J, Leem J, Park S, Kim H, Lee D, Kim J, Kim D. Hydrogen Sulfide Intoxication with Dilated Cardiomyopathy. J Occup Health 2009; 51:522-5. [DOI: 10.1539/joh.n9004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Eui‐Cheol Lee
- Department of Occupational and Environmental MedicineKosin University Gospel HospitalRepublic of Korea
| | - Jun Kwan
- Department of Internal MedicineCollege of Medicine, Inha UniversityRepublic of Korea
| | - Jong‐Han Leem
- Department of Occupational and Environmental MedicineCollege of Medicine, Inha UniversityRepublic of Korea
| | - Shin‐Goo Park
- Department of Occupational and Environmental MedicineCollege of Medicine, Inha UniversityRepublic of Korea
| | - Hwan‐Cheol Kim
- Department of Occupational and Environmental MedicineCollege of Medicine, Inha UniversityRepublic of Korea
| | - Dong‐Hoon Lee
- Department of Occupational and Environmental MedicineCollege of Medicine, Inha UniversityRepublic of Korea
| | - Jeong‐Hoon Kim
- Department of Occupational and Environmental MedicineCollege of Medicine, Inha UniversityRepublic of Korea
| | - Dong‐Hyun Kim
- Department of Occupational and Environmental MedicineCollege of Medicine, Inha UniversityRepublic of Korea
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Almeida AF, Nation PN, Guidotti TL. Mechanism and treatment of sulfide-induced coma: a rat model. Int J Toxicol 2008; 27:287-93. [PMID: 18569170 DOI: 10.1080/10915810802210166] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Sodium hydrosulfide and dimethylsulfide duplicate the effects of hydrogen sulfide in causing coma in Sprague-Dawley rats and are additive for lethality. Nitrite, pyruvate and dithiothreitol had no significant effect on coma or lethality but bicarbonate with and without glucose reduced duration of coma. This finding suggests an antidotal treatment.
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Affiliation(s)
- A F Almeida
- Department of Public Health Sciences, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
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27
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Abstract
Potential carcinogenic effects, blue baby syndrome, and occasional intoxications caused by nitrite, as well as the suspected health risks related to fertilizer overuse, contributed to the negative image that inorganic nitrite and nitrate have had for decades. Recent experimental studies related to the molecular interaction between nitrite and heme proteins in blood and tissues, the potential role of nitrite in hypoxic vasodilatation, and an unexpected protective action of nitrite against ischemia/reperfusion injury, however, paint a different picture and have led to a renewed interest in the physiological and pharmacological properties of nitrite and nitrate. The range of effects reported suggests that these simple oxyanions of nitrogen have a much richer profile of biological actions than hitherto assumed, and several efforts are currently underway to investigate possible beneficial effects in the clinical arena. We provide here a brief historical account of the medical uses of nitrite and nitrate over the centuries that may serve as a basis for a careful reassessment of the health implications of their exposure and intake and may inform investigations into their therapeutic potential in the future.
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Affiliation(s)
- Anthony R Butler
- Bute Medical School, University of St. Andrews, St. Andrews, Fife, KY16 9ST, Scotland.
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Way JL, Leung P, Cannon E, Morgan R, Tamulinas C, Leong-Way J, Baxter L, Nagi A, Chui C. The mechanism of cyanide intoxication and its antagonism. CIBA FOUNDATION SYMPOSIUM 2007; 140:232-43. [PMID: 3073059 DOI: 10.1002/9780470513712.ch14] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The mechanism of cyanide intoxication has been attributed to the inhibition of cytochrome oxidase, thereby decreasing the tissue utilization of oxygen. One mechanism of cyanide antagonism is by sequestering cyanide with methaemoglobin to form cyanmethaemoglobin and another mechanism is detoxifying with a sulphur donor to thiocyanate. Questions have been raised with regard to these classical mechanisms. Oxygen with nitrite-thiosulphate antagonizes the lethal effects of cyanide. Theoretically, increased oxygen should serve no useful purpose, as it is the tissue utilization of oxygen which is inhibited. In the nitrite-thiosulphate antidotal combination, the proposal is made that the predominate antidotal action of nitrite is a vasogenic action, rather than methaemoglobin formation, because when methaemoglobin formation is inhibited by methylene blue the protective action of sodium nitrite persists. This suggests that methaemoglobin formation plays only a small part, if any, in the therapeutic antagonism of the lethal effects of cyanide. The roles and implications of sodium thiosulphate and non-rhodanese substrates in the detoxification mechanism are compared. Lastly, a new approach to cyanide antagonism has been initiated which involves the erythrocyte encapsulation of thiosulphate and sulphurtransferase as an antidote and prophylaxis against cyanide.
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Affiliation(s)
- J L Way
- Department of Medical Pharmacology and Toxicology, Texas A & M University, College of Medicine, College Station 77843
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Abstract
Manure pits and silos are potentially dangerous, gas-containing confined spaces on the farm that may generate hazardous levels of hydrogen sulphide and nitrogen dioxide respectively. Although these inhalation injuries are uncommon, emergency physicians who work within transport distance of rural areas should be aware of the toxic agents involved and their acute management. This article reviews the toxicology, clinical manifestations and treatment of acute, farm-related hydrogen sulphide and nitrogen dioxide exposures.
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Affiliation(s)
- L G Shepherd
- Department of Emergency Medicine, St. Thomas Elgin General Hospital, St. Thomas, Ontario, N5P 3W2, Canada.
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Wismer TA, Murphy LA, Gwaltney-Brant SM, Albretsen JC. Management and prevention of toxicoses in search-and-rescue dogs responding to urban disasters. J Am Vet Med Assoc 2003; 222:305-10. [PMID: 12564591 DOI: 10.2460/javma.2003.222.305] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Tina A Wismer
- American Society for the Prevention of Cruelty to Animals, Animal Poison Control Center, 1717 S Philo Rd, Ste 36, Urbana, IL 61802, USA
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Gabbay DS, De Roos F, Perrone J. Twenty-foot fall averts fatality from massive hydrogen sulfide exposure. J Emerg Med 2001; 20:141-4. [PMID: 11207408 DOI: 10.1016/s0736-4679(00)00301-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Hydrogen sulfide is a colorless irritant and asphyxiant gas with a noxious odor of "rotten eggs." Acute hydrogen sulfide exposure may cause, depending on the level and duration of toxicity, symptoms ranging from mild mucous membrane irritation to permanent neurologic impairment and cardiopulmonary arrest. We present a case of an oil refinery worker exposed to a typically fatal concentration of hydrogen sulfide gas (>1000 ppm) while working on top of a 20-foot ladder. The "knockdown" effect of exposure to high concentrations of hydrogen sulfide caused him to lose consciousness and fall from the top of the ladder. He was transported to the Emergency Department as a major trauma victim. Ironically, this 20-foot fall saved his life and possibly those of the rescuers by immediately removing him from the source of the hydrogen sulfide. Treatment of hazardous materials incidents and the pathophysiology and treatment options for hydrogen sulfide poisoning are discussed.
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Affiliation(s)
- D S Gabbay
- Department of Emergency Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
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Tanaka S, Fujimoto S, Tamagaki Y, Wakayama K, Shimada K, Yoshikawa J. Bronchial injury and pulmonary edema caused by hydrogen sulfide poisoning. Am J Emerg Med 1999; 17:427-9. [PMID: 10452448 DOI: 10.1016/s0735-6757(99)90102-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Horowitz BZ, Marquardt K, Swenson E. Calcium polysulfide overdose: a report of two cases. JOURNAL OF TOXICOLOGY. CLINICAL TOXICOLOGY 1997; 35:299-303. [PMID: 9140325 DOI: 10.3109/15563659709001215] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Calcium polysulfide or lime-sulfur solution is a common agricultural product used as a fungicide. Despite its easy availability, only two prior cases of intentional ingestion, both from Japan, have been reported in the literature. CASE REPORTS Two cases of calcium polysulfide ingestion are presented. In the first case severe acidosis, coma and cardiac arrest occurred. Despite aggressive supportive therapy, the patient expired. Autopsy examination revealed hemorrhagic necrosis of the gastric mucosa. The second patient also exhibited altered mental status and metabolic acidosis. He experienced liver dysfunction, rhabdomyolysis, renal dysfunction, and aspiration pneumonia. He had endoscopically proven esophageal and gastric mucosal burns which developed into esophageal strictures. CONCLUSIONS Calcium polysulfide ingestions cause direct caustic injury to the upper gastrointestinal tract, coma and severe metabolic acidosis.
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Affiliation(s)
- B Z Horowitz
- Division of Emergency Medicine and Clinical Toxicology, University of California, Davis Medical Center, Sacramento 95817, USA
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Snyder JW, Safir EF, Summerville GP, Middleberg RA. Occupational fatality and persistent neurological sequelae after mass exposure to hydrogen sulfide. Am J Emerg Med 1995; 13:199-203. [PMID: 7893309 DOI: 10.1016/0735-6757(95)90094-2] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Exposure to hydrogen sulfide (H2S) has been associated with death as well as survival following coma with or without hypoxic brain damage. The release of H2S at a beachfront construction site led to the emergency evaluation and treatment of 37 people, with six admissions and one death. At least one victim, who underwent extensive therapy with hyperbaric oxygen, developed persistent neurological sequelae. Despite increased awareness of the potentially life-threatening consequences of exposure to H2S, significant poisoning continues to occur, even in workplaces where the hazards are well-known and can be avoided. Recommended therapy includes nitrites, hyperbaric oxygen, and supportive care, but documentation of efficacy is lacking. Because patients with chronic neurological sequelae after acute H2S exposure continue to be reported, we suggest that any survivor of H2S poisoning who presents in coma or who manifests objectively verifiable evidence of neurotoxicity on physical examination or lab testing should undergo baseline and annual neurological and neuropsychological testing for at least five years. This approach could standardize and enhance our knowledge of, and ability to detect, the subtle but permanent alterations of central nervous system function that follow H2S exposure.
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Affiliation(s)
- J W Snyder
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA
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Simon RR, Curry SC, Gerkin RD. Ann Emerg Med 1987; 16:828-829. [DOI: 10.1016/s0196-0644(87)80606-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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40
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Hoidal CR, Hall AH, Robinson MD, Kulig K, Rumack BH. Hydrogen sulfide poisoning from toxic inhalations of roofing asphalt fumes. Ann Emerg Med 1986; 15:826-30. [PMID: 3729106 DOI: 10.1016/s0196-0644(86)80383-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Hydrogen sulfide poisoning from inhalation of roofing asphalt fumes is a rare but devastating injury. Two cases of toxic inhalation involving exposure to several gases, including hydrogen sulfide, evolved from cooling asphalt, are presented. Both victims were treated with supportive measures, including 100% normobaric oxygen, and one also received sodium nitrite. In one patient rapid, complete recovery was temporally associated with nitrite administration. The patient not treated with sodium nitrite survived with apparently permanent severe neurological sequelae.
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Bitterman N, Talmi Y, Lerman A, Melamed Y, Taitelman U. The effect of hyperbaric oxygen on acute experimental sulfide poisoning in the rat. Toxicol Appl Pharmacol 1986; 84:325-8. [PMID: 3715879 DOI: 10.1016/0041-008x(86)90140-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In order to evaluate the efficiency of hyperbaric oxygen in experimental acute sulfide poisoning, we studied the effect of 1 ATA (atmosphere absolute) oxygen and sodium nitrite therapy. We then studied the effect of oxygen at 3 ATA alone and in combination with intraperitoneal sodium nitrite injection on rats poisoned by intraperitoneal injection of LD75 sulfide. Electroencephalogram and heart rate were continuously monitored. We also studied the effect of sodium nitrite and hyperbaric oxygen administered before the poisoning (protective effect). In our experimental set, death of untreated poisoned animals occurred within 5 min. There is a parallel between modification of the EEG pattern and apnea. Respiratory arrest always preceded cardiac arrest. Pure oxygen (1 ATA O2) is effective in preventing death in experimental sulfide poisoning. 3 ATA oxygen was significantly more effective in preventing death than 1 ATA oxygen, or sodium nitrite alone. The best therapeutic regimen was a combination of 3 ATA oxygen and sodium nitrite administration.
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42
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Smilkstein MJ, Bronstein AC, Pickett HM, Rumack BH. Hyperbaric oxygen therapy for severe hydrogen sulfide poisoning. J Emerg Med 1985; 3:27-30. [PMID: 4093555 DOI: 10.1016/0736-4679(85)90216-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The optimum therapy for hydrogen sulfide poisoning is unclear. Adjuncts used in the treatment of cyanide poisoning have been advocated because of the shared mechanism of toxicity between hydrogen sulfide and cyanide. Following success in cyanide poisoning, hyperbaric oxygen therapy (HBO) has been suggested for use in treating hydrogen sulfide poisoning. A case of severe hydrogen sulfide poisoning was successfully treated with HBO after standard therapy was apparently ineffective. HBO as a therapeutic adjunct in hydrogen sulfide poisoning and the rationale for its use are discussed.
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Beauchamp RO, Bus JS, Popp JA, Boreiko CJ, Andjelkovich DA. A critical review of the literature on hydrogen sulfide toxicity. Crit Rev Toxicol 1984; 13:25-97. [PMID: 6378532 DOI: 10.3109/10408448409029321] [Citation(s) in RCA: 592] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The information available on the biological activity of hydrogen sulfide has been examined for present status of critical results pertaining to the toxicity of hydrogen sulfide. This review of the literature is intended as an evaluative report rather than an annotated bibliography of all the source material examined on hydrogen sulfide. The information was selected as it might relate to potential toxic effects of hydrogen sulfide to man and summarized, noting information gaps that may require further investigation. Several recommendations are listed for possible consideration for either toxicological research or additional short- and long-term tests. Two bibliographies have been provided to assist in locating references considered in this report: (1) literature examined but not cited and (2) reference citations. The majority of the references in the first bibliography were considered peripheral information and less appropriate for inclusion in this report.
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Smith L, Kruszyna H, Smith RP. The effect of methemoglobin on the inhibition of cytochrome c oxidase by cyanide, sulfide or azide. Biochem Pharmacol 1977; 26:2247-50. [PMID: 22333 DOI: 10.1016/0006-2952(77)90287-8] [Citation(s) in RCA: 70] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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