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Tat J, Heskett K, Boss GR. Acute rotenone poisoning: A scoping review. Heliyon 2024; 10:e28334. [PMID: 38633629 PMCID: PMC11021885 DOI: 10.1016/j.heliyon.2024.e28334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 04/19/2024] Open
Abstract
Context Rotenone is a toxic chemical found in various plants, including some used as food. Rotenone poisoning can be fatal and there is no antidote. Mechanistically, rotenone inhibits mitochondrial complex I, leading to reduced ATP production, compensatory glycolytic upregulation and secondary lactate production, and oxidative stress. Our literature review examined acute rotenone poisoning in humans, including exposure scenarios, clinical presentations, and treatments. Methods We searched five databases for relevant literature from database inception through the search date: July 12, 2022, pairing controlled vocabulary and keywords for "rotenone" with terms relating to human exposures and outcomes, such as "ingestion," "exposure," and "poisoning." We included all peer-reviewed reports found using the search terms where the full English text was available. Data abstracted included the number, age, weight, and sex of the exposed person(s), country where exposure happened, exposure scenario, ingestion context, estimated dose, clinical features, whether hospitalization occurred, treatments, and outcomes. Results After removing non-qualifying sources from 2,631 publications, we identified 11 case reports describing 18 victims, 15 of whom were hospitalized and five died. Most cases occurred in private quarters where victims unknowingly consumed rotenone-containing plants. Vomiting and metabolic acidosis occurred most commonly. Some patients exhibited impaired cardiopulmonary function. Supportive treatment addressed symptoms and included gastric lavage and/or activated charcoal to remove rotenone from the stomach, vasopressors for hypotension, mechanical ventilation for respiratory insufficiency, and sodium bicarbonate for acidosis. Some patients received N-acetylcysteine to counter oxidative stress. Conclusions Rotenone poisoning, though rare, can be fatal. Exposure prevention is impractical since rotenone is found in some plants used as food or pesticides. Cases may be under-diagnosed because symptoms are non-specific and under-reported in English-language journals since most cases occurred in non-English speaking countries. Treatments are supportive. Exploring antioxidant therapy in animal models of rotenone poisoning may be indicated considering rotenone's mechanism of toxicity.
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Affiliation(s)
- John Tat
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Karen Heskett
- The Library, University of California, San Diego, La Jolla, CA, USA
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
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2
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Kalyanaraman H, Casteel DE, China SP, Zhuang S, Boss GR, Pilz RB. A plasma membrane-associated form of the androgen receptor enhances nuclear androgen signaling in osteoblasts and prostate cancer cells. Sci Signal 2024; 17:eadi7861. [PMID: 38289986 PMCID: PMC10916501 DOI: 10.1126/scisignal.adi7861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 01/09/2024] [Indexed: 02/01/2024]
Abstract
Androgen binding to the androgen receptor (AR) in the cytoplasm induces the AR to translocate to the nucleus, where it regulates the expression of target genes. Here, we found that androgens rapidly activated a plasma membrane-associated signaling node that enhanced nuclear AR functions. In murine primary osteoblasts, dihydrotestosterone (DHT) binding to a membrane-associated form of AR stimulated plasma membrane-associated protein kinase G type 2 (PKG2), leading to the activation of multiple kinases, including ERK. Phosphorylation of AR at Ser515 by ERK increased the nuclear accumulation and binding of AR to the promoter of Ctnnb1, which encodes the transcription factor β-catenin. In male mouse osteoblasts and human prostate cancer cells, DHT induced the expression of Ctnnb1 and CTNN1B, respectively, as well as β-catenin target genes, stimulating the proliferation, survival, and differentiation of osteoblasts and the proliferation of prostate cancer cells in a PKG2-dependent fashion. Because β-catenin is a master regulator of skeletal homeostasis, these results explain the reported male-specific osteoporotic phenotype of mice lacking PKG2 in osteoblasts and imply that PKG2-dependent AR signaling is essential for maintaining bone mass in vivo. Our results suggest that widely used pharmacological PKG activators, such as sildenafil, could be beneficial for male and estrogen-deficient female patients with osteoporosis but detrimental in patients with prostate cancer.
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Affiliation(s)
- Hema Kalyanaraman
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Darren E. Casteel
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Shyamsundar Pal China
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Shunhui Zhuang
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Renate B. Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
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3
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Kalyanaraman H, Casteel DE, Cabriales JA, Tat J, Zhuang S, Chan A, Dretchen KL, Boss GR, Pilz RB. The Antioxidant/Nitric Oxide-Quenching Agent Cobinamide Prevents Aortic Disease in a Mouse Model of Marfan Syndrome. JACC Basic Transl Sci 2024; 9:46-62. [PMID: 38362350 PMCID: PMC10864892 DOI: 10.1016/j.jacbts.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 02/17/2024]
Abstract
Major pathologic changes in the proximal aorta underlie the life-threatening aortic aneurysms and dissections in Marfan Syndrome; current treatments delay aneurysm development without addressing the primary pathology. Because excess oxidative stress and nitric oxide/protein kinase G signaling likely contribute to the aortopathy, we hypothesized that cobinamide, a strong antioxidant that can attenuate nitric oxide signaling, could be uniquely suited to prevent aortic disease. In a well-characterized mouse model of Marfan Syndrome, cobinamide dramatically reduced elastin breaks, prevented excess collagen deposition and smooth muscle cell apoptosis, and blocked DNA, lipid, and protein oxidation and excess nitric oxide/protein kinase G signaling in the ascending aorta. Consistent with preventing pathologic changes, cobinamide diminished aortic root dilation without affecting blood pressure. Cobinamide exhibited excellent safety and pharmacokinetic profiles indicating it could be a practical treatment. We conclude that cobinamide deserves further study as a disease-modifying treatment of Marfan Syndrome.
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Affiliation(s)
- Hema Kalyanaraman
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
| | - Darren E. Casteel
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
| | - Justin A. Cabriales
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
| | - John Tat
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
| | - Shunhui Zhuang
- 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
| | | | - Gerry R. Boss
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
| | - Renate B. Pilz
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
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4
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Behymer MM, Mo H, Fujii N, Suresh V, Arzumanian AS, Chan A, Nath AK, McCain R, MacRae CA, Peterson R, Boss GR, Davisson VJ, Knipp GT. Investigating the Replacement of Carboxylates with Carboxamides to Modulate the Safety and Efficacy of Platinum(II) Thioether Cyanide Scavengers. Toxicol Sci 2023; 197:kfad119. [PMID: 37952247 PMCID: PMC10823771 DOI: 10.1093/toxsci/kfad119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023] Open
Abstract
Cyanide represents a persistent threat for accidental or malicious misuse due to easy conversion into a toxic gas and access to large quantities through several industries. The high safety index of hydroxocobalamin is a cornerstone quality as a cyanide scavenger. Unfortunately, intravenous infusion of hydroxocobalamin limits the utility in a mass casualty setting. We previously reported platinum(II) [Pt(II)] complexes with trans-directing sulfur ligands as an efficacious alternative to hydroxocobalamin when delivered by a bolus intramuscular injection in mice and rabbits. Thus, to enable Pt(II) as an alternative to hydroxocobalamin, a high safety factor is needed. The objective is to maintain efficacy and mitigate the risk for nephrotoxicity. Platinum amino acid complexes with the ability to form five- or six-membered rings and possessing either carboxylates or carboxamides are evaluated in vitro for cyanide scavenging. In vivo efficacy was evaulated in the zebrafish and mice cyanide exposure models. In addition, Pt(II) complex toxicity and pharmacokinetics were evaluated in a cyanide naive Sprague-Dawley model. Doses for toxicity are escalated to 5x from the efficacious dose in mice using a body surface area adjustment. The results show the carboxamide ligands display a time and pH dependence on cyanide scavenging in vitro and efficacy in vivo. Additionally, exchanging the carboxylate for carboxamide showed reduced indications of renal injury. A pharmacokinetic analysis of the larger bidentate complexes displayed rapid absorption by intramuscular administration and having similar plasma exposure. These findings point to the importance of pH and ligand structures for methionine carboxamide complexes with Pt(II).
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Affiliation(s)
- Matthew M Behymer
- Department of Industrial and Molecular Pharmaceutics, Purdue University, West Lafayette, Indiana 47907, USA
| | - Huaping Mo
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana 47907, USA
| | - Naoaki Fujii
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana 47907, USA
| | - Vallabh Suresh
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana 47907, USA
| | - Ari S Arzumanian
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana 47907, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, California 92093, USA
| | - Anjali K Nath
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA
| | - Robyn McCain
- Purdue Translational Pharmacology CTSI Core Facility, Purdue University, West Lafayette, Indiana, USA
| | - Calum A MacRae
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts 02115, USA
| | - Randall Peterson
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, Utah 84112, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, California 92093, USA
| | - Vincent Jo Davisson
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana 47907, USA
| | - Gregory T Knipp
- Department of Industrial and Molecular Pharmaceutics, Purdue University, West Lafayette, Indiana 47907, USA
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Tat J, Chang SC, Link CD, Razo-Lopez S, Ingerto MJ, Katebian B, Chan A, Kalyanaraman H, Pilz RB, Boss GR. The vitamin B 12 analog cobinamide ameliorates azide toxicity in cells, Drosophila melanogaster, and mice. Clin Toxicol (Phila) 2023; 61:212-222. [PMID: 37010385 PMCID: PMC10348668 DOI: 10.1080/15563650.2023.2185125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 04/04/2023]
Abstract
CONTEXT The azide anion (N3-) is highly toxic. It exists most commonly as sodium azide, which is used widely and is readily available, raising the potential for occupational incidents and use as a weapon of mass destruction. Azide-poisoned patients present with vomiting, seizures, hypotension, metabolic acidosis, and coma; death can occur. No specific azide antidote exists, with treatment being solely supportive. Azide inhibits mitochondrial cytochrome c oxidase and is likely oxidized to nitric oxide in vivo. Cytochrome c oxidase inhibition depletes intracellular adenosine triphosphate and increases oxidative stress, while increased nitric oxide causes hypotension and exacerbates oxidative damage. Here, we tested whether the cobalamin (vitamin B12) analog cobinamide, a strong and versatile antioxidant that also neutralizes nitric oxide, can reverse azide toxicity in mammalian cells, Drosophila melanogaster, and mice. RESULTS We found cobinamide bound azide with a moderate affinity (Ka 2.87 × 105 M-1). Yet, cobinamide improved growth, increased intracellular adenosine triphosphate, and reduced apoptosis and malondialdehyde, a marker of oxidative stress, in azide-exposed cells. Cobinamide rescued Drosophila melanogaster and mice from lethal exposure to azide and was more effective than hydroxocobalamin. Azide likely generated nitric oxide in the mice, as evidenced by increased serum nitrite and nitrate, and reduced blood pressure and peripheral body temperature in the animals; the reduced temperature was likely due to reflex vasoconstriction in response to the hypotension. Cobinamide improved recovery of both blood pressure and body temperature. CONCLUSION We conclude cobinamide likely acted by neutralizing both oxidative stress and nitric oxide, and that it should be given further consideration as an azide antidote.
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Affiliation(s)
- John Tat
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Stephen C. Chang
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Cole D. Link
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Suelen Razo-Lopez
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Michael J. Ingerto
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Behdod Katebian
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Hema Kalyanaraman
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Renate B. Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
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6
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Kalyanaraman H, China SP, Cabriales JA, Moininazeri J, Casteel DE, Garcia JJ, Wong VW, Chen A, Sah RL, Boss GR, Pilz RB. Protein Kinase G2 Is Essential for Skeletal Homeostasis and Adaptation to Mechanical Loading in Male but Not Female Mice. J Bone Miner Res 2023; 38:171-185. [PMID: 36371651 PMCID: PMC9825661 DOI: 10.1002/jbmr.4746] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 11/14/2022]
Abstract
We previously showed that the NO/cGMP/protein kinase G (PKG) signaling pathway positively regulates osteoblast proliferation, differentiation, and survival in vitro, and that cGMP-elevating agents have bone-anabolic effects in mice. Here, we generated mice with an osteoblast-specific (OB) knockout (KO) of type 2 PKG (gene name Prkg2) using a Col1a1(2.3 kb)-Cre driver. Compared to wild type (WT) littermates, 8-week-old male OB Prkg2-KO mice had fewer osteoblasts, reduced bone formation rates, and lower trabecular and cortical bone volumes. Female OB Prkg2-KO littermates showed no bone abnormalities, despite the same degree of PKG2 deficiency in bone. Expression of osteoblast differentiation- and Wnt/β-catenin-related genes was lower in primary osteoblasts and bones of male KO but not female KO mice compared to WT littermates. Osteoclast parameters were unaffected in both sexes. Since PKG2 is part of a mechano-sensitive complex in osteoblast membranes, we examined its role during mechanical loading. Cyclical compression of the tibia increased cortical thickness and induced mechanosensitive and Wnt/β-catenin-related genes to a similar extent in male and female WT mice and female OB Prkg2-KO mice, but loading had a minimal effect in male KO mice. We conclude that PKG2 drives bone acquisition and adaptation to mechanical loading via the Wnt/β-catenin pathway in male mice. The striking sexual dimorphism of OB Prkg2-KO mice suggests that current U.S. Food and Drug Administration-approved cGMP-elevating agents may represent novel effective treatment options for male osteoporosis. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Hema Kalyanaraman
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
- These two authors contributed equally to the work
| | - Shyamsundar Pal China
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
- These two authors contributed equally to the work
| | - Justin A. Cabriales
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Jafar Moininazeri
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Darren E. Casteel
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Julian J. Garcia
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Van W. Wong
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Albert Chen
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Robert L. Sah
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Renate B. Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
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7
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Behymer M, Mo H, Fujii N, Suresh V, Chan A, Lee J, Nath AK, Saha K, Mahon SB, Brenner M, MacRae CA, Peterson R, Boss GR, Knipp GT, Davisson VJ. Identification of Platinum(II) Sulfide Complexes Suitable as Intramuscular Cyanide Countermeasures. Chem Res Toxicol 2022; 35:1983-1996. [PMID: 36201358 PMCID: PMC9682522 DOI: 10.1021/acs.chemrestox.2c00157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The development of rapidly acting cyanide countermeasures using intramuscular injection (IM) represents an unmet medical need to mitigate toxicant exposures in mass casualty settings. Previous work established that cisplatin and other platinum(II) or platinum(IV)-based agents effectively mitigate cyanide toxicity in zebrafish. Cyanide's in vivo reaction with platinum-containing materials was proposed to reduce the risk of acute toxicities. However, cyanide antidote activity depended on a formulation of platinum-chloride salts with dimethyl sulfoxide (DMSO) followed by dilution in phosphate-buffered saline (PBS). A working hypothesis to explain the DMSO requirement is that the formation of platinum-sulfoxide complexes activates the cyanide scavenging properties of platinum. Preparations of isolated NaPtCl5-DMSO and Na (NH3)2PtCl-DMSO complexes in the absence of excess DMSO provided agents with enhanced reactivity toward cyanide in vitro and fully recapitulated in vivo cyanide rescue in zebrafish and mouse models. The enhancement of the cyanide scavenging effects of the DMSO ligand could be attributed to the activation of platinum(IV) and (II) with a sulfur ligand. Unfortunately, the efficacy of DMSO complexes was not robust when administered IM. Alternative Pt(II) materials containing sulfide and amine ligands in bidentate complexes show enhanced reactivity toward cyanide addition. The cyanide addition products yielded tetracyanoplatinate(II), translating to a stoichiometry of 1:4 Pt to each cyanide scavenger. These new agents demonstrate a robust and enhanced potency over the DMSO-containing complexes using IM administration in mouse and rabbit models of cyanide toxicity. Using the zebrafish model with these Pt(II) complexes, no acute cardiotoxicity was detected, and dose levels required to reach lethality exceeded 100 times the effective dose. Data are presented to support a general chemical design approach that can expand a new lead candidate series for developing next-generation cyanide countermeasures.
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Affiliation(s)
- Matthew
M. Behymer
- Department
of Industrial and Physical Pharmacy, Purdue
University, 575 Stadium Mall Drive, West Lafayette, Indiana47907, United States
| | - Huaping Mo
- Department
of Medicinal Chemistry and Molecular Pharmacology, Purdue University, 575
Stadium Mall Drive, West Lafayette, Indiana47907, United
States
| | - Naoaki Fujii
- Department
of Medicinal Chemistry and Molecular Pharmacology, Purdue University, 575
Stadium Mall Drive, West Lafayette, Indiana47907, United
States
| | - Vallabh Suresh
- Department
of Medicinal Chemistry and Molecular Pharmacology, Purdue University, 575
Stadium Mall Drive, West Lafayette, Indiana47907, United
States
| | - Adriano Chan
- Department
of Medicine, University of California, San Diego, California92093, United States
| | - Jangweon Lee
- Beckman
Laser Institute and Medical Clinic, Department of Medicine, University of California, Irvine, California92697, United States
| | - Anjali K. Nath
- Department
of Cardiology, Beth Israel Deaconess Medical
Center, Boston, Massachusetts02115, United States
| | - Kusumika Saha
- Division
of Cardiovascular Medicine, Brigham and
Women’s Hospital, Boston, Massachusetts02115, United States
| | - Sari B. Mahon
- Beckman
Laser Institute and Medical Clinic, Department of Medicine, University of California, Irvine, California92697, United States
| | - Matthew Brenner
- Beckman
Laser Institute and Medical Clinic, Department of Medicine, University of California, Irvine, California92697, United States
| | - Calum A. MacRae
- Division
of Cardiovascular Medicine, Brigham and
Women’s Hospital, Boston, Massachusetts02115, United States
| | - Randall Peterson
- Department
of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake
City, Utah84112, United States
| | - Gerry R. Boss
- Department
of Medicine, University of California, San Diego, California92093, United States
| | - Gregory T. Knipp
- Department
of Industrial and Physical Pharmacy, Purdue
University, 575 Stadium Mall Drive, West Lafayette, Indiana47907, United States
| | - Vincent Jo Davisson
- Department
of Medicinal Chemistry and Molecular Pharmacology, Purdue University, 575
Stadium Mall Drive, West Lafayette, Indiana47907, United
States,
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8
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Bebarta VS, Shi X, Zheng S, Hendry-Hofer TB, Severance CC, Behymer MM, Boss GR, Mahon S, Brenner M, Knipp GT, Davisson VJ, Peterson RT, MacRae CA, Rutter J, Gerszten RE, Nath AK. Intramuscular administration of glyoxylate rescues swine from lethal cyanide poisoning and ameliorates the biochemical sequalae of cyanide intoxication. Toxicol Sci 2022; 191:90-105. [PMID: 36326479 PMCID: PMC9887668 DOI: 10.1093/toxsci/kfac116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Cyanide-a fast-acting poison-is easy to obtain given its widespread use in manufacturing industries. It is a high-threat chemical agent that poses a risk of occupational exposure in addition to being a terrorist agent. FDA-approved cyanide antidotes must be given intravenously, which is not practical in a mass casualty setting due to the time and skill required to obtain intravenous access. Glyoxylate is an endogenous metabolite that binds cyanide and reverses cyanide-induced redox imbalances independent of chelation. Efficacy and biochemical mechanistic studies in an FDA-approved preclinical animal model have not been reported. Therefore, in a swine model of cyanide poisoning, we evaluated the efficacy of intramuscular glyoxylate on clinical, metabolic, and biochemical endpoints. Animals were instrumented for continuous hemodynamic monitoring and infused with potassium cyanide. Following cyanide-induced apnea, saline control or glyoxylate was administered intramuscularly. Throughout the study, serial blood samples were collected for pharmacokinetic, metabolite, and biochemical studies, in addition, vital signs, hemodynamic parameters, and laboratory values were measured. Survival in glyoxylate-treated animals was 83% compared with 12% in saline-treated control animals (p < .01). Glyoxylate treatment improved physiological parameters including pulse oximetry, arterial oxygenation, respiration, and pH. In addition, levels of citric acid cycle metabolites returned to baseline levels by the end of the study. Moreover, glyoxylate exerted distinct effects on redox balance as compared with a cyanide-chelating countermeasure. In our preclinical swine model of lethal cyanide poisoning, intramuscular administration of the endogenous metabolite glyoxylate improved survival and clinical outcomes, and ameliorated the biochemical effects of cyanide.
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Affiliation(s)
- Vik S Bebarta
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado 80045, USA
| | - Xu Shi
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02115, USA
| | - Shunning Zheng
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02115, USA
| | - Tara B Hendry-Hofer
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado 80045, USA
| | - Carter C Severance
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado 80045, USA
| | - Matthew M Behymer
- Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, Indiana 47907, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, California 92093, USA
| | - Sari Mahon
- Department of Medicine, Beckman Laser Institute, University of California, Irvine, California 92697, USA
| | - Matthew Brenner
- Department of Medicine, Beckman Laser Institute, University of California, Irvine, California 92697, USA
| | - Gregory T Knipp
- Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, Indiana 47907, USA
| | - Vincent Jo Davisson
- Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, Indiana 47907, USA
| | - Randall T Peterson
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, Utah 84112, USA
| | - Calum A MacRae
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts 02115, USA
| | - Jared Rutter
- Department of Biochemistry, Howard Hughes Medical Institute, University of Utah, Salt Lake City, Utah 84112, USA
| | - Robert E Gerszten
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02115, USA,Broad Institute, Cambridge, Massachusetts 02142, USA,Harvard Medical School, Boston, Massachusetts 02115, USA
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9
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Haouzi P, MacCann M, Brenner M, Mahon S, Bebarta VS, Chan A, Judenherc-Haouzi A, Tubbs N, Boss GR. Treatment of life-threatening H2S intoxication: Lessons from the trapping agent tetranitrocobinamide. Environ Toxicol Pharmacol 2022; 96:103998. [PMID: 36228991 DOI: 10.1016/j.etap.2022.103998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
We sought to evaluate the efficacy of trapping free hydrogen sulfide (H2S) following severe H2S intoxication. Sodium hydrosulfide solution (NaHS, 20 mg/kg) was administered intraperitoneally in 69 freely moving rats. In a first group (protocol 1), 40 rats were randomly assigned to receive saline (n = 20) or the cobalt compound tetranitrocobinamide (TNCbi) (n = 20, 75 mg/kg iv), one minute into coma, when free H2S was still present in the blood. A second group of 27 rats received TNCbi or saline, following epinephrine, 5 min into coma, when the concentration of free H2S has drastically decreased in the blood. In protocol 1, TNCbi significantly increased immediate survival (65 vs 20 %, p < 0.01) while in protocol 2, administration of TNCbi led to the same outcome as untreated animals. We hypothesize that the decreased efficacy of TNCbi with time likely reflects the rapid spontaneous disappearance of the pool of free H2S in the blood following H2S exposure.
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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.
| | - Marissa MacCann
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University, College of Medicine, Hershey, PA, 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 Mahon
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA, USA
| | - Vikhyat S Bebarta
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Annick Judenherc-Haouzi
- Heart and Vascular Institute, Department of Medicine, Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Nicole Tubbs
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
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10
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Bhadra S, Chan A, Hendry-Hofer TB, Boss GR, Bebarta VS, Logue BA. Analysis of bisaminotetrazole cobinamide, a next-generation antidote for cyanide, hydrogen sulfide and methanethiol poisoning, in swine plasma by liquid chromatography-tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1208:123392. [PMID: 35952445 DOI: 10.1016/j.jchromb.2022.123392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/07/2022] [Accepted: 07/24/2022] [Indexed: 11/29/2022]
Abstract
Cyanide, hydrogen sulfide, and methanethiol are common toxic inhalation agents that inhibit mitochondrial cytochrome c oxidase and result in cellular hypoxia, cytotoxic anoxia, apnea, respiratory failure, cardiovascular collapse, seizure and potentially death. While all are occupational gas exposure hazards that have the potential to cause mass casualties from industrial accidents or acts of terrorism, only cyanide has approved antidotes, and each of these has major limitations, including difficult administration in mass-casualty settings. While bisaminotetrazole cobinamide (Cbi(AT)2) has recently gained attention because of its efficacy in treating these metabolic poisons, there is no method available for the analysis of Cbi(AT)2 in any biological matrix. Hence, in this study, a simple and rapid liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the analysis of Cbi(AT)2 in swine plasma. The method is extremely simple, consisting of protein precipitation, separation and drying of the supernatant, reconstitution in an aqueous solvent, and LC-MS/MS analysis. The method produced an LOD of 0.3 μM with a wide dynamic range (2 - 500 μM). Inter- and intraassay accuracies (100 ± 12 % and 100 ± 19 %, respectively) were acceptable and the precision (<12 % and < 9 % relative standard deviation, respectively) was good. The developed method was used to analyze Cbi(AT)2 from treated swine and the preliminary pharmacokinetic parameters showed impressive antidotal behavior, most notably a long estimated elimination half-life (t1/2 = 37.5 h). This simple and rapid method can be used to facilitate the development of Cbi(AT)2 as a therapeutic against toxic cyanide, hydrogen sulfide and methanethiol exposure.
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Affiliation(s)
- Subrata Bhadra
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD 57007, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Tara B Hendry-Hofer
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Vikhyat S Bebarta
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Brian A Logue
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD 57007, USA.
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11
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Chang S, Tat J, China SP, Kalyanaraman H, Zhuang S, Chan A, Lai C, Radic Z, Abdel-Rahman EA, Casteel DE, Pilz RB, Ali SS, Boss GR. Cobinamide is a strong and versatile antioxidant that overcomes oxidative stress in cells, flies, and diabetic mice. PNAS Nexus 2022; 1:pgac191. [PMID: 36276587 PMCID: PMC9578022 DOI: 10.1093/pnasnexus/pgac191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/12/2022] [Indexed: 01/29/2023]
Abstract
Increased oxidative stress underlies a variety of diseases, including diabetes. Here, we show that the cobalamin/vitamin B12 analog cobinamide is a strong and multifaceted antioxidant, neutralizing superoxide, hydrogen peroxide, and peroxynitrite, with apparent rate constants of 1.9 × 108, 3.7 × 104, and 6.3 × 106 M-1 s-1, respectively, for cobinamide with the cobalt in the +2 oxidation state. Cobinamide with the cobalt in the +3 oxidation state yielded apparent rate constants of 1.1 × 108 and 8.0 × 102 M-1 s-1 for superoxide and hydrogen peroxide, respectively. In mammalian cells and Drosophila melanogaster, cobinamide outperformed cobalamin and two well-known antioxidants, imisopasem manganese and manganese(III)tetrakis(4-benzoic acid)porphyrin, in reducing oxidative stress as evidenced by: (i) decreased mitochondrial superoxide and return of the mitochondrial membrane potential in rotenone- and antimycin A-exposed H9c2 rat cardiomyocytes; (ii) reduced JNK phosphorylation in hydrogen-peroxide-treated H9c2 cells; (iii) increased growth in paraquat-exposed COS-7 fibroblasts; and (iv) improved survival in paraquat-treated flies. In diabetic mice, cobinamide administered in the animals' drinking water completely prevented an increase in lipid and protein oxidation, DNA damage, and fibrosis in the heart. Cobinamide is a promising new antioxidant that has potential use in diseases with heightened oxidative stress.
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Affiliation(s)
| | | | | | | | - Shunhui Zhuang
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Cassandra Lai
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Zoran Radic
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA
| | - Engy A Abdel-Rahman
- Tumor Biology Research Program, Children’s Cancer Hospital, Cairo 57357, Egypt,Pharmacology Department, Faculty of Medicine, Assuit University, Assuit 71515, Egypt
| | - Darren E Casteel
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Renate B Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
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12
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Schwaerzer GK, Casteel DE, Cividini F, Kalyanaraman H, Zhuang S, Gu Y, Peterson KL, Dillmann W, Boss GR, Pilz RB, Pilz RB. Constitutive protein kinase G activation exacerbates stress-induced cardiomyopathy. Br J Pharmacol 2022; 179:2413-2429. [PMID: 34000062 PMCID: PMC9926932 DOI: 10.1111/bph.15530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/29/2021] [Accepted: 05/04/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND PURPOSE Heart failure is associated with high morbidity and mortality, and new therapeutic targets are needed. Preclinical data suggest that pharmacological activation of protein kinase G (PKG) can reduce maladaptive ventricular remodelling and cardiac dysfunction in the stressed heart. However, clinical trial results have been mixed and the effects of long-term PKG activation in the heart are unknown. EXPERIMENTAL APPROACH We characterized the cardiac phenotype of mice carrying a heterozygous knock-in mutation of PKG1 (Prkg1R177Q/+ ), which causes constitutive, cGMP-independent activation of the kinase. We examined isolated cardiac myocytes and intact mice, the latter after stress induced by surgical transaortic constriction or angiotensin II (Ang II) infusion. KEY RESULTS Cardiac myocytes from Prkg1R177Q/+ mice showed altered phosphorylation of sarcomeric proteins and reduced contractility in response to electrical stimulation, compared to cells from wild type mice. Under basal conditions, young PKG1R177Q/+ mice exhibited no obvious cardiac abnormalities, but aging animals developed mild increases in cardiac fibrosis. In response to angiotensin II infusion or fixed pressure overload induced by transaortic constriction, young PKGR177Q/+ mice exhibited excessive hypertrophic remodelling with increased fibrosis and myocyte apoptosis, leading to increased left ventricular dilation and dysfunction compared to wild type litter mates. CONCLUSION AND IMPLICATIONS Long-term PKG1 activation in mice may be harmful to the heart, especially in the presence of pressure overload and neurohumoral stress. LINKED ARTICLES This article is part of a themed issue on cGMP Signalling in Cell Growth and Survival. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.11/issuetoc.
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Affiliation(s)
- Gerburg K. Schwaerzer
- Department of Medicine, University of California San Diego, La Jolla, California 92093,These three authors contributed equally to the work
| | - Darren E. Casteel
- Department of Medicine, University of California San Diego, La Jolla, California 92093,These three authors contributed equally to the work
| | - Federico Cividini
- Department of Medicine, University of California San Diego, La Jolla, California 92093,These three authors contributed equally to the work
| | - Hema Kalyanaraman
- Department of Medicine, University of California San Diego, La Jolla, California 92093
| | - Shunhui Zhuang
- Department of Medicine, University of California San Diego, La Jolla, California 92093
| | - Yusu Gu
- Department of Medicine, University of California San Diego, La Jolla, California 92093
| | - Kirk L. Peterson
- Department of Medicine, University of California San Diego, La Jolla, California 92093
| | - Wolfgang Dillmann
- Department of Medicine, University of California San Diego, La Jolla, California 92093
| | - Gerry R. Boss
- Department of Medicine, University of California San Diego, La Jolla, California 92093
| | - Renate B. Pilz
- Department of Medicine, University of California San Diego, La Jolla, California 92093,Correspondence should be addressed to R.B.P. ()
| | - Renate B Pilz
- Department of Medicine, University of California San Diego, La Jolla, California, 92093, USA
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13
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Chan A, Lee J, Bhadra S, Bortey-Sam N, Hendry-Hofer TB, Bebarta VS, Mahon SB, Brenner M, Logue B, Pilz RB, Boss GR. Development of sodium tetrathionate as a cyanide and methanethiol antidote. Clin Toxicol (Phila) 2022; 60:332-341. [PMID: 34328378 PMCID: PMC8800944 DOI: 10.1080/15563650.2021.1953517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONTEXT Hydrogen cyanide and methanethiol are two toxic gases that inhibit mitochondrial cytochrome c oxidase. Cyanide is generated in structural fires and methanethiol is released by decaying organic matter. Current treatments for cyanide exposure do not lend themselves to treatment in the field and no treatment exists for methanethiol poisoning. Sodium tetrathionate (tetrathionate), a product of thiosulfate oxidation, could potentially serve as a cyanide antidote, and, based on its chemical structure, we hypothesized it could react with methanethiol. RESULTS We show that tetrathionate, unlike thiosulfate, reacts directly with cyanide in vitro under physiological conditions, and based on rabbit studies where we monitor cyanide poisoning in real-time, tetrathionate likely reacts directly with cyanide in vivo. We found that tetrathionate administered by intramuscular injection rescues >80% of juvenile, young adult, and old adult mice from exposure to inhaled hydrogen cyanide gas that is >80% lethal. Tetrathionate also rescued young adult rabbits from intravenously administered sodium cyanide. Tetrathionate was reasonably well-tolerated by mice and rats, yielding a therapeutic index of ∼5 in juvenile and young adult mice, and ∼3.3 in old adult mice; it was non-mutagenic in Chinese Hamster ovary cells and by the Ames bacterial test. We found by gas chromatography-mass spectrometry that both tetrathionate and thiosulfate react with methanethiol to generate dimethyldisulfide, but that tetrathionate was much more effective than thiosulfate at recovering intracellular ATP in COS-7 cells and rescuing mice from a lethal exposure to methanethiol gas. CONCLUSION We conclude that tetrathionate has the potential to be an effective antidote against cyanide and methanethiol poisoning.
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Affiliation(s)
- Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Jangwoen Lee
- Beckman Laser Institute, University of California, Irvine, Irvine, CA, USA
| | - Subrata Bhadra
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD, USA
| | - Nesta Bortey-Sam
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Vikhyat S. Bebarta
- Department of Emergency Medicine, University of Colorado, Aurora, CO, USA
| | - Sari B. Mahon
- Beckman Laser Institute, University of California, Irvine, Irvine, CA, USA
| | - Matthew Brenner
- Beckman Laser Institute, University of California, Irvine, Irvine, CA, USA
| | - Brian Logue
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD, USA
| | - Renate B. Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
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14
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Philipopoulos GP, Tat J, Chan A, Jiang J, Mukai D, Burney T, Doosty M, Mahon S, Patel HH, White CW, Brenner M, Lee J, Boss GR. Methyl mercaptan gas: mechanisms of toxicity and demonstration of the effectiveness of cobinamide as an antidote in mice and rabbits. Clin Toxicol (Phila) 2022; 60:615-622. [PMID: 34989638 PMCID: PMC9662850 DOI: 10.1080/15563650.2021.2017949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
CONTEXT Methyl mercaptan (CH3SH) is a colorless, toxic gas with potential for occupational exposure and used as a weapon of mass destruction. Inhalation at high concentrations can result in dyspnea, hypoventilation, seizures, and death. No specific methyl mercaptan antidote exists, highlighting a critical need for such an agent. Here, we investigated the mechanism of CH3SH toxicity, and rescue from CH3SH poisoning by the vitamin B12 analog cobinamide, in mammalian cells. We also developed lethal CH3SH inhalation models in mice and rabbits, and tested the efficacy of intramuscular injection of cobinamide as a CH3SH antidote. RESULTS We found that cobinamide binds to CH3SH (Kd = 84 µM), and improved growth of cells exposed to CH3SH. CH3SH reduced cellular oxygen consumption and intracellular ATP content and activated the stress protein c-Jun N-terminal kinase (JNK); cobinamide reversed these changes. A single intramuscular injection of cobinamide (20 mg/kg) rescued 6 of 6 mice exposed to a lethal dose of CH3SH gas, while all six saline-treated mice died (p = 0.0013). In rabbits exposed to CH3SH gas, 11 of 12 animals (92%) treated with two intramuscular injections of cobinamide (50 mg/kg each) survived, while only 2 of 12 animals (17%) treated with saline survived (p = 0.001). CONCLUSION We conclude that cobinamide could potentially serve as a CH3SH antidote.
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Affiliation(s)
| | - John Tat
- Department of Medicine, University of California, San Diego, CA, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, CA, USA
| | - Jingjing Jiang
- Department of Medicine, University of California, San Diego, CA, USA
| | - David Mukai
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Tanya Burney
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Melody Doosty
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Sari Mahon
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Hemal H Patel
- VA San Diego Healthcare System and Department of Anesthesiology, University of California, San Diego, CA, USA
| | - Carl W White
- Department of Pediatrics, University of Colorado, Aurora, CO, USA
| | - Matthew Brenner
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Jangwoen Lee
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, CA, USA
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15
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Sahu D, Huan J, Wang H, Sahoo D, Casteel DE, Klemke RL, Boss GR, Hansel DE. Bladder Cancer Invasion Is Mediated by Mammalian Target of Rapamycin Complex 2-Driven Regulation of Nitric Oxide and Invadopodia Formation. Am J Pathol 2021; 191:2203-2218. [PMID: 34428425 DOI: 10.1016/j.ajpath.2021.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/14/2021] [Accepted: 08/06/2021] [Indexed: 01/05/2023]
Abstract
Bladder cancer invasion depends on mammalian target of rapamycin complex 2 (mTORC2) activity, although the downstream mTORC2 effectors that mediate this effect have not been fully defined. One potential downstream effector is the arginine derivative nitric oxide (NO). We identified a stage-associated increase in the expression of the NO-generating enzymes endothelial NO synthase (NOS) and inducible NOS (iNOS) in human bladder cancer. Reduction of NOS activity by pharmacologic inhibition or silencing of NOS enzymes reduced cancer cell invasion, with similar effects observed using the NO scavenger cobinamide. By contrast, enhanced invasion was seen with the NO donor Deta-NONOate and an analog of the downstream NO second messenger cGMP. We next evaluated NOS expression in invadopodia, which are cellular protrusions that form the invasive tips of cancer cells. Invadopodia were enriched in both iNOS protein and mTORC2 activity, and invadopodia formation was increased by Deta-NONOate and decreased by cobinamide and ablation of mTORC2 activity. mTORC2 additionally increased expression of iNOS. Using a zebrafish model, injection of iNOS- or rictor-silenced cells reduced the frequency of bladder cancer cell metastasis in zebrafish. These results indicate that mTORC2 can mediate bladder cancer cell invasion through increased iNOS expression, resulting in increased NO and cGMP production in invadopodia and further propagation of invadopodia formation.
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Affiliation(s)
- Divya Sahu
- Department of Pathology & Laboratory Medicine, University of California at San Diego, La Jolla, California
| | - Jianya Huan
- Department of Pathology & Laboratory Medicine, Oregon Health & Science University, Portland, Oregon
| | - Huawei Wang
- Department of Pathology & Laboratory Medicine, University of California at San Diego, La Jolla, California
| | - Debashis Sahoo
- Department of Pathology & Laboratory Medicine, University of California at San Diego, La Jolla, California
| | - Darren E Casteel
- Department of Medicine, University of California at San Diego, La Jolla, California
| | - Richard L Klemke
- Department of Pathology & Laboratory Medicine, University of California at San Diego, La Jolla, California
| | - Gerry R Boss
- Department of Medicine, University of California at San Diego, La Jolla, California
| | - Donna E Hansel
- Department of Pathology & Laboratory Medicine, Oregon Health & Science University, Portland, Oregon.
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16
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Tat J, Heskett K, Satomi S, Pilz RB, Golomb BA, Boss GR. Sodium azide poisoning: a narrative review. Clin Toxicol (Phila) 2021; 59:683-697. [PMID: 34128439 PMCID: PMC8349855 DOI: 10.1080/15563650.2021.1906888] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 12/30/2022]
Abstract
CONTEXT Sodium azide is a highly toxic chemical. Its production has increased dramatically over the last 30 years due to its widespread use in vehicular airbags, and it is available for purchase online. Thus, accidental exposure to azide or use as a homicidal or suicidal agent could be on the rise, and secondary exposure to medical personnel can occur. No antidote exists for azide poisoning. We conducted a systematic review of azide poisoning to assess recent poisoning reports, exposure scenarios, clinical presentations, and treatment strategies. METHODS We searched both medical and newspaper databases to review the literature between 01/01/2000 and 12/31/2020, pairing the controlled vocabulary and keyword terms "sodium azide" or "hydrazoic acid" with terms relating to exposures and outcomes, such as "ingestion," "inhalation," "exposure," "poisoning," and "death." We included all peer-reviewed papers and news articles describing human azide poisoning cases from English and non-English publications that could be identified using English keywords. Data abstracted included the number, age, and gender of cases, mode of exposure, exposure setting, azide dose and route of exposure, symptoms, outcome, and treatment modalities. RESULTS We identified 663 peer-reviewed papers and 303 newspaper articles. After removing duplicated and non-qualifying sources, 54 publications were reviewed describing 156 cases, yielding an average of 7.8 reported azide poisoning cases per year. This rate is three times higher than in a previous review covering the period of 1927 to 1999. Poisoning occurred most commonly in laboratory workers, during secondary exposure of medical personnel, or from a ripped airbag. Hypotension occurred commonly, in some cases requiring vasopressors and one patient received an intra-aortic ballon pump. Gastric lavage and/or activated charcoal were used for oral azide ingestion, and sodium nitrite, sodium thiosulfate, and/or hydroxocobalamin were used in severely poisoned patients. CONCLUSIONS Recent increases in azide poisoning reports may stem from greater commercial use and availability. Treatment of systemic poisoning may require aggressive hemodynamic support due to profound hypotension. Based on mechanistic considerations, hydroxocobalamin is a rational choice for treating azide poisoning.
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Affiliation(s)
- John Tat
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Karen Heskett
- The Library, University of California, San Diego, La Jolla, CA, USA
| | - Shiho Satomi
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Renate B. Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Beatrice A. Golomb
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
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17
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Lu YS, Vijayakumar S, Chaix A, Pimentel BR, Bentz KC, Li S, Chan A, Wahl C, Ha JS, Hunka DE, Boss GR, Cohen SM, Sailor MJ. Remote Detection of HCN, HF, and Nerve Agent Vapors Based on Self-Referencing, Dye-Impregnated Porous Silicon Photonic Crystals. ACS Sens 2021; 6:418-428. [PMID: 33263399 DOI: 10.1021/acssensors.0c01931] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A one-dimensional photonic crystal is prepared from porous silicon (pSi) and impregnated with a chemically specific colorimetric indicator dye to provide a self-referenced vapor sensor for the selective detection of hydrogen fluoride (HF), hydrogen cyanide (HCN), and the chemical nerve agent diisopropyl fluorophosphate (DFP). The photonic crystal is prepared with two stop bands: one that coincides with the optical absorbance of the relevant activated indicator dye and the other in a spectrally "clear" region, to provide a reference. The inner pore walls of the pSi sample are then modified with octadecylsilane to provide a hydrophobic interior, and the indicator dye of interest is then loaded into the mesoporous matrix. Remote analyte detection is achieved by measurement of the intensity ratio of the two stop bands in the white light reflectance spectrum, which provides a means to reliably detect colorimetric changes in the indicator dye. Indicator dyes were chosen for their specificity for the relevant agents: rhodamine-imidazole (RDI) for HF and DFP, and monocyanocobinamide (MCbi) for HCN. The ratiometric readout allows detection of HF and HCN at concentrations (14 and 5 ppm, respectively) that are below their respective IDLH (immediately dangerous to life and health) concentrations (30 ppm for HF; 50 ppm for HCN); detection of DFP at a concentration of 114 ppb is also demonstrated. The approach is insensitive to potential interferents such as ammonia, hydrogen chloride, octane, and the 43-component mixture of VOCs known as EPA TO-14A, and to variations in relative humidity (20-80% RH). Detection of HF and HCN spiked into the complex mixture EPA TO-14A is demonstrated. The approach provides a general means to construct robust remote detection systems for chemical agents.
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Affiliation(s)
- Yi-Sheng Lu
- Materials Science and Engineering Program, University of California, San Diego, La Jolla, California 92093, United States
| | - Sanahan Vijayakumar
- Materials Science and Engineering Program, University of California, San Diego, La Jolla, California 92093, United States
| | - Arnaud Chaix
- Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, California 92093, United States
| | - Brian R. Pimentel
- Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, California 92093, United States
| | - Kyle C. Bentz
- Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, California 92093, United States
| | - Sheng Li
- Department of Medicine, University of California, San Diego, La Jolla, California 92093, United States
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, California 92093, United States
| | - Charlotte Wahl
- Leidos, 10260 Campus Point Drive, San Diego, California 92121, United States
| | - James S. Ha
- Leidos, 10260 Campus Point Drive, San Diego, California 92121, United States
| | - Deborah E. Hunka
- Leidos, 10260 Campus Point Drive, San Diego, California 92121, United States
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, California 92093, United States
| | - Seth M. Cohen
- Materials Science and Engineering Program, University of California, San Diego, La Jolla, California 92093, United States
- Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, California 92093, United States
| | - Michael J. Sailor
- Materials Science and Engineering Program, University of California, San Diego, La Jolla, California 92093, United States
- Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, California 92093, United States
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18
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Hendry-Hofer TB, Ng PC, McGrath AM, Soules K, Mukai DS, Chan A, Maddry JK, White CW, Lee J, Mahon SB, Brenner M, Boss GR, Bebarta VS. Intramuscular cobinamide as an antidote to methyl mercaptan poisoning. Inhal Toxicol 2021; 33:25-32. [PMID: 33356664 PMCID: PMC8063453 DOI: 10.1080/08958378.2020.1866123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Methyl mercaptan occurs naturally in the environment and is found in a variety of occupational settings, including the oil, paper, plastics, and pesticides industries. It is a toxic gas and deaths from methyl mercaptan exposure have occurred. The Department of Homeland Security considers it a high threat chemical agent that could be used by terrorists. Unfortunately, no specific treatment exists for methyl mercaptan poisoning. METHODS We conducted a randomized trial in 12 swine comparing no treatment to intramuscular injection of the vitamin B12 analog cobinamide (2.0 mL, 12.5 mg/kg) following acute inhalation of methyl mercaptan gas. Physiological and laboratory parameters were similar in the control and cobinamide-treated groups at baseline and at the time of treatment. RESULTS All six cobinamide-treated animals survived, whereas only one of six control animals lived (17% survival) (p = 0.0043). The cobinamide-treated animals returned to a normal breathing pattern by 3.8 ± 1.1 min after treatment (mean ± SD), while all but one animal in the control group had intermittent gasping, never regaining a normal breathing pattern. Blood pressure and arterial oxygen saturation returned to baseline values within 15 minutes of cobinamide-treatment. Plasma lactate concentration increased progressively until death (10.93 ± 6.02 mmol [mean ± SD]) in control animals, and decreased toward baseline (3.79 ± 2.93 mmol [mean ± SD]) by the end of the experiment in cobinamide-treated animals. CONCLUSION We conclude that intramuscular administration of cobinamide improves survival and clinical outcomes in a large animal model of acute, high dose methyl mercaptan poisoning.
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Affiliation(s)
- Tara B. Hendry-Hofer
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Patrick C. Ng
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Brooke Army Medical Center, Ft Sam Houston, San Antonio, Texas
| | - Alison M. McGrath
- Department of Environmental Health and Safety, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kirsten Soules
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - David S. Mukai
- Beckman Laser Institute, University of California, Irvine, California
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, California
| | - Joseph K. Maddry
- 59th Medical Wing/Science & Technology, Lackland Air Force Base, Texas,San Antonio Military Medical Center, JBSA-Ft Sam Houston, San Antonio, Texas
| | - Carl W. White
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Jangwoen Lee
- Beckman Laser Institute, University of California, Irvine, California
| | - Sari B. Mahon
- Beckman Laser Institute, University of California, Irvine, California
| | - Matthew Brenner
- Beckman Laser Institute, University of California, Irvine, California
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, California
| | - Vikhyat S. Bebarta
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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19
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Wahwah N, Dhar D, Chen H, Zhuang S, Chan A, Casteel DE, Kalyanaraman H, Pilz RB, Boss GR. Metabolic interaction between amino acid deprivation and cisplatin synergistically reduces phosphoribosyl-pyrophosphate and augments cisplatin cytotoxicity. Sci Rep 2020; 10:19907. [PMID: 33199755 PMCID: PMC7670436 DOI: 10.1038/s41598-020-76958-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/04/2020] [Indexed: 11/09/2022] Open
Abstract
Cisplatin is a mainstay of cancer chemotherapy. It forms DNA adducts, thereby activating poly(ADP-ribose) polymerases (PARPs) to initiate DNA repair. The PARP substrate NAD+ is synthesized from 5-phosphoribose-1-pyrophosphate (PRPP), and we found that treating cells for 6 h with cisplatin reduced intracellular PRPP availability. The decrease in PRPP was likely from (1) increased PRPP consumption, because cisplatin increased protein PARylation and PARP1 shRNA knock-down returned PRPP towards normal, and (2) decreased intracellular phosphate, which down-regulated PRPP synthetase activity. Depriving cells of a single essential amino acid decreased PRPP synthetase activity with a half-life of ~ 8 h, and combining cisplatin and amino acid deprivation synergistically reduced intracellular PRPP. PRPP is a rate-limiting substrate for purine nucleotide synthesis, and cisplatin inhibited de novo purine synthesis and DNA synthesis, with amino acid deprivation augmenting cisplatin’s effects. Amino acid deprivation enhanced cisplatin’s cytotoxicity, increasing cellular apoptosis and DNA strand breaks in vitro, and intermittent deprivation of lysine combined with a sub-therapeutic dose of cisplatin inhibited growth of ectopic hepatomas in mice. Augmentation of cisplatin’s biochemical and cytotoxic effects by amino acid deprivation suggest that intermittent deprivation of an essential amino acid could allow dose reduction of cisplatin; this could reduce the drug’s side effects, and allow its use in cisplatin-resistant tumors.
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Affiliation(s)
- Nisreen Wahwah
- Department of Medicine, University of California, San Diego, La Jolla, CA, 92093-0652, USA
| | - Debanjan Dhar
- Department of Medicine, University of California, San Diego, La Jolla, CA, 92093-0652, USA
| | - Hui Chen
- Department of Medicine, University of California, San Diego, La Jolla, CA, 92093-0652, USA
| | - Shunhui Zhuang
- Department of Medicine, University of California, San Diego, La Jolla, CA, 92093-0652, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA, 92093-0652, USA
| | - Darren E Casteel
- Department of Medicine, University of California, San Diego, La Jolla, CA, 92093-0652, USA
| | - Hema Kalyanaraman
- Department of Medicine, University of California, San Diego, La Jolla, CA, 92093-0652, USA
| | - Renate B Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA, 92093-0652, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA, 92093-0652, USA.
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20
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Abstract
This cross-sectional study assesses the association between blood donation and willingness to register as an organ donor among California high school students.
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Affiliation(s)
- John Tat
- Department of Medicine, University of California, San Diego, La Jolla
| | - Barton Hays
- San Diego Science Educators Association, San Diego, California
| | | | - Alexander Kuo
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California
| | - Renate B. Pilz
- Department of Medicine, University of California, San Diego, La Jolla
| | | | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla
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21
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Hendry-Hofer TB, Ng PC, McGrath AM, Mukai D, Brenner M, Mahon S, Maddry JK, Boss GR, Bebarta VS. Intramuscular aminotetrazole cobinamide as a treatment for inhaled hydrogen sulfide poisoning in a large swine model. Ann N Y Acad Sci 2020; 1479:159-167. [PMID: 32233102 DOI: 10.1111/nyas.14339] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/28/2020] [Accepted: 03/06/2020] [Indexed: 01/28/2023]
Abstract
Hydrogen sulfide (H2 S), a high-threat chemical agent, occurs naturally in a variety of settings. Despite multiple incidents of exposures and deaths, no FDA-approved antidote exists. A rapid-acting, easy to administer antidote is needed. We conducted a randomized control trial in swine comparing intramuscular administration of aminotetrazole cobinamide (2.9 mL, 18 mg/kg) to no treatment following inhalation of H2 S gas. We found that aminotetrazole cobinamide administered 2 min after the onset of respiratory depression-defined as a tidal volume of less than 3 mL/kg for 2 consecutive minutes-yielded 100% survival, while all control animals died. Respiratory depression resolved in the treatment group within 3.6 ± 1.5 min (mean ± SD) of cobinamide administration, whereas control animals had intermittent gasping until death. Blood pressure and arterial oxygen saturation (SO2 ) returned to baseline values within 5 and 10 min, respectively, of cobinamide treatment, and plasma lactate concentration decreased to less than 50% of the highest value by the end of the experiment. In control animals, plasma lactate rose continuously until death. We conclude that intramuscular aminotetrazole cobinamide is effective in a large animal, inhalational model of acute, severe H2 S poisoning.
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Affiliation(s)
- Tara B Hendry-Hofer
- Department of Emergency Medicine, School of Medicine, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado
| | - Patrick C Ng
- Department of Emergency Medicine, School of Medicine, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado.,Brooke Army Medical Center, Ft Sam Houston, San Antonio, Texas
| | - Alison M McGrath
- Department of Environmental Health and Safety, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado
| | - David Mukai
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California
| | - Matthew Brenner
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California
| | - Sari Mahon
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California
| | - Joseph K Maddry
- Brooke Army Medical Center, Ft Sam Houston, San Antonio, Texas.,59th Medical Wing/Science & Technology, Lackland Air Force Base, Lackland AFB, Texas
| | - Gerry R Boss
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Vikhyat S Bebarta
- Department of Emergency Medicine, School of Medicine, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado.,Office of the Chief Scientist, US Air Force Reserve, Joint Base San Antonio-Lackland, San Antonio, Texas
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22
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Schwaerzer GK, Kalyanaraman H, Casteel DE, Dalton ND, Gu Y, Lee S, Zhuang S, Wahwah N, Schilling JM, Patel HH, Zhang Q, Makino A, Milewicz DM, Peterson KL, Boss GR, Pilz RB. Aortic pathology from protein kinase G activation is prevented by an antioxidant vitamin B 12 analog. Nat Commun 2019; 10:3533. [PMID: 31387997 PMCID: PMC6684604 DOI: 10.1038/s41467-019-11389-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 07/11/2019] [Indexed: 01/08/2023] Open
Abstract
People heterozygous for an activating mutation in protein kinase G1 (PRKG1, p.Arg177Gln) develop thoracic aortic aneurysms and dissections (TAAD) as young adults. Here we report that mice heterozygous for the mutation have a three-fold increase in basal protein kinase G (PKG) activity, and develop age-dependent aortic dilation. Prkg1R177Q/+ aortas show increased smooth muscle cell apoptosis, elastin fiber breaks, and oxidative stress compared to aortas from wild type littermates. Transverse aortic constriction (TAC)—to increase wall stress in the ascending aorta—induces severe aortic pathology and mortality from aortic rupture in young mutant mice. The free radical-neutralizing vitamin B12-analog cobinamide completely prevents age-related aortic wall degeneration, and the unrelated anti-oxidant N-acetylcysteine ameliorates TAC-induced pathology. Thus, increased basal PKG activity induces oxidative stress in the aorta, raising concern about the widespread clinical use of PKG-activating drugs. Cobinamide could be a treatment for aortic aneurysms where oxidative stress contributes to the disease, including Marfan syndrome. Individuals carrying a gain-of-function mutation in PKG1 develop thoracic aortic aneurysms and dissections. Here Schwaerzer et al. show that mice carrying the same mutation recapitulate the human disease, and find that treatment with anti-oxidants including cobinamide, a vitamin B12 analog, prevents disease progression.
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Affiliation(s)
- Gerburg K Schwaerzer
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Hema Kalyanaraman
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Darren E Casteel
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Nancy D Dalton
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Yusu Gu
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Seunghoe Lee
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Shunhui Zhuang
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Nisreen Wahwah
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Jan M Schilling
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, 92093, USA
| | - Hemal H Patel
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, 92093, USA
| | - Qian Zhang
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Ayako Makino
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Dianna M Milewicz
- Division of Medical Genetics and Cardiology, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Kirk L Peterson
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Gerry R Boss
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Renate B Pilz
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA.
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23
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Ng PC, Hendry-Hofer TB, Witeof AE, Mahon SB, Brenner M, Boss GR, Bebarta VS. Efficacy of Oral Administration of Sodium Thiosulfate and Glycine in a Large, Swine Model of Oral Cyanide Toxicity. Ann Emerg Med 2019; 74:423-429. [PMID: 31080026 DOI: 10.1016/j.annemergmed.2019.03.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 02/08/2019] [Accepted: 03/19/2019] [Indexed: 01/16/2023]
Abstract
STUDY OBJECTIVE Cyanide is a deadly poison, particularly with oral exposure, in which larger doses can occur before any symptoms develop. Multiple governmental agencies highlight oral cyanide as an agent that can be used in a terrorist attack because it can be easily weaponized and is readily available. Currently, there are no Food and Drug Administration-approved antidotes specifically for oral cyanide. An oral countermeasure that can neutralize and prevent absorption of cyanide from the gastrointestinal tract after oral exposure is needed. The objective of this study is to determine if the combination of glycine and sodium thiosulfate administered orally is effective in reducing mortality in a large, swine model of oral cyanide toxicity. METHODS Nine swine (45 to 55 kg) were instrumented, sedated, and stabilized. Potassium cyanide (at 8 mg/kg) in saline solution was delivered as a onetime bolus through an orogastric tube. Three minutes after cyanide administration, animals that were randomized to the treatment group received sodium thiosulfate (508.2 mg/kg, 3.25-M solution) and glycine (30 mg/kg, 3.5-M solution) through an orogastric tube. Survival at 60 minutes was the primary outcome. We compared survival between groups by log-rank Mantel-Cox analysis and trended laboratory results and vital signs. RESULTS At baseline and treatment, all animals were similar. Survival at 60 minutes was 100% in treated animals compared with 0% in the control group (P=.003). By the study end, defined as death or 60 minutes after cyanide administration, there was a significant difference in the lactate concentration between the treatment and control groups (control 9.43 mmol/L [SD 4.08]; treatment 1.66 mmol/L [SD 0.82]; difference between means 7.69 mmol/L [SD 2.07]; 95% confidence interval difference -14.05 to -1.32). Mean arterial pressure was significantly different between the treatment and control groups at study end (control 26 mm Hg [SD 6.7]; treatment 81 mm Hg [SD 14]; difference between means 55.2 mm Hg [SD 7.1]; 95% confidence interval difference 37.8 to 72.6). pH and oxygen saturation were also significantly different between the treatment and control groups at study end. CONCLUSION The combination of oral sodium thiosulfate and glycine significantly improved survival and physiologic parameters in a large-animal model of oral cyanide toxicity.
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Affiliation(s)
- Patrick C Ng
- Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO; Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Tara B Hendry-Hofer
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Alyssa E Witeof
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Sari B Mahon
- Laser Microbeam and Medical Program, Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA
| | - Matthew Brenner
- Laser Microbeam and Medical Program, Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA; Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, Irvine, CA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, CA
| | - Vikhyat S Bebarta
- Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO; Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
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24
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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: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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25
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Petrikovics I, Kiss L, Chou CE, Ebrahimpour A, Kovács K, Kiss M, Logue B, Chan A, Manage ABW, Budai M, Boss GR, Rockwood GA. Antidotal efficacies of the cyanide antidote candidate dimethyl trisulfide alone and in combination with cobinamide derivatives. Toxicol Mech Methods 2019; 29:438-444. [DOI: 10.1080/15376516.2019.1585504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Ilona Petrikovics
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Lóránd Kiss
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Ching-En Chou
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Afshin Ebrahimpour
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Kristóf Kovács
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Márton Kiss
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Brian Logue
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, CA, USA
| | - Ananda B. W. Manage
- Department of Mathematics and Statistics, Sam Houston State University, Huntsville, TX, USA
| | - Marianna Budai
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, CA, USA
| | - Gary A. Rockwood
- US Army Medical Research Institute of Chemical Defense, APG, MD, USA
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Hendry-Hofer TB, Witeof AE, Ng PC, Mahon SB, Brenner M, Boss GR, Bebarta VS. Intramuscular sodium tetrathionate as an antidote in a clinically relevant swine model of acute cyanide toxicity. Clin Toxicol (Phila) 2019; 58:29-35. [PMID: 31008657 DOI: 10.1080/15563650.2019.1602272] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: Cyanide is a metabolic poison used in multiple industries and is a high threat chemical agent. Current antidotes require intravenous administration, limiting their usefulness in a mass casualty scenario. Sodium tetrathionate reacts directly with cyanide yielding thiosulfate and the non-toxic compound thiocyanate. Thiosulfate, in turn, neutralizes a second molecule of cyanide, thus, per mole, sodium tetrathionate neutralizes two moles of cyanide. Historical studies examined its efficacy as a cyanide antidote, but it has not been evaluated in a clinically relevant, large animal model, nor has it previously been administered by intramuscular injection.Objective: The objective of this study is to evaluate the efficacy of intramuscular sodium tetrathionate on survival and clinical outcomes in a large, swine model of severe cyanide toxicity.Methods: Anesthetized swine were instrumented for continuous monitoring of hemodynamics, then acclimated and breathing spontaneously prior to potassium cyanide infusion (0.17 mg/kg/min). At 6-min post-apnea (no breaths for 20 s), the cyanide infusion was terminated, and animals were treated with sodium tetrathionate (∼18 mg/kg) or normal saline control. Clinical parameters and laboratory values were evaluated at various time points until death or termination of the experiment (90 min post-treatment).Results: Laboratory values, vital signs, and time to apnea were similar in both groups at baseline and treatment. Survival in the sodium tetrathionate treated group was 100% and 17% in controls (p = 0.0043). All animals treated with sodium tetrathionate returned to breathing at a mean time of 10.85 min after antidote, and all but one control remained apneic through end of the experiment. Animals treated with tetrathionate showed improvement in blood lactate (p ≤ 0.002) starting at 30 min post-treatment. The average time to death in the control group is 63.3 ± 23.2 min. No systemic or localized adverse effects of intramuscular administration of sodium tetrathionate were observed.Conclusion: Sodium tetrathionate significantly improves survival and clinical outcomes in a large, swine model of acute cyanide poisoning.
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Affiliation(s)
- Tara B Hendry-Hofer
- Department of Emergency Medicine, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Alyssa E Witeof
- Department of Emergency Medicine, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Patrick C Ng
- Department of Emergency Medicine, School of Medicine, University of Colorado, Aurora, CO, USA.,Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USA
| | - Sari B Mahon
- Beckman Laser Institute, University of California, Irvine, Irvine, CA, USA
| | - Matthew Brenner
- Beckman Laser Institute, University of California, Irvine, Irvine, CA, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Vikhyat S Bebarta
- Department of Emergency Medicine, School of Medicine, University of Colorado, Aurora, CO, USA.,USAF Reserve, Office of the Chief Scientist, San Antonio, TX, USA
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27
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Hendry-Hofer TB, Ng PC, Witeof AE, Mahon SB, Brenner M, Boss GR, Bebarta VS. A Review on Ingested Cyanide: Risks, Clinical Presentation, Diagnostics, and Treatment Challenges. J Med Toxicol 2018; 15:128-133. [PMID: 30539383 DOI: 10.1007/s13181-018-0688-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/06/2018] [Accepted: 11/19/2018] [Indexed: 12/30/2022] Open
Abstract
Cyanide, a metabolic poison, is a rising chemial threat and ingestion is the most common route of exposure. Terrorist organizations have threatened to attack the USA and international food and water supplies. The toxicokinetics and toxicodynamics of oral cyanide are unique, resulting in high-dose exposures, severe symptoms, and slower onset of symptoms. There are no FDA-approved therapies tested for oral cyanide ingestions and no approved intramuscular or oral therapies, which would be valuable in mass casualty settings. The aim of this review is to evaluate the risks of oral cyanide and its unique toxicokinetics, as well as address the lack of available rapid diagnostics and treatments for mass casualty events. We will also review current strategies for developing new therapies. A review of the literature using the PRISMA checklist detected 7284 articles, screened 1091, and included 59 articles or other reports. Articles referenced in this review were specific to risk, clinical presentation, diagnostics, current treatments, and developing therapies. Current diagnostics of cyanide exposure can take hours or days, which can delay treatment. Moreover, current therapies for cyanide poisoning are administered intravenously and are not specifically tested for oral exposures, which can result in higher cyanide doses and unique toxicodynamics. New therapies developed for oral cyanide exposures that are easily delivered, safe, and can be administered quickly by first responders in a mass casualty event are needed. Current research is aimed at identifying an antidote that is safe, effective, easy to administer, and has a rapid onset of action.
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Affiliation(s)
- Tara B Hendry-Hofer
- Department of Emergency Medicine and Toxicology, University of Colorado School of Medicine, 12700 E. 19th Ave., Aurora, CO, 80045, USA.
| | - Patrick C Ng
- Department of Emergency Medicine and Toxicology, University of Colorado School of Medicine, 12700 E. 19th Ave., Aurora, CO, 80045, USA.,Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USA
| | - Alyssa E Witeof
- Department of Emergency Medicine and Toxicology, University of Colorado School of Medicine, 12700 E. 19th Ave., Aurora, CO, 80045, USA
| | - Sari B Mahon
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Matthew Brenner
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, CA, USA
| | - Vikhyat S Bebarta
- Department of Emergency Medicine and Toxicology, University of Colorado School of Medicine, 12700 E. 19th Ave., Aurora, CO, 80045, USA.,Office of the Chief Scientist, USAF Reserve, 59th MDW, JB, San Antonio, TX, USA
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Ng PC, Hendry-Hofer TB, Garrett N, Brenner M, Mahon SB, Maddry JK, Haouzi P, Boss GR, Gibbons TF, Araña AA, Bebarta VS. Intramuscular cobinamide versus saline for treatment of severe hydrogen sulfide toxicity in swine. Clin Toxicol (Phila) 2018; 57:189-196. [PMID: 30430872 DOI: 10.1080/15563650.2018.1504955] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Hydrogen sulfide (H2S) is found in petroleum, natural gas, and decaying organic matter. Terrorist groups have attempted to use it in enclosed spaces as a chemical weapon. Mass casualty scenarios have occurred from industrial accidents and release from oil field sites. There is no FDA approved antidote for sulfide poisoning. We have previously reported that intravenous cobinamide is effective for sulfide poisoning. A rapid-acting antidote that is easy to administer intramuscularly (IM) would be ideal for use in a prehospital setting. In this study, we assessed survival in sulfide-poisoned swine treated with IM cobinamide. METHODS Eleven swine (45-55 kg) were anesthetized, intubated, and instrumented with continuous femoral and pulmonary artery pressure monitoring. After stabilization, anesthesia was adjusted such that animals ventilated spontaneously with a FiO2 of 0.21. Sodium hydrosulfide (NaHS, 8 mg/mL) was infused intravenously at 0.9 mg/kg.min until apnea or severe hypotension. Animals were randomly assigned to receive cobinamide (4 mg/kg), or no treatment at the apnea/hypotension trigger. The NaHS infusion rate was sustained for 1.5 min post trigger, decreased to 0.2 mg/kg.min for 10 min, and then discontinued. RESULTS The amount of NaHS required to produce apnea or hypotension was not statistically different in both groups (cobinamide: 9.0 mg/kg ±6.1; saline: 5.9 mg/kg ±5.5; mean difference: -3.1, 95% CI: -11.3, 5.0). All of the cobinamide treated animals survived (5/5), none of the control (0/6) animals survived (p < .01). Mean time to return to spontaneous ventilation in the cobinamide treated animals was 3.2 (±1.1) min. Time to return to baseline systolic blood pressure (±5%) in cobinamide-treated animals was 5 min. CONCLUSION Intramuscular cobinamide was effective in improving survival in this large swine model of severe hydrogen sulfide toxicity.
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Affiliation(s)
- Patrick C Ng
- a Rocky Mountain Poison and Drug Center , Denver Health and Hospital Authority , Denver , CO , USA
| | - Tara B Hendry-Hofer
- b Department of Emergency Medicine , University of Colorado, School of Medicine , Aurora , CO , USA
| | - Norma Garrett
- c Medical Toxicology and the Department of Emergency Medicine , San Antonio Military Medical Center , San Antonio , TX , USA
| | - Matthew Brenner
- d Beckman Laser Institute , University of California, Irvine , Irvine , CA , USA
| | - Sari B Mahon
- d Beckman Laser Institute , University of California, Irvine , Irvine , CA , USA
| | - Joseph K Maddry
- e USAF En Route Care Research Center , US Army Institute of Surgical Research , San Antonio , TX , USA
| | - Philippe Haouzi
- f Division of Pulmonary and Critical Care Medicine , Pennsylvania State University, College of Medicine , Hershey , PA , USA
| | - Gerry R Boss
- g Department of Medicine , University of California, San Diego , La Jolla , CA , USA
| | - Thomas F Gibbons
- h Laboratory Services Branch , Clinical Research Division, Wilford Hall Ambulatory Surgical Center , San Antonio , TX , USA
| | - Allyson A Araña
- e USAF En Route Care Research Center , US Army Institute of Surgical Research , San Antonio , TX , USA
| | - Vikhyat S Bebarta
- b Department of Emergency Medicine , University of Colorado, School of Medicine , Aurora , CO , USA
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Morningstar J, Lee J, Hendry-Hofer T, Witeof A, Lyle LT, Knipp G, MacRae CA, Boss GR, Peterson RT, Davisson VJ, Gerszten RE, Bebarta VS, Mahon S, Brenner M, Nath AK. Intramuscular administration of hexachloroplatinate reverses cyanide-induced metabolic derangements and counteracts severe cyanide poisoning. FASEB Bioadv 2018; 1:81-92. [PMID: 31355359 PMCID: PMC6660183 DOI: 10.1096/fba.1024] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Cyanide is a highly toxic industrial chemical that is widely used by manufactures. Smoke inhalation during household fires is the most common source of cyanide poisoning while additional risks to civilians include industrial accidents and terrorist attacks. Despite the risks to large numbers of individuals, an antidote capable of administration at scale adequate for a mass casualty, prehospital scenario does not yet exist. Previously, we demonstrated that intravenous cisplatin analogues accelerate recovery from cyanide poisoning in mice and rabbits. Of the dozens of platinum‐based organometallic complexes tested, hexachloroplatinate (HCP) emerged as a promising lead compound, exhibiting strong affinity for cyanide and efficacy across model systems. Here, we show HCP is an antidote to lethal cyanide exposure and is importantly effective when delivered intramuscularly. The pharmacokinetic profile of HCP exhibited bioavailability in the systemic circulation 2.5 minutes post‐treatment and subsequent renal clearance of HCP‐cyanide. HCP restored parameters of cellular physiology including cytochrome c oxidase redox state and TCA cycle metabolism. We next validated these findings in a large animal model (swine). Finally, preclinical safety studies in mice revealed minimal toxicity. Cumulatively, these findings demonstrate that HCP is a promising lead compound for development of an intramuscular injectable cyanide antidote for mass casualty scenarios.
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Affiliation(s)
- Jordan Morningstar
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Jangwoen Lee
- Beckman Laser Institute and Department of Medicine, University of California, Irvine, CA 92697, USA
| | - Tara Hendry-Hofer
- Deparment of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Alyssa Witeof
- Deparment of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - L Tiffany Lyle
- Department of Comparative Pathology, Purdue University, West Lafayette, IN 47907, USA
| | - Gregg Knipp
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN 47907, USA
| | - Calum A MacRae
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.,Broad Institute, Cambridge, MA 02142, USA
| | - Gerry R Boss
- Deparment of Medicine, University of California, San Diego, CA 92093, USA
| | - Randall T Peterson
- Deparment of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, UT 84112 USA
| | - Vincent J Davisson
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN 47907, USA
| | - Robert E Gerszten
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA.,Broad Institute, Cambridge, MA 02142, USA
| | - Vikhyat S Bebarta
- Deparment of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Sari Mahon
- Beckman Laser Institute and Department of Medicine, University of California, Irvine, CA 92697, USA
| | - Matt Brenner
- Beckman Laser Institute and Department of Medicine, University of California, Irvine, CA 92697, USA
| | - Anjali K Nath
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA.,Broad Institute, Cambridge, MA 02142, USA
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Ng PC, Hendry-Hofer TB, Witeof AE, Brenner M, Mahon SB, Boss GR, Bebarta VS. Characterization of a Swine ( Sus scrofa) Model of Oral Potassium Cyanide Intoxication. Comp Med 2018; 68:375-379. [PMID: 30208987 DOI: 10.30802/aalas-cm-18-000041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cyanide is a readily available and potentially lethal substance. Oral exposure can result in larger doses, compared with other routes. Currently, there are no antidotes specific for use in the treatment of oral cyanide poisoning, and studies cannot be done in humans. We report on a new large animal model of oral cyanide toxicity to evaluate potential antidotes. Six female swine (Sus scrofa; weight, 45 to 55 kg) were anesthetized, intubated, and instrumented. Animals received a KCN bolus of either 5 or 8 mg/kg delivered via orogastric tube. Time to apnea was recorded; parameters monitored included heart rate, respiratory rate, blood pressure, pulse oximetry, end-tidal CO2, arterial blood gasses, and lactate concentrations. The Welch t test was used to calculate confidence intervals, mean, and standard deviation, and a Kaplan-Meier survival curve was used to compare survival between the 2 groups. At baseline, all animals in both groups were similar. Animals in the 5-mg/kg group had a more rapid time to apnea (5.1 ± 2.1 min), longer time to death (48.5 ± 38.1 min), and a greater rate of survival than the 8-mg/kg group (apnea, 10.6 ± 10.7 min; death, 26.1 ± 5.8 min). All animals displayed signs of toxicity (acidemia, hyperlactatemia, hypotension, apnea). We here report a large animal (swine) model of oral cyanide poisoning with dose-dependent effects in regard to time to death and survival rate. This model likely will be valuable for the development of medical countermeasures for oral cyanide poisoning.
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Affiliation(s)
- Patrick C Ng
- Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, Colorado, USA; Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
| | - Tara B Hendry-Hofer
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Alyssa E Witeof
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Matthew Brenner
- Laser Microbeam and Medical Program, Beckman Laser Institute and Medical Clinic, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, Irvine, California, USA
| | - Sari B Mahon
- Laser Microbeam and Medical Program, Beckman Laser Institute and Medical Clinic, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Vikhyat S Bebarta
- Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, Colorado, USA; Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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31
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Sahu D, Klemke R, Boss GR, Hansel DE. Role of mTORC2 and Nitric oxide in Bladder Cancer Invasion. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.804.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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32
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Anantharam P, Whitley EM, Mahama B, Kim DS, Sarkar S, Santana C, Chan A, Kanthasamy AG, Kanthasamy A, Boss GR, Rumbeiha WK. Cobinamide is effective for treatment of hydrogen sulfide-induced neurological sequelae in a mouse model. Ann N Y Acad Sci 2017; 1408:61-78. [PMID: 29239480 DOI: 10.1111/nyas.13559] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/16/2017] [Accepted: 10/30/2017] [Indexed: 12/21/2022]
Abstract
Hydrogen sulfide (H2 S) is a highly neurotoxic gas. Acute exposure can lead to neurological sequelae among survivors. A drug for treating neurological sequelae in survivors of acute H2 S intoxication is needed. Using a novel mouse model we evaluated the efficacy of cobinamide (Cob) for increasing survival of, and reducing neurological sequalae in, mice exposed to sublethal doses of H2 S. There were two objectives: (1) to determine the dose-response efficacy of Cob and (2) to determine the effective therapeutic time window of Cob. To explore objective 1, mice were injected intramuscularly with Cob at 0, 50, or 100 mg/kg at 2 min after H2 S exposure. For objective 2, mice were injected intramuscularly with 100 mg/kg Cob at 2, 15, and 30 min after H2 S exposure. For both objectives, mice were exposed to 765 ppm of H2 S gas. Cob significantly reduced H2 S-induced lethality in a dose-dependent manner (P < 0.05). Cob-treated mice exhibited significantly fewer seizures and knockdowns compared with the H2 S-exposed group. Cob also reversed H2 S-induced weight loss, behavioral deficits, neurochemical changes, cytochrome c oxidase enzyme inhibition, and neurodegeneration in a dose- and time-dependent manner (P < 0.01). Overall, these findings show that Cob increases survival and is neuroprotective in a mouse model of H2 S-induced neurological sequelae.
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Affiliation(s)
- Poojya Anantharam
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, Iowa
| | | | - Belinda Mahama
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, Iowa
| | - Dong-Suk Kim
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, Iowa
| | - Souvarish Sarkar
- Department of Biomedical Sciences, Iowa State University, Ames, Iowa
| | - Cristina Santana
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, Iowa
| | - Adriano Chan
- Department of Biomedical Sciences, Iowa State University, Ames, Iowa
| | | | - Arthi Kanthasamy
- Department of Biomedical Sciences, Iowa State University, Ames, Iowa
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, San Diego, California
| | - Wilson K Rumbeiha
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, Iowa
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Abstract
An inexpensive red, green, blue (RGB) color sensor was developed for detecting low ppm concentrations of hydrogen cyanide gas. A piece of glass fiber filter paper containing monocyanocobinamide [CN(H2O)Cbi] was placed directly above the RGB color sensor and an on chip LED. Light reflected from the paper was monitored for RGB color change upon exposure to hydrogen cyanide at concentrations of 1.0-10.0 ppm as a function of 25%, 50%, and 85% relative humidity. A rapid color change occurred within 10 s of exposure to 5.0 ppm hydrogen cyanide gas (near the NIOSH recommended exposure limit). A more rapid color change occurred at higher humidity, suggesting a more effective reaction between hydrogen cyanide and CN(H2O)Cbi. The sensor could provide the first real time respirator end-of-service-life alert for hydrogen cyanide gas.
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Affiliation(s)
- Lee A. Greenawald
- National
Institute for Occupational Safety and Health, National Personal Protective
Technology Laboratory, Evaluation and Testing Branch (CDC/NIOSH/NPPTL/ETB), Centers for Disease Control and Prevention, 1095 Willowdale Road, Morgantown, West Virginia 26505, United States
| | - Gerry R. Boss
- Department
of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | | | - Aaron Reeder
- National
Institute for Occupational Safety and Health, National Personal Protective
Technology Laboratory, Evaluation and Testing Branch (CDC/NIOSH/NPPTL/ETB), Centers for Disease Control and Prevention, 626 Cochrans Mill Road, Pittsburgh, Pennsylvania 15236, United States
| | - Suzanne Bell
- C.
Eugene Bennett Department of Chemistry, West Virginia University, 217 Clark Hall, Morgantown, West Virginia 26506, United States
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34
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Bebarta VS, Garrett N, Brenner M, Mahon SB, Maddry JK, Boudreau S, Castaneda M, Boss GR. Efficacy of Intravenous Cobinamide Versus Hydroxocobalamin or Saline for Treatment of Severe Hydrogen Sulfide Toxicity in a Swine (Sus scrofa) Model. Acad Emerg Med 2017; 24:1088-1098. [PMID: 28472554 DOI: 10.1111/acem.13213] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/22/2017] [Accepted: 04/27/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Hydrogen sulfide (H2 S) is a potentially deadly gas that naturally occurs in petroleum and natural gas. The Occupational Health and Safety Administration cites H2 S as a leading cause of workplace gas inhalation deaths. Mass casualties of H2 S toxicity may be caused by exposure from industrial accidents or release from oil field sites. H2 S is also an attractive terrorism tool because of its high toxicity and ease with which it can be produced. Several potential antidotes have been proposed for hydrogen sulfide poisoning but none have been completely successful. OBJECTIVE The objective was to compare treatment response assessed by the time to spontaneous ventilation among groups of swine with acute H2 S-induced apnea treated with intravenous (IV) cobinamide (4 mg/kg in 0.8 mL of 225 mmol/L solution), IV hydroxocobalamin (4 mg/kg in 5 mL of saline), or saline alone. METHODS Twenty-four swine (45-55 kg) were anesthetized, intubated, and instrumented with continuous femoral and pulmonary artery pressure monitoring. After stabilization, anesthesia was adjusted such that animals would spontaneously ventilate with an FiO2 of 0.21. Sodium hydrosulfide (NaHS; concentration of 8 mg/mL) was begun at 1 mg/kg/min until apnea was confirmed for 20 seconds by capnography. This infusion rate was sustained for 1.5 minutes postapnea and then decreased to a maintenance rate for the remainder of the study to replicate sustained clinical exposure. Animals were randomly assigned to receive cobinamide (4 mg/kg), hydroxocobalamin (4 mg/kg), or saline and monitored for 60 minutes beginning 1 minute postapnea. G* power analysis using the Z-test determined that equal group sizes of eight animals were needed to achieve a power of 80% in detecting a 50% difference in return to spontaneous ventilations at α = 0.05. RESULTS There were no significant differences in baseline variables. Moreover, there were no significant differences in the mg/kg dose of NaHS (5.6 mg/kg; p = 0.45) required to produce apnea. Whereas all of the cobinamide-treated animals survived (8/8), none of the control (0/8) or hydroxocobalamin (0/8)-treated animals survived. Mean (±SD) time to spontaneous ventilation in the cobinamide-treated animals was 3.2 (±1.1) minutes. CONCLUSIONS Cobinamide successfully rescued the severely NaHS-poisoned swine from apnea in the absence of assisted ventilation.
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Affiliation(s)
- Vikhyat S. Bebarta
- Department of Emergency Medicine; University of Colorado Denver-Anschutz Medical Campus; Aurora CO
| | - Normalynn Garrett
- CREST Research Program; Department of Emergency Medicine; San Antonio Military Medical Center; San Antonio TX
| | - Matthew Brenner
- Beckman Laser Institute and Medical Clinic; University of California at Irvine; Irvine CA
| | - Sari B Mahon
- Beckman Laser Institute and Medical Clinic; University of California at Irvine; Irvine CA
| | - Joseph K. Maddry
- Air Force En Route Care Research Center; San Antonio TX
- CREST Research Program; Department of Emergency Medicine; San Antonio Military Medical Center; San Antonio TX
| | - Susan Boudreau
- CREST Research Program; Department of Emergency Medicine; San Antonio Military Medical Center; San Antonio TX
| | - Maria Castaneda
- CREST Research Program; Department of Emergency Medicine; San Antonio Military Medical Center; San Antonio TX
| | - Gerry R. Boss
- Department of Medicine; University of California at San Diego; La Jolla CA
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35
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Garcia-Carbonell R, Divakaruni AS, Lodi A, Vicente-Suarez I, Saha A, Cheroutre H, Boss GR, Tiziani S, Murphy AN, Guma M. Critical Role of Glucose Metabolism in Rheumatoid Arthritis Fibroblast-like Synoviocytes. Arthritis Rheumatol 2017; 68:1614-26. [PMID: 26815411 DOI: 10.1002/art.39608] [Citation(s) in RCA: 183] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 01/19/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Up-regulation of glucose metabolism has been implicated not only in tumor cell growth but also in immune cells upon activation. However, little is known about the metabolite profile in rheumatoid arthritis (RA), particularly in fibroblast-like synoviocytes (FLS). This study was undertaken to evaluate whether changes in glucose metabolism in RA FLS could play a role in inflammation and joint damage. METHODS Synovium and FLS were obtained from patients with RA and patients with osteoarthritis (OA). The rate of glycolysis after stimulation of FLS with lipopolysaccharide and platelet-derived growth factor BB was measured using glycolysis stress test technology. FLS function was evaluated using a glycolysis inhibitor, 2-deoxy-d-glucose (2-DG). After stimulation of the FLS, a migration scratch assay, MTT assay, and enzyme-linked immunosorbent assay were performed to measure the effect of 2-DG on FLS migration, viability of the FLS, and cytokine secretion, respectively. IRDye 800CW 2-DG was used to assess glucose uptake in the arthritic joints and stromal cells of mice after K/BxN mouse serum transfer. The mice were injected daily, intraperitoneally, with 3-bromopyruvate (BrPa; 5 mg/kg) to assess the effect of inhibition of glycolysis in vivo. RESULTS Compared to human OA FLS, the balance between glycolysis and oxidative phosphorylation was shifted toward glycolysis in RA FLS. Glucose transporter 1 (GLUT1) messenger RNA (mRNA) expression correlated with baseline functions of the RA FLS. Glucose deprivation or incubation of the FLS with glycolytic inhibitors impaired cytokine secretion and decreased the rate of proliferation and migration of the cells. In a mouse model of inflammatory arthritis, GLUT1 mRNA expression in the synovial lining cells was observed, and increased levels of glucose uptake and glycolytic gene expression were detected in the stromal compartment of the arthritic mouse joints. Inhibition of glycolysis by BrPa, administered in vivo, significantly decreased the severity of arthritis in this mouse model. CONCLUSION Targeting metabolic pathways is a novel approach to understanding the mechanisms of disease. Inhibition of glycolysis may directly modulate synoviocyte-mediated inflammatory functions and could be an effective treatment strategy for arthritis.
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Affiliation(s)
| | | | | | | | - Arindam Saha
- University of California, San Diego School of Medicine, La Jolla
| | - Hilde Cheroutre
- La Jolla Institute for Allergy & Immunology, La Jolla, California
| | - Gerry R Boss
- University of California, San Diego School of Medicine, La Jolla
| | | | - Anne N Murphy
- University of California, San Diego School of Medicine, La Jolla
| | - Monica Guma
- University of California, San Diego School of Medicine, La Jolla
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36
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Brenner M, Azer SM, Oh KJ, Han CH, Lee J, Mahon SB, Du X, Mukai D, Burney T, Saidian M, Chan A, Straker DI, Bebarta VS, Boss GR. Oral Glycine and Sodium Thiosulfate for Lethal Cyanide Ingestion. ACTA ACUST UNITED AC 2017; 7. [PMID: 28868209 PMCID: PMC5578424 DOI: 10.4172/2167-7972.1000355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Objective Accidental or intentional cyanide ingestion is an-ever present danger. Rapidly acting, safe, inexpensive oral cyanide antidotes are needed that can neutralize large gastrointestinal cyanide reservoirs. Since humans cannot be exposed to cyanide experimentally, we studied oral cyanide poisoning in rabbits, testing oral sodium thiosulfate with and without gastric alkalization. Setting University research laboratory. Subjects New Zealand white rabbits. Interventions Seven animal groups studied; Groups 1–5 received high dose oral NaCN (50 mg, >LD100) and were treated immediately with oral (via nasogastric tube): 1) saline, 2) glycine, 3) sodium thiosulfate or 4) sodium thiosulfate and glycine, or 5) after 2 min with intramuscular injection of sodium nitrite and sodium thiosulfate plus oral sodium thiosulfate and glycine. Groups 6–7 received moderate dose oral NaCN (25 mg, LD70) and delayed intramuscular 6) saline or 7) sodium nitrite-sodium thiosulfate. Measurements and Main Results All animals in the high dose NaCN group receiving oral saline or glycine died very rapidly, with a trend towards delayed death in glycine-treated animals; saline versus glycine-treated animals died at 10.3+3.9 and 14.6+5.9 min, respectively (p=0.13). In contrast, all sodium thiosulfate-treated high dose cyanide animals survived (p<0.01), with more rapid recovery in animals receiving both thiosulfate and glycine, compared to thiosulfate alone (p<0.03). Delayed intramuscular treatment alone in the moderate cyanide dose animals increased survival over control animals from 30% to 71%. Delayed treatment in high dose cyanide animals was not as effective as immediate treatment, but did increase survival time and rescued 29% of animals (p<0.01 versus cyanide alone). Conclusions Oral sodium thiosulfate with gastric alkalization rescued animals from lethal doses of ingested cyanide. The combination of oral glycine and sodium thiosulfate may have potential for treating high dose acute cyanide ingestion and merits further investigation. The combination of systemic and oral therapy may provide further options.
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Affiliation(s)
- Matthew Brenner
- Beckman Laser Institute, University of California, Irvine, California, USA.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, Irvine, California, USA
| | - Sarah M Azer
- Beckman Laser Institute, University of California, Irvine, California, USA
| | - Kyung-Jin Oh
- Department of Urology, Chonnam National University Medical School, South Korea
| | - Chang Hoon Han
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Geonggi-do, South Korea
| | - Jangwoen Lee
- Beckman Laser Institute, University of California, Irvine, California, USA
| | - Sari B Mahon
- Beckman Laser Institute, University of California, Irvine, California, USA
| | - Xiaohua Du
- Pulmonary Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - David Mukai
- Beckman Laser Institute, University of California, Irvine, California, USA
| | - Tanya Burney
- Beckman Laser Institute, University of California, Irvine, California, USA
| | - Mayer Saidian
- Beckman Laser Institute, University of California, Irvine, California, USA.,The Institute for Drug Research, School of Pharmacy, Hebrew University of Jerusalem, Jerusalem Israel
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Derek I Straker
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Vikhyat S Bebarta
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
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37
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Nath AK, Shi X, Harrison DL, Morningstar JE, Mahon S, Chan A, Sips P, Lee J, MacRae CA, Boss GR, Brenner M, Gerszten RE, Peterson RT. Cisplatin Analogs Confer Protection against Cyanide Poisoning. Cell Chem Biol 2017; 24:565-575.e4. [PMID: 28416275 DOI: 10.1016/j.chembiol.2017.03.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 01/19/2017] [Accepted: 03/16/2017] [Indexed: 02/04/2023]
Abstract
Cisplatin holds an illustrious position in the history of chemistry most notably for its role in the virtual cure of testicular cancer. Here we describe a role for this small molecule in cyanide detoxification in vivo. Cyanide kills organisms as diverse as insects, fish, and humans within seconds to hours. Current antidotes exhibit limited efficacy and are not amenable to mass distribution requiring the development of new classes of antidotes. The binding affinity of the cyanide anion for the positively charged metal platinum is known to create an extremely stable complex in vitro. We therefore screened a panel of diverse cisplatin analogs and identified compounds that conferred protection from cyanide poisoning in zebrafish, mice, and rabbits. Cumulatively, this discovery pipeline begins to establish the characteristics of platinum ligands that influence their solubility, toxicity, and efficacy, and provides proof of concept that platinum-based complexes are effective antidotes for cyanide poisoning.
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Affiliation(s)
- Anjali K Nath
- Division of Cardiology, Department of Medicine, Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA 02129, USA; Department of Systems Biology, Harvard Medical School, Boston, MA 02215, USA; Broad Institute, Cambridge, MA 02142, USA.
| | - Xu Shi
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Devin L Harrison
- Division of Cardiology, Department of Medicine, Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA 02129, USA; Department of Systems Biology, Harvard Medical School, Boston, MA 02215, USA
| | - Jordan E Morningstar
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Sari Mahon
- Department of Medicine, Beckman Laser Institute, University of California, Irvine, CA 92697, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Patrick Sips
- Division of Cardiology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Jangwoen Lee
- Department of Medicine, Beckman Laser Institute, University of California, Irvine, CA 92697, USA
| | - Calum A MacRae
- Broad Institute, Cambridge, MA 02142, USA; Division of Cardiology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Matthew Brenner
- Department of Medicine, Beckman Laser Institute, University of California, Irvine, CA 92697, USA
| | - Robert E Gerszten
- Broad Institute, Cambridge, MA 02142, USA; Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Randall T Peterson
- Division of Cardiology, Department of Medicine, Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA 02129, USA; Department of Systems Biology, Harvard Medical School, Boston, MA 02215, USA; Broad Institute, Cambridge, MA 02142, USA.
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Kalyanaraman H, Ramdani G, Joshua J, Schall N, Boss GR, Cory E, Sah RL, Casteel DE, Pilz RB. A Novel, Direct NO Donor Regulates Osteoblast and Osteoclast Functions and Increases Bone Mass in Ovariectomized Mice. J Bone Miner Res 2017; 32:46-59. [PMID: 27391172 PMCID: PMC5199609 DOI: 10.1002/jbmr.2909] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 07/01/2016] [Accepted: 07/05/2016] [Indexed: 01/06/2023]
Abstract
Most US Food and Drug Administration (FDA)-approved treatments for osteoporosis target osteoclastic bone resorption. Only PTH derivatives improve bone formation, but they have drawbacks, and novel bone-anabolic agents are needed. Nitrates, which generate NO, improved BMD in estrogen-deficient rats and may improve bone formation markers and BMD in postmenopausal women. However, nitrates are limited by induction of oxidative stress and development of tolerance, and may increase cardiovascular mortality after long-term use. Here we studied nitrosyl-cobinamide (NO-Cbi), a novel, direct NO-releasing agent, in a mouse model of estrogen deficiency-induced osteoporosis. In murine primary osteoblasts, NO-Cbi increased intracellular cGMP, Wnt/β-catenin signaling, proliferation, and osteoblastic gene expression, and protected cells from apoptosis. Correspondingly, in intact and ovariectomized (OVX) female C57Bl/6 mice, NO-Cbi increased serum cGMP concentrations, bone formation, and osteoblastic gene expression, and in OVX mice, it prevented osteocyte apoptosis. NO-Cbi reduced osteoclasts in intact mice and prevented the known increase in osteoclasts in OVX mice, partially through a reduction in the RANKL/osteoprotegerin gene expression ratio, which regulates osteoclast differentiation, and partially through direct inhibition of osteoclast differentiation, observed in vitro in the presence of excess RANKL. The positive NO effects in osteoblasts were mediated by cGMP/protein kinase G (PKG), but some of the osteoclast-inhibitory effects appeared to be cGMP-independent. NO-Cbi increased trabecular bone mass in both intact and OVX mice, consistent with its in vitro effects on osteoblasts and osteoclasts. NO-Cbi is a novel direct NO-releasing agent that, in contrast to nitrates, does not generate oxygen radicals, and combines anabolic and antiresorptive effects in bone, making it an excellent candidate for treating osteoporosis. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Hema Kalyanaraman
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Ghania Ramdani
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Jisha Joshua
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Nadine Schall
- Institute of Pharmacology and Toxicology, University of Bonn, 53105 Bonn, Germany
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Esther Cory
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093-0652
| | - Robert L. Sah
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093-0652
| | - Darren E. Casteel
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
| | - Renate B. Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652
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Bebarta VS, Brittain M, Chan A, Garrett N, Yoon D, Burney T, Mukai D, Babin M, Pilz RB, Mahon SB, Brenner M, Boss GR. Sodium Nitrite and Sodium Thiosulfate Are Effective Against Acute Cyanide Poisoning When Administered by Intramuscular Injection. Ann Emerg Med 2016; 69:718-725.e4. [PMID: 28041825 DOI: 10.1016/j.annemergmed.2016.09.034] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/16/2016] [Accepted: 09/22/2016] [Indexed: 11/29/2022]
Abstract
STUDY OBJECTIVE The 2 antidotes for acute cyanide poisoning in the United States must be administered by intravenous injection. In the out-of-hospital setting, intravenous injection is not practical, particularly for mass casualties, and intramuscular injection would be preferred. The purpose of this study is to determine whether sodium nitrite and sodium thiosulfate are effective cyanide antidotes when administered by intramuscular injection. METHODS We used a randomized, nonblinded, parallel-group study design in 3 mammalian models: cyanide gas inhalation in mice, with treatment postexposure; intravenous sodium cyanide infusion in rabbits, with severe hypotension as the trigger for treatment; and intravenous potassium cyanide infusion in pigs, with apnea as the trigger for treatment. The drugs were administered by intramuscular injection, and all 3 models were lethal in the absence of therapy. RESULTS We found that sodium nitrite and sodium thiosulfate individually rescued 100% of the mice, and that the combination of the 2 drugs rescued 73% of the rabbits and 80% of the pigs. In all 3 species, survival in treated animals was significantly better than in control animals (log rank test, P<.05). In the pigs, the drugs attenuated an increase in the plasma lactate concentration within 5 minutes postantidote injection (difference: plasma lactate, saline solution-treated versus nitrite- or thiosulfate-treated 1.76 [95% confidence interval 1.25 to 2.27]). CONCLUSION We conclude that sodium nitrite and sodium thiosulfate administered by intramuscular injection are effective against severe cyanide poisoning in 3 clinically relevant animal models of out-of-hospital emergency care.
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Affiliation(s)
- Vikhyat S Bebarta
- Department of Emergency Medicine, University of Colorado, School of Medicine, Aurora, CO
| | | | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA
| | - Norma Garrett
- Medical Toxicology and the Department of Emergency Medicine, San Antonio Military Medical Center/59 MDW, San Antonio, TX
| | - David Yoon
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA
| | - Tanya Burney
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA
| | - David Mukai
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA
| | | | - Renate B Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA
| | - Sari B Mahon
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA
| | - Matthew Brenner
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA
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Sahu D, Gupta S, Hau AM, Nakashima K, Leivo MZ, Searles SC, Elson P, Bomalaski JS, Casteel DE, Boss GR, Hansel DE. Argininosuccinate Synthetase 1 Loss in Invasive Bladder Cancer Regulates Survival through General Control Nonderepressible 2 Kinase-Mediated Eukaryotic Initiation Factor 2α Activity and Is Targetable by Pegylated Arginine Deiminase. Am J Pathol 2016; 187:200-213. [PMID: 27979310 DOI: 10.1016/j.ajpath.2016.09.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 08/10/2016] [Accepted: 09/01/2016] [Indexed: 11/29/2022]
Abstract
Loss of argininosuccinate synthetase 1 (ASS1), a key enzyme for arginine synthesis, occurs in many cancers, making cells dependent on extracellular arginine and targetable by the arginine-degrading enzyme pegylated arginine deiminase (ADI-PEG 20). We evaluated ASS1 expression and effects of ASS1 loss in bladder cancer which, despite affecting >70,000 people in the United States annually, has limited therapies. ASS1 loss was identified in conventional and micropapillary urothelial carcinoma, small cell, and squamous cell carcinoma subtypes of invasive bladder cancer, as well as in T24, J82, and UM-UC-3 but not in 5637, RT112, and RT4 cell lines. ASS1-deficient cells showed preferential sensitivity to ADI-PEG 20, evidenced by decreased colony formation, reduced cell viability, and increased sub-G1 fractions. ADI-PEG 20 induced general control nonderepressible 2-dependent eukaryotic initiation factor 2α phosphorylation and activating transcription factor 4 and C/EBP homologous protein up-regulation, associated with caspase-independent apoptosis and autophagy. These effects were ablated with selective siRNA silencing of these proteins. ASS1 overexpression in UM-UC-3 or ASS1 silencing in RT112 cells reversed these effects. ADI-PEG 20 treatment of mice bearing contralateral flank UM-UC-3 and RT112 xenografts selectively arrested tumor growth in UM-UC-3 xenografts, which had reduced tumor size, reduced Ki-67, and increased terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling staining. This suggests that ASS1 loss occurs in invasive bladder cancer and is targetable by ADI-PEG 20.
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Affiliation(s)
- Divya Sahu
- Department of Pathology, University of California at San Diego, La Jolla, California
| | - Sounak Gupta
- Department of Pathology, University of California at San Diego, La Jolla, California
| | - Andrew M Hau
- Department of Pathology, University of California at San Diego, La Jolla, California
| | - Kazufumi Nakashima
- Department of Pathology, University of California at San Diego, La Jolla, California
| | - Mariah Z Leivo
- Department of Pathology, University of California at San Diego, La Jolla, California
| | - Stephen C Searles
- Department of Pathology, University of California at San Diego, La Jolla, California
| | - Paul Elson
- Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Darren E Casteel
- Department of Medicine, University of California at San Diego, La Jolla, California
| | - Gerry R Boss
- Department of Medicine, University of California at San Diego, La Jolla, California
| | - Donna E Hansel
- Department of Pathology, University of California at San Diego, La Jolla, California.
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Broderick KE, Potluri P, Zhuang S, Scheffler IE, Sharma VS, Pilz RB, Boss GR. Cyanide Detoxification by the Cobalamin Precursor Cobinamide. Exp Biol Med (Maywood) 2016; 231:641-9. [PMID: 16636313 DOI: 10.1177/153537020623100519] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cyanide is a highly toxic agent that inhibits mitochondrial cytochrome-c oxidase, thereby depleting cellular ATP. it contributes to smoke inhalation deaths in fires and could be used as a weapon of mass destruction. Cobalamin (vitamin B12) binds cyanide with a relatively high affinity and is used in Europe to treat smoke inhalation victims. Cobinamide, the penultimate compound in cobalamin biosynthesis, binds cyanide with about 1010 greater affinity than cobalamin, and we found It was several-fold more effective than cobalamin in (i) reversing cyanide inhibition of oxidative phosphorylation in mammalian cells; (ii) rescuing mammalian cells and Drosophila melanogaster from cyanide toxicity; and (iii) reducing cyanide inhibition of Drosophila Malpighian tubule secretion. Cobinamide could be delivered by oral ingestion, inhalation, or injection to Drosophila, and it was as effective when administered up to 5 mins post-cyanide exposure as when given preexposure. We conclude that cobinamide is an effective cyanide detoxifying agent that has potential use as a cyanide antidote, both in smoke inhalation victims and in persons exposed to cyanide used as a weapon of mass destruction.
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Affiliation(s)
- Kate E Broderick
- Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0652, USA
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Greenawald LA, Boss GR, Reeder A, Bell S. Development of a Hydrogen Sulfide End-of-Service-Life Indicator for Respirator Cartridges Using Cobinamide. Sens Actuators B Chem 2016; 230:658-666. [PMID: 27022206 PMCID: PMC4807636 DOI: 10.1016/j.snb.2016.02.129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
An inexpensive paper-based sensor was developed for detecting low ppm concentrations of hydrogen sulfide gas. A piece of filter paper containing aquohydroxocobinamide [OH(H2O)Cbi] was placed on the end of a bifurcated optical fiber, and the reflectance spectrum of the OH(H2O)Cbi was monitored during exposure to 10.0 ppm hydrogen sulfide gas (NIOSH recommended exposure limit). Reaction of sulfide (HS-) yielded an increase in reflectance from 400-450 nm, and decrease from 470-550 nm. Spectral changes were monitored as a function of time at 25, 50, and 85% relative humidity. Spectral shifts at high-er humidity suggested reduction of the Cbi(III) compound. The sensor was used to detect hydrogen sulfide breakthrough from respirator carbon beds and results correlated well with a standard electrochemical detector. The simple paper-based sensor could provide a real-time end-of-service-life alert for hydrogen sulfide gas.
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Kambale KJ, Ali ER, Sadiki NH, Kayembe KP, Mvumbi LG, Yandju DL, Boivin MJ, Boss GR, Stadler DD, Lambert WE, Lasarev MR, Okitundu LA, Mumba Ngoyi D, Banea JP, Tshala-Katumbay DD. Lower sulfurtransferase detoxification rates of cyanide in konzo-A tropical spastic paralysis linked to cassava cyanogenic poisoning. Neurotoxicology 2016; 59:256-262. [PMID: 27246648 DOI: 10.1016/j.neuro.2016.05.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 11/17/2022]
Abstract
Using a matched case-control design, we sought to determine whether the odds of konzo, a distinct spastic paraparesis associated with food (cassava) cyanogenic exposure in the tropics, were associated with lower cyanide detoxification rates (CDR) and malnutrition. Children with konzo (N=122, 5-17 years of age) were age- and sex-matched with presumably healthy controls (N=87) and assessed for motor and cognition performances, cyanogenic exposure, nutritional status, and cyanide detoxification rates (CDR). Cyanogenic exposure was ascertained by thiocyanate (SCN) concentrations in plasma (P-SCN) and urine (U-SCN). Children with a height-for-age z-score (HAZNCHS)<-2 were classified as nutritionally stunted. CDR was measured as time required to convert cyanide to SCN, and expressed as ms/μmol SCN/mg protein or as mmolSCN/ml plasma/min. Mean (SD) U-SCN in children with konzo was 521.9 (353.6) μmol/l and was, significantly higher than 384.6 (223.7) μmol/l in those without konzo. Conditional regression analysis of data for age- and sex- matched case-control pairs showed that konzo was associated with stunting (OR: 5.8; 95% CI: 2.7-12.8; p<0.01; N=83 paired groups) and higher U-SCN (OR: 1.1; 95% CI: 1.02-1.20 per 50-μmol increase in U-SCN; p=0.02; N=47 paired groups). After adjusting for stunting and U-SCN, the odds of developing konzo was reduced by 63% (95% CI: 11-85%, p=0.03; N=41 paired groups) for each 5mmol SCN/(ml plasma/min)-increase in CDR. Linear regression analysis indicated a significant association between BOT-2 or KABC-II scores and both the HAZNCHS z-score and the U-SCN concentration, but not the CDR. Our findings provide evidence in support of interventions to remove cyanogenic compounds from cassava prior to human consumption or, peharps, enhance the detoxification of cyanide in those relying on the cassava as the main source of food.
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Affiliation(s)
- K J Kambale
- Department of Biomedical Sciences, University of Kinshasa, Congo-Kinshasa, Democratic Republic of the Congo
| | - E R Ali
- Department of Biology, University of Kinshasa, Congo-Kinshasa, Democratic Republic of the Congo; Institut National de Recherches Biomédicales (INRB), Congo-Kinshasa, Democratic Republic of the Congo
| | - N H Sadiki
- School of Public Health, University of Kinshasa, Congo-Kinshasa, Democratic Republic of the Congo
| | - K P Kayembe
- School of Public Health, University of Kinshasa, Congo-Kinshasa, Democratic Republic of the Congo
| | - L G Mvumbi
- Department of Biomedical Sciences, University of Kinshasa, Congo-Kinshasa, Democratic Republic of the Congo
| | - D L Yandju
- Department of Biology, University of Kinshasa, Congo-Kinshasa, Democratic Republic of the Congo
| | - M J Boivin
- Department of Psychiatry and Neurology/Ophthalmology, Michigan State University, East Lansing, MI, USA
| | - G R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - D D Stadler
- Graduate Programs in Human Nutrition, Oregon Health & Science University, Portland, OR, USA
| | - W E Lambert
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA
| | - M R Lasarev
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA; Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - L A Okitundu
- Department of Neurology, University of Kinshasa, Congo-Kinshasa, Democratic Republic of the Congo
| | - D Mumba Ngoyi
- Department of Tropical Medicine, University of Kinshasa, Congo-Kinshasa, Democratic Republic of the Congo; Institut National de Recherches Biomédicales (INRB), Congo-Kinshasa, Democratic Republic of the Congo
| | - J P Banea
- School of Public Health, University of Kinshasa, Congo-Kinshasa, Democratic Republic of the Congo; National Nutrition Program, Ministry of Health, Congo-Kinshasa, Democratic Republic of the Congo
| | - D D Tshala-Katumbay
- Department of Neurology, University of Kinshasa, Congo-Kinshasa, Democratic Republic of the Congo; Institut National de Recherches Biomédicales (INRB), Congo-Kinshasa, Democratic Republic of the Congo; Department of Neurology, Oregon Health & Science University, Portland, OR, USA.
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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: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Greenawald LA, Snyder JL, Fry NL, Sailor MJ, Boss GR, Finklea HO, Bell S. Development of a cobinamide-based end-of-service-life indicator for detection of hydrogen cyanide gas. Sens Actuators B Chem 2015; 221:379-385. [PMID: 26213448 PMCID: PMC4511729 DOI: 10.1016/j.snb.2015.06.085] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
We describe an inexpensive paper-based sensor for rapid detection of low concentrations (ppm) of hydrogen cyanide gas. A piece of filter paper pre-spotted with a dilute monocyanocobinamide [CN(H2O)Cbi] solution was placed on the end of a bifurcated optical fiber and the reflectance spectrum of the CN(H2O)Cbi was monitored during exposure to 1.0-10.0 ppm hydrogen cyanide gas. Formation of dicyanocobinamide yielded a peak at 583 nm with a simultaneous decrease in reflectance from 450-500 nm. Spectral changes were monitored as a function of time at several relative humidity values: 25, 50, and 85% relative humidity. With either cellulose or glass fiber papers, spectral changes occurred within 10 s of exposure to 5.0 ppm hydrogen cyanide gas (NIOSH recommended short-term exposure limit). We conclude that this sensor could provide a real-time end-of-service-life alert to a respirator user.
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Affiliation(s)
- Lee A. Greenawald
- Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health/National Personal Protective Technology Laboratory (CDC/NIOSH/NPPTL), 1095 Willowdale Road, Morgantown, WV 26505, USA
- Corresponding author. (L.A. Greenawald)
| | | | - Nicole L. Fry
- Department of Chemistry and Biochemistry, 9500 Gilman Drive, University of California, San Diego, La Jolla, CA 92093, USA
| | - Michael J. Sailor
- Department of Chemistry and Biochemistry, 9500 Gilman Drive, University of California, San Diego, La Jolla, CA 92093, USA
| | - Gerry R. Boss
- Department of Medicine, 9500 Gilman Drive, University of California, San Diego, La Jolla, CA 92093, USA
| | - Harry O. Finklea
- C. Eugene Bennett Department of Chemistry, 217 Clark Hall, West Virginia University, Morgantown, WV 26506, USA
| | - Suzanne Bell
- C. Eugene Bennett Department of Chemistry, 217 Clark Hall, West Virginia University, Morgantown, WV 26506, USA
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Sahu D, Gupta S, Hau AM, Elson P, Bomalaski J, Boss GR, Hansel DE. Abstract 4712: Targeting the arginine-nitric oxide pathway to arrest development and progression of invasive bladder cancer. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-4712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In United States there will be an estimated 74,690 new diagnoses and 15,580 deaths in 2014 due to bladder cancer. Lack of reliable markers of early disease and limited chemotherapy options have resulted in poor patient outcomes. A better approach is to treat patients with early intervention using targeted therapy. Arginine metabolic pathway has been identified to be deregulated in bladder cancer. Arginine is either derived from the microenvironment or synthesized by cells containing arginosuccinate synthase I (ASS1). Arginine undergoes subsequent conversion to nitric oxide (NO), which which can activate numerous intracellular signaling mediators, including guanylate cyclase (GC). We evaluated dual targeting of this metabolic pathway by arginine deprivation (ADI-PEG 20, Polaris Pharmaceuticals, San Diego, CA) and NO chelation (Cobinamide) as a therapy for bladder cancer.
Experimental Design: Expression of arginine-NO pathway components in FFPE tissue sections was assessed by IHC and correlated with histopathology, outcomes and progression to identify pathway activation during early and late disease and stratified based on moderate to strong expression (2+, 3+) compared to absent to weak expression (0, 1+). In addition, a panel of bladder cell lines was screened for arginine-NO pathway components by immunoblotting and representative ASS1 negative and positive cells were used to evaluate the effects of arginine deprivation and/or NO chelation in vitro on colony formation and cell viability by clonogenic and MTT assays. Effects of NO production on bladder cancer survival and motility was assessed utilizing siRNA gene silencing and small molecule inhibitors. Effects of arginine deprivation by ADI-PEG 20 treatment in vivo was assessed by a mouse xenograft model.
Results: Analysis of human tumors showed that ASS1 loss and increase in NOS occurred early in the course of bladder neoplastic progression. We identified loss of the ASS1 enzyme in bladder cancer cells and compensatory dependence on extracellular arginine, which can be successfully targeted using arginine removal to induce bladder cancer cell death, both in vitro and in vivo. We also identified increased nitric oxide synthase (NOS; the enzyme that catalyzes NO production) and GC activation in invasive bladder cancer cell lines. We characterized the effects of NO production on bladder cancer cell survival, growth and motility. Disruption of the NO pathway through gene silencing and small molecule inhibitors resulted in decreased cell survival, migration and invasion.
Conclusions: Thus, dual targeting of this metabolic pathway using arginine chelation by the arginine degrading enzyme ADI-PEG20 and NO scavenging by a novel compound Cobinamide can be a potential mechanism to prevent development and/or progression of early bladder neoplasia.
Citation Format: Divya Sahu, Sounak Gupta, Andrew M. Hau, Paul Elson, John Bomalaski, Gerry R. Boss, Donna E. Hansel. Targeting the arginine-nitric oxide pathway to arrest development and progression of invasive bladder cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4712. doi:10.1158/1538-7445.AM2015-4712
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Kadjo AF, Dasgupta PK, Boss GR. Comment on "Rapid visual detection of blood cyanide" by C. Männel-Croisé and F. Zelder, Analytical Methods, 2012, 4, 2632. Anal Methods 2015; 7:5707-5711. [PMID: 26640525 PMCID: PMC4670041 DOI: 10.1039/c4ay00190g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Cyanide poisoning from Inhaled HCN is all too common in victims of smoke inhalation in fires. While the toxic effects arise primarily from its inhibitory effects on cytochrome c oxidase, the majority of the cyanide binds to methemoglobin (metHb) in the blood. It can be considered as the detoxification mechanism: one of the antidotes used earlier was nitrite which primarily works by converting hemoglobin to metHb (normally present to the extent of ~1% of the total hemoglobin). Vitamin B12 (hydroxocobalamin) and related analogs have long been known to have high affinity for cyanide and has been used as antidotes - the binding of cyanide to many compounds in this general family also results in a significant change in color that can be used for analytical purposes. Männel Croisé and Zelder (Anal. Methods, 2012, 4, 2632) have advocated direct addition of a related compound to blood samples and isolating the colored measurand on a solid phase extraction cartridge. While they demonstrated attractive rapid measurement of cyanide in spiked blood samples, we believe that this is not a practically usable procedure regardless of the exact chromogenic reagent used. Cyanide bound to metHb dissociates too slowly for a 1 min reaction to work as suggested - we believe for reasons unknown (eg., metHb levels in their blood samples unusually low), cyanide added to their blood samples did not (have time to) bind to metHb and these samples may not resemble real situations where significant amount of the cyanide will be bound to metHb.
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Affiliation(s)
- Akinde F Kadjo
- Department of Chemistry and Biochemistry, University of Texas at Arlington, Arlington TX 76019-1065, USA
| | - Purnendu K Dasgupta
- Department of Chemistry and Biochemistry, University of Texas at Arlington, Arlington TX 76019-1065, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0652, USA
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Spitler R, Ho H, Norpetlian F, Kong X, Jiang J, Yokomori K, Andersen B, Boss GR, Berns MW. Combination of low level light therapy and nitrosyl-cobinamide accelerates wound healing. J Biomed Opt 2015; 20:051022. [PMID: 25562608 PMCID: PMC4284311 DOI: 10.1117/1.jbo.20.5.051022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 12/04/2014] [Indexed: 06/04/2023]
Abstract
Low level light therapy (LLLT) has numerous therapeutic benefits, including improving wound healing, but the precise mechanisms involved are not well established; in particular, the underlying role of cytochrome C oxidase (C-ox) as the primary photoacceptor and the associated biochemical mechanisms still require further investigation. We previously showed the nitric oxide (NO) donating drug nitrosyl-cobinamide (NO-Cbi) enhances wound healing through a cGMP/cGMP-dependent protein kinase/ERK1/2 mechanism. Here, we show that the combination of LLLT and NO-Cbi markedly improves wound healing compared to either treatment alone. LLLT-enhanced wound healing proceeded through an electron transport chain-C-ox-dependent mechanism with a reduction of reactive oxygen species and increased adenosine triphosphate production. C-ox was validated as the primary photoacceptor by three observations: increased oxygen consumption, reduced wound healing in the presence of sodium azide, and disassociation of cyanide, a known C-ox ligand, following LLLT. We conclude that LLLT and NO-Cbi accelerate wound healing through two independent mechanisms, the electron transport chain-C-ox pathway and cGMP signaling, respectively, with both resulting in ERK1/2 activation.
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Affiliation(s)
- Ryan Spitler
- University of California Irvine, Irvine, California 92612 United States
| | - Hsiang Ho
- University of California Irvine, Irvine, California 92612 United States
| | | | - Xiangduo Kong
- University of California Irvine, Irvine, California 92612 United States
| | - Jingjing Jiang
- University of California San Diego, La Jolla, California 92093 United States
| | - Kyoko Yokomori
- University of California Irvine, Irvine, California 92612 United States
| | - Bogi Andersen
- University of California Irvine, Irvine, California 92612 United States
| | - Gerry R. Boss
- University of California San Diego, La Jolla, California 92093 United States
| | - Michael W. Berns
- University of California Irvine, Irvine, California 92612 United States
- University of California San Diego, La Jolla, California 92093 United States
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Chan A, Jiang J, Fridman A, Guo LT, Shelton GD, Liu MT, Green C, Haushalter KJ, Patel HH, Lee J, Yoon D, Burney T, Mukai D, Mahon SB, Brenner M, Pilz RB, Boss GR. Nitrocobinamide, a new cyanide antidote that can be administered by intramuscular injection. J Med Chem 2015; 58:1750-9. [PMID: 25650735 DOI: 10.1021/jm501565k] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Currently available cyanide antidotes must be given by intravenous injection over 5-10 min, making them ill-suited for treating many people in the field, as could occur in a major fire, an industrial accident, or a terrorist attack. These scenarios call for a drug that can be given quickly, e.g., by intramuscular injection. We have shown that aquohydroxocobinamide is a potent cyanide antidote in animal models of cyanide poisoning, but it is unstable in solution and poorly absorbed after intramuscular injection. Here we show that adding sodium nitrite to cobinamide yields a stable derivative (referred to as nitrocobinamide) that rescues cyanide-poisoned mice and rabbits when given by intramuscular injection. We also show that the efficacy of nitrocobinamide is markedly enhanced by coadministering sodium thiosulfate (reducing the total injected volume), and we calculate that ∼1.4 mL each of nitrocobinamide and sodium thiosulfate should rescue a human from a lethal cyanide exposure.
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Affiliation(s)
- Adriano Chan
- Departments of †Medicine, ‡Pathology, §Chemistry and Biochemistry, and ∥Anesthesiology, University of California-San Diego , La Jolla, California 92093-0652, United States
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Bebarta VS, Tanen DA, Boudreau S, Castaneda M, Zarzabal LA, Vargas T, Boss GR. In reply. Ann Emerg Med 2015; 65:235. [PMID: 25601262 DOI: 10.1016/j.annemergmed.2014.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Vikhyat S Bebarta
- Medical Toxicology, San Antonio Military Medical Center, San Antonio, TX
| | - David A Tanen
- David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center, Torrance, CA
| | - Susan Boudreau
- Department of Emergency Medicine, San Antonio Military Medical Center, San Antonio, TX
| | - Maria Castaneda
- Department of Emergency Medicine, San Antonio Military Medical Center, San Antonio, TX
| | | | - Toni Vargas
- Office of the Chief Scientist/59(th) MDW, Wilford Hall Ambulatory Surgical Center, San Antonio, TX
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