1. Conceptual approaches for treatment of phosgene inhalation-induced lung injury.
- Author
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Holmes WW, Keyser BM, Paradiso DC, Ray R, Andres DK, Benton BJ, Rothwell CC, Hoard-Fruchey HM, Dillman JF, Sciuto AM, and Anderson DR
- Subjects
- Animals, Disease Models, Animal, Inhalation Exposure, Lung metabolism, Lung pathology, Lung physiopathology, Lung Injury chemically induced, Lung Injury diagnosis, Lung Injury metabolism, Lung Injury physiopathology, Male, Mice, Molecular Targeted Therapy, Signal Transduction drug effects, Antidotes therapeutic use, Chemical Warfare Agents, Lung drug effects, Lung Injury drug therapy, Phosgene
- Abstract
Toxic industrial chemicals are used throughout the world to produce everyday products such as household and commercial cleaners, disinfectants, pesticides, pharmaceuticals, plastics, paper, and fertilizers. These chemicals are produced, stored, and transported in large quantities, which poses a threat to the local civilian population in cases of accidental or intentional release. Several of these chemicals have no known medical countermeasures for their toxic effects. Phosgene is a highly toxic industrial chemical which was used as a chemical warfare agent in WWI. Exposure to phosgene causes latent, non-cardiogenic pulmonary edema which can result in respiratory failure and death. The mechanisms of phosgene-induced pulmonary injury are not fully identified, and currently there is no efficacious countermeasure. Here, we provide a proposed mechanism of phosgene-induced lung injury based on the literature and from studies conducted in our lab, as well as provide results from studies designed to evaluate survival efficacy of potential therapies following whole-body phosgene exposure in mice. Several therapies were able to significantly increase 24h survival following an LCt50-70 exposure to phosgene; however, no treatment was able to fully protect against phosgene-induced mortality. These studies provide evidence that mortality following phosgene toxicity can be mitigated by neuro- and calcium-regulators, antioxidants, phosphodiesterase and endothelin receptor antagonists, angiotensin converting enzymes, and transient receptor potential cation channel inhibitors. However, because the mechanism of phosgene toxicity is multifaceted, we conclude that a single therapeutic is unlikely to be sufficient to ameliorate the multitude of direct and secondary toxic effects caused by phosgene inhalation., (Published by Elsevier Ireland Ltd.)
- Published
- 2016
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