Sodium thiosulfate: A donor or carrier signaling molecule for hydrogen sulfide?

Sodium thiosulfate has been used for decades in the treatment of calciphylaxis and cyanide detoxification, and has recently shown initial therapeutic promise in critical diseases such as neuronal ischemia, diabetes mellitus, heart failure and acute lung injury. However, the precise mechanism of sodium thiosulfate remains incompletely defined and sometimes contradictory. Although sodium thiosulfate has been widely accepted as a donor of hydrogen sulfide (H 2 S), emerging findings suggest that it is the executive signaling molecule for H 2 S and that its effects may not be dependent on H 2 S. This article presents an overview of the current understanding of sodium thiosulfate, including its synthesis, biological characteristics, and clinical applications of sodium thiosulfate, as well as the underlying mechanisms in vivo. We also discussed the interplay of sodium thiosulfate and H 2 S. Our review highlights sodium thiosulfate as a key player in sulfide signaling with the broad clinical potential for the future. [Display omitted] • The synthesis, biological properties and clinical applications of sodium thiosulfate are summarized. • The two current opposing views on the mechanism of sodium thiosulfate are also discussed in this paper. • Sodium thiosulfate is highlighted as a possible key player in sulfide signaling. [ABSTRACT FROM AUTHOR]