Chelation therapy in intoxications with mercury, lead and copper

Yang Cao; Marit Aralt Skaug; Ole Andersen; Jan Aaseth

doi:10.1016/j.jtemb.2014.04.010

Chelation therapy in intoxications with mercury, lead and copper

J Trace Elem Med Biol. 2015:31:188-92. doi: 10.1016/j.jtemb.2014.04.010. Epub 2014 May 14.

Authors

Yang Cao¹, Marit Aralt Skaug², Ole Andersen³, Jan Aaseth⁴

Affiliations

¹ Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
² Faculty of Public Health, Hedmark University College, Elverum, Norway. Electronic address: marit.skaug@hihm.no.
³ Department of Science, Systems and Models, Roskilde University, Roskilde, Denmark.
⁴ Innlandet Hospital Trust, Kongsvinger Hospital Division, Kongsvinger, Norway.

PMID: 24894443
DOI: 10.1016/j.jtemb.2014.04.010

Abstract

In the present review we provide an update of the appropriate use of chelating agents in the treatment of intoxications with compounds of mercury, lead and copper. The relatively new chelators meso-2,3-dimercaptosuccinic acid (DMSA) and 2,3-dimercapto-propanesulphonate (DMPS) can effectively mobilize deposits of mercury as well as of lead into the urine. These drugs can be administered orally and have relatively low toxicity compared to the classical antidote dimercaptopropanol (BAL). d-Penicillamine has been widely used in copper overload, although 2,3-dimercaptosuccinic acid or tetrathiomolybdate may be more suitable alternatives today. In copper-toxicity, a free radical scavenger might be recommended as adjuvant to the chelator therapy.

Keywords: DMPS; DMSA; Deferoxamine; Heavy metal; Penicillamine.

Publication types

Review

MeSH terms

Administration, Oral
Animals
Chelating Agents / administration & dosage
Chelating Agents / adverse effects
Chelating Agents / therapeutic use
Chelation Therapy* / adverse effects
Copper*
Drug Therapy, Combination
Evidence-Based Medicine*
Free Radical Scavengers / therapeutic use
Humans
Infusions, Parenteral
Lead Poisoning / drug therapy*
Mercury Poisoning / drug therapy*
Penicillamine / administration & dosage
Penicillamine / adverse effects
Penicillamine / therapeutic use
Succimer / administration & dosage
Succimer / adverse effects
Succimer / therapeutic use*
Trientine / administration & dosage
Trientine / adverse effects
Trientine / therapeutic use
Unithiol / administration & dosage
Unithiol / adverse effects
Unithiol / therapeutic use*

Substances

Chelating Agents
Free Radical Scavengers
Unithiol
Copper
Succimer
Penicillamine
Trientine