Chelation in metal intoxication: Principles and paradigms

Jan Aaseth, Marit Aralt Skaug, yang Cao, Ole Andersen

    Research output: Contribution to journalReviewResearchpeer-review

    Abstract

    The present review provides an update of the general principles for the investigation and use of chelating agents in the treatment of intoxications by metals. The clinical use of the old chelators EDTA (ethylenediamine tetraacetate) and BAL (2,3-dimercaptopropanol) is now limited due to the inconvenience of parenteral administration, their own toxicity and tendency to increase the neurotoxicity of several metals. The hydrophilic dithiol chelators DMSA (meso-2,3-dimercaptosuccinic acid) and DMPS (2,3-dimercapto-propanesulphonate) are less toxic and more efficient than BAL in the clinical treatment of heavy metal poisoning, and available as capsules for oral use. In copper overload, DMSA appears to be a potent antidote, although d-penicillamine is still widely used. In the chelation of iron, the thiols are inefficient, since iron has higher affinity for ligands with nitrogen and oxygen, but the new oral iron antidotes deferiprone and desferasirox have entered into the clinical arena. Comparisons of these agents and deferoxamine infusions are in progress. General principles for research and development of new chelators are briefly outlined in this review
    Original languageEnglish
    JournalJournal of Trace Elements in Medicine and Biology
    Volume31
    Pages (from-to)260-266
    ISSN0946-672X
    DOIs
    Publication statusPublished - 2015

    Bibliographical note

    Special Section: 10th Nordic Symposium on Trace Elements in Human Health and Disease, edited by Jan Aaseth

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