title: Glutathione transferase activity and formation of macromolecular adducts in two cases of acute methyl bromide poisoning.
abstract: OBJECTIVE
  To determine the activity of glutathione transferase and to measure the S-methylcysteine adducts in blood proteins, after acute inhalation exposure to methyl bromide. To examine the influence of the polymorphism of glutathione-S-transferase theta (GSTT1) on the neurotoxicity of methyl bromide.
  
  
  METHODS
  Two workers acutely exposed to methyl bromide with inadequate respiratory protective devices were poisoned. Seven weeks after the accident, blood samples were drawn from both patients, for measurement of glutathione transferase activity in erythrocytes (conjugator status--that is, GSTT1 phenotype) and measurement of binding products of methyl bromide with blood proteins. Conjugator status was determined by a standard procedure. The binding product of methyl bromide, S-methylcysteine, was measured in globin and albumin.
  
  
  RESULTS
  Duration and intensity of exposure were identical for both patients as they worked together with the same protective devices and with similar physical effort. However, one patient had very severe poisoning, whereas the other only developed mild neurotoxic symptoms. The first patient was a "conjugator" with normal glutathone transferase activity, whereas this activity was undetectable in the erythrocytes of the second patient, who consequently had higher concentrations of S-methylcysteine adduct in albumin (149 v 91 nmol/g protein) and in globin (77 v 30 nmol/g protein).
  
  
  CONCLUSIONS
  Methyl bromide is genotoxic and neurotoxic. Its genotoxicity seems to be the consequence of the alkylating activity of the parent compound, and conjugation to glutathione has a protective effect. The data presented here suggest a different mechanism for methyl bromide neurotoxicity which could be related to the transformation of methylglutathione into toxic metabolites such as methanethiol and formaldehyde. If such metabolites are the ultimate toxic species, N-acetylcysteine treatment could have a toxifying rather than a detoxifying effect.
authors.affiliation: Centre Anti-poisons, Clinique, Interuniversitaire de Médicine du Travail, Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Garnier
authors.forename: M O
authors.initials: MO
authors.lastname: Rambourg-Schepens
authors.forename: A
authors.initials: A
authors.lastname: Müller
authors.forename: E
authors.initials: E
authors.lastname: Hallier
mesh_terms: D000208:Acute Disease; D000328:Adult; D003545:Cysteine / Q000031:analogs & derivatives* / Q000097:blood; D005651:Fumigation / Q000009:adverse effects; D005982:Glutathione Transferase / Q000097:blood*; D006801:Humans; D006842:Hydrocarbons, Brominated / Q000097:blood* / Q000506:poisoning*; D008297:Male; D009422:Nervous System Diseases / Q000139:chemically induced; D016273:Occupational Exposure / Q000009:adverse effects*; D010641:Phenotype
chemical_list: D006842:Hydrocarbons, Brominated; C005218:methyl bromide; C008425:S-methylcysteine; D005982:Glutathione Transferase; D003545:Cysteine