title: Reversal of arsenic-induced hepatic apoptosis with combined administration of DMSA and its analogues in guinea pigs: role of glutathione and linked enzymes.
abstract: Arsenicosis, due to contaminated drinking water in the Indo-Bangladesh region, is a serious health hazard in terms of morbidity and mortality. Reactive oxygen species (ROS) generated due to arsenic toxicity have been attributed as one of the initial signals that impart cellular toxicity, which is controlled by the internal antioxidant glutathione (GSH). In the present study, we investigated (i) the role of GSH and its linked enzymes, glutathione peroxidase and glutathione reductase, in reversing chronic arsenic toxicity using a thiol chelating agent, meso-2,3-dimercaptosuccinic acid (DMSA), or one of its analogues individually or in combination; (ii) if alterations in the carbon side chain of DMSA increased efficacy; and (iii) whether the combination therapy enhance arsenic removal from hepatic tissue and prevent hepatic apoptosis. Results indicated that chronic arsenic exposure led to a ROS-mediated, mitochondrial-driven, caspase-dependent apoptosis in hepatic cells with a significant increase in glutathione disulfide (GSSG) levels and decreased glutathione reductase levels. Monotherapy with DMSA and its analogues did show minimal recovery postchelation. However, the combination of DMSA with long carbon chain analogues like monoisoamyl DMSA (MiADMSA) or monocyclohexyl DMSA (MchDMSA) showed a better efficacy in terms of reducing the arsenic burden as well as reversing altered biochemical variables indicative of oxidative stress and apoptosis. We also observed that GSH and its linked enzymes, especially glutathione reductase, play a vital role in scavenging ROS, maintaining GSH pools, and providing clinical recoveries. On the basis of the above observations, we recommend that combinational therapy of DMSA and its long carbon chain analogues MiADMSA or MchDMSA would be more effective in arsenic toxicity.
authors.affiliation: Division of Pharmacology and Toxicology, Defence Research and Development Establishment, Jhansi Road, Gwalior-474 002, India.
authors.forename: Deepshikha
authors.initials: D
authors.lastname: Mishra
authors.forename: Ashish
authors.initials: A
authors.lastname: Mehta
authors.forename: Swaran J S
authors.initials: SJ
authors.lastname: Flora
mesh_terms: D000818:Animals; D000931:Antidotes / Q000008:administration & dosage; D017209:Apoptosis / Q000187:drug effects*; D020261:Arsenic Poisoning / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D018053:Arsenites / Q000633:toxicity; D002614:Chelating Agents / Q000378:metabolism / Q000627:therapeutic use*; D004195:Disease Models, Animal; D004791:Enzyme Inhibitors / Q000633:toxicity; D004798:Enzymes / Q000378:metabolism*; D005978:Glutathione / Q000378:metabolism*; D005979:Glutathione Peroxidase / Q000378:metabolism; D005980:Glutathione Reductase / Q000378:metabolism; D006168:Guinea Pigs; D008099:Liver / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D008297:Male; D018384:Oxidative Stress / Q000187:drug effects; D017382:Reactive Oxygen Species / Q000378:metabolism; D017670:Sodium Compounds / Q000633:toxicity; D004113:Succimer / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000931:Antidotes; D018053:Arsenites; D002614:Chelating Agents; D004791:Enzyme Inhibitors; D004798:Enzymes; D017382:Reactive Oxygen Species; D017670:Sodium Compounds; C017947:sodium arsenite; D004113:Succimer; D005979:Glutathione Peroxidase; D005980:Glutathione Reductase; D005978:Glutathione