title: Mustard Gas Inhalation Injury: Therapeutic Strategy.
abstract: Mustard gas (sulfur mustard [SM], bis-[2-chloroethyl] sulfide) is a vesicating chemical warfare agent and a potential chemical terrorism agent. Exposure of SM causes debilitating skin blisters (vesication) and injury to the eyes and the respiratory tract; of these, the respiratory injury, if severe, may even be fatal. Therefore, developing an effective therapeutic strategy to protect against SM-induced respiratory injury is an urgent priority of not only the US military but also the civilian antiterrorism agencies, for example, the Homeland Security. Toward developing a respiratory medical countermeasure for SM, four different classes of therapeutic compounds have been evaluated in the past: anti-inflammatory compounds, antioxidants, protease inhibitors and antiapoptotic compounds. This review examines all of these different options; however, it suggests that preventing cell death by inhibiting apoptosis seems to be a compelling strategy but possibly dependent on adjunct therapies using the other drugs, that is, anti-inflammatory, antioxidant, and protease inhibitor compounds.
authors.affiliation: Research Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Keyser
authors.affiliation: Research Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA.
authors.forename: Devon K
authors.initials: DK
authors.lastname: Andres
authors.affiliation: Analytical Toxicology Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA.
authors.forename: Wesley W
authors.initials: WW
authors.lastname: Holmes
authors.affiliation: Analytical Toxicology Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Paradiso
authors.affiliation: Research Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Appell
authors.affiliation: Research Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA.
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Letukas
authors.affiliation: Research Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA.
authors.forename: Betty
authors.initials: B
authors.lastname: Benton
authors.affiliation: Research Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA.
authors.forename: Offie E
authors.initials: OE
authors.lastname: Clark
authors.affiliation: Division of Experimental Therapeutics, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
authors.forename: Xiugong
authors.initials: X
authors.lastname: Gao
authors.affiliation: Division of Experimental Therapeutics, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
authors.forename: Prabhati
authors.initials: P
authors.lastname: Ray
authors.affiliation: Analytical Toxicology Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA.
authors.forename: Dana R
authors.initials: DR
authors.lastname: Anderson
authors.affiliation: Research Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA radharaman.ray.civ@mail.mil.
authors.forename: Radharaman
authors.initials: R
authors.lastname: Ray
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000931:Antidotes / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use*; D017209:Apoptosis / Q000187:drug effects; D002619:Chemical Warfare Agents / Q000633:toxicity*; D004359:Drug Therapy, Combination; D005739:Gas Poisoning / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008954:Models, Biological; D009151:Mustard Gas / Q000633:toxicity*; D011480:Protease Inhibitors / Q000627:therapeutic use*; D020545:Respiratory Mucosa / Q000187:drug effects / Q000276:immunology / Q000378:metabolism / Q000473:pathology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000931:Antidotes; D000975:Antioxidants; D002619:Chemical Warfare Agents; D011480:Protease Inhibitors; D009151:Mustard Gas
keywords: anti-inflammatory; antioxidants; apoptosis; inhalation; protease; sulfur mustard