title: Chelation therapy in intoxications with mercury, lead and copper.
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.
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Yang
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Faculty of Public Health, Hedmark University College, Elverum, Norway. Electronic address: marit.skaug@hihm.no.
authors.forename: Marit Aralt
authors.initials: MA
authors.lastname: Skaug
authors.affiliation: Department of Science, Systems and Models, Roskilde University, Roskilde, Denmark.
authors.forename: Ole
authors.initials: O
authors.lastname: Andersen
authors.affiliation: Innlandet Hospital Trust, Kongsvinger Hospital Division, Kongsvinger, Norway.
authors.forename: Jan
authors.initials: J
authors.lastname: Aaseth
mesh_terms: D000284:Administration, Oral; D000818:Animals; D002614:Chelating Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015913:Chelation Therapy / Q000009:adverse effects; D003300:Copper; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D007263:Infusions, Parenteral; D007855:Lead Poisoning / Q000188:drug therapy*; D008630:Mercury Poisoning / Q000188:drug therapy*; D010396:Penicillamine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004113:Succimer / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014266:Trientine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D014494:Unithiol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D002614:Chelating Agents; D016166:Free Radical Scavengers; D014494:Unithiol; D003300:Copper; D004113:Succimer; D010396:Penicillamine; D014266:Trientine
keywords: DMPS; DMSA; Deferoxamine; Heavy metal; Penicillamine