title: Respiratory effects of sulfur mustard exposure, similarities and differences with asthma and COPD.
abstract: BACKGROUND
  Previous research has found relationships between sulfur mustard (SM) toxicity and its adverse effects.
  
  
  OBJECTIVE
  SM is highly toxic to the respiratory system, leading to hacking cough, rhinorrheachest tightness, acute pharyngitis and laryngitis, chronic bronchitis and lung fibrosis. In this review, based on the scientific literature, we provide an updated summary of information on SM exposures and their differences with asthma and COPD.
  
  
  METHODS
  Information of this review was obtained by searching Medline/PubMed, ScienceDirect, Scopus, Google Scholar, ISI Web of Knowledge and Chemical Abstracts.
  
  
  RESULTS
  SM exposure can decrease pulmonary function tests (PFTs) values. In addition, inflammatory cell accumulation in the respiratory tract and increased expression of some pro-inflammatory cytokines including tumor necrosis factor-α (TNFα), IL-1a, IL-1β, and reactive oxygen radicals due to SM exposure have been shown. Matrix metalloproteinase (MMP) which degrade extracellular matrix proteins, contributing to inflammatory cell recruitment, tissue injury and fibrosis are also up-regulated in the lung after SM exposure. In the lung, SM exposure also can cause serious pathological changes including airway inflammation, parenchymal tissue destruction and airway obstruction which can lead to asthma or chronic obstructive pulmonary disease (COPD). Following SM poisoning, DNA damage, apoptosis and autophagy are observed in the lung along with the increased expression of activated caspases and DNA repair enzymes.
  
  
  CONCLUSIONS
  In the present article, respiratory symptoms, changes in PFTs, lung pathology and lung inflammation due to SM exposure and the similarities and differences between them and those observed in asthma and COPD were reviewed.
authors.affiliation: a Pharmaceutical Research Center and Department of Physiology, School of Medicine .|b Student Research Committee , and.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Khazdair
authors.affiliation: c Neurogenic Inflammation Research Centre and Department of Physiology, School of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Boskabady
authors.affiliation: a Pharmaceutical Research Center and Department of Physiology, School of Medicine .
authors.forename: Vahideh
authors.initials: V
authors.lastname: Ghorani
mesh_terms: D001249:Asthma / Q000473:pathology*; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000473:pathology; D055370:Lung Injury / Q000139:chemically induced* / Q000473:pathology; D009151:Mustard Gas / Q000633:toxicity*; D029424:Pulmonary Disease, Chronic Obstructive / Q000473:pathology*
chemical_list: D009151:Mustard Gas
keywords: Asthma; COPD; lung inflammation; lung pathology; pulmonary function tests; respiratory symptoms; sulfur mustard