title: Cellular and molecular mechanisms of acute exposure to sulfur mustard: a systematic review.
abstract: BACKGROUND
  Mustard gas (e.g. sulfur mustard (SM)) has been used as a chemical agent in several battles and is still a potential worldwide menace. Besides local absorption, particularly in the skin, eyes and lungs, systemic spread of the agent also has detrimental effects on gonads, bone marrow and nervous system. Moreover, chronic exposure of SM to respiratory system causes death. Inducing oxidative stress, and disturbing DNA and tissue repair systems, inflammation and cell death signaling pathways have been introduced as molecular mechanisms of the injury.
  
  
  METHODS
  In this systematic review, more than 1200 (2000-2014) articles focusing on gross or molecular pathological reports in the acute phase of the respiratory injury after SM exposure were reviewed, followed by two different layers of gross and molecular pathological data (clinic and laboratory) integrated together in a spatio-temporal order. Role of epithelial, neutrophil and macrophage cells and three signaling pathways of inflammation, oxidative stress and cell death are covered in details.
  
  
  CONCLUSIONS
  Our results propose a critical role of interleukin-17 producing cells in acute and chronic inflammatory responses.
authors.affiliation: a Chemical Injuries Research Center , Baqiyatallah University of Medical Sciences , Tehran , Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Nourani
authors.affiliation: b Applied Microbiology Research Center , Baqiyatallah University of Medical Sciences , Tehran , Iran.
authors.forename: Hamideh
authors.initials: H
authors.lastname: Mahmoodzadeh Hosseini
authors.affiliation: a Chemical Injuries Research Center , Baqiyatallah University of Medical Sciences , Tehran , Iran.
authors.forename: Sadegh
authors.initials: S
authors.lastname: Azimzadeh Jamalkandi
authors.affiliation: b Applied Microbiology Research Center , Baqiyatallah University of Medical Sciences , Tehran , Iran.
authors.forename: Abbas Ali
authors.initials: AA
authors.lastname: Imani Fooladi
mesh_terms: D016923:Cell Death; D002619:Chemical Warfare Agents / Q000633:toxicity*; D004249:DNA Damage / Q000187:drug effects; D004260:DNA Repair / Q000187:drug effects; D007249:Inflammation / Q000139:chemically induced / Q000235:genetics; D020381:Interleukin-17 / Q000096:biosynthesis* / Q000235:genetics; D009151:Mustard Gas / Q000633:toxicity*; D018384:Oxidative Stress / Q000187:drug effects* / Q000235:genetics; D015398:Signal Transduction
chemical_list: D002619:Chemical Warfare Agents; D020381:Interleukin-17; D009151:Mustard Gas
keywords: Airway; COPD; epithelium; inflammation; oxidative stress