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[The role of the sweat glands in excreting antimony from the body in people living in the biogeochemical provinces of the Fergana Valley].

The features of antimony excretion by sweat glands were studied in normal subjects and patients with chronic bronchitis, chronic gastritis, chronic nephritis and calculous pyelonephritis, visceral leishmaniasis, living in some biogeochemical provinces of Fergana Valley. A micromethod based on the coloured reaction of the element with brilliant green was worked out to detect antimony in sweat. Sweat antimony elimination was proved to play a significant role in health and disease. The workers engaged in antimony production, the inhabitants of antimony biogeochemical regions should have their sweat excretion tested to score the Sb level. It is recommended as an additional test for screening and controlling the effects of visceral leishmaniasis chemotherapy by solusurmine in patients with kidney disorders.

Antimony↗

[The antimony conflict].

Antimony, which was already well known to the ancients, in the Middle Ages was known as Lupus metallorurn--the grey wolf--a key material in alchemists' attempts at purifying gold. Over subsequent centuries antimony returned within the bounds of conventional scientific and experimental knowledge, but inspired numerous studies, works of literature and investigations in important fields of medicine. Antimony has always aroused more interest than one might expect from a simple metal. The fact that it has been used since ancient times in cosmetics and then in alchemy gave it both positive and negative connotations, reflecting its possible uses and the benefits for health but also the potential harm. For a certain period antimony was virtually the symbol for a range of uses in alchemy or empirical medicine, in the face of modern scientific knowledge, and aroused debate that went well beyond its actual physical and chemical properties. Bernardino Ramazzini's work in the 17th-18th centuries signalled the recognition that the use of antimony was linked to health risks. Today it is put to many uses in many fields of industry and medicine, so our interest in this metal is no longer exclusively a question of history, but is highly topical.

Antimony↗

[The corrosion behavior of antimony in a Ag-Sn-Cu-Sb amalgam].

Specimen of amalgam containing antimony were stored in solutions with different pH and different content of rhodanide until 21 days. The most antimony were solved within 24 hours. After 7 days an increase of the antimony concentration were not observed in physiological pH. An inhibition of corrosion by rhodanide existed only after incubation from 21 days. The quantity of antimony (10-21 micrograms) were analysed by mean of atomic absorption spectroscopy. It represent not a risk for the health. The natural presence of this element in environment and in human body is discussed to the analysed quantity of solved antimony.

Antimony↗

[Antimony and other heavy metals in metallic kitchen ware].

The antimony in metallic kitchen ware was determined. The content of this element in metals used for the production or repairing of utensils, containers and packaging which come in contact with foods is regulated and should be less than 5% in under the Japanese Food Sanitation Law. In eight metallic samples, antimony was detected in solder used for the production of a can for green tea and an eggbeater. The contents were 1.30% in the former and 1.90% in the latter. No antimony was detected in solder used for a cookie cutter. A sample of solder used for electric work, not for food utensils, contained 0.81% of antimony. In other metallic utensils which come in contact with food such as aluminum foil, a brass spoon, a stainless steel fork, a wire netting, and an iron rock for vegetable color stabilizing, antimony was not detected at a 0.05% detection limit. A qualitative test using rhodamine B also showed positive results in only three solder samples. Lead concentrations in solder used for the kitchen ware were from 39.3 to 51.3%. These concentrations were higher than the limit (20%) of lead content by the Law. No cadmium was detected in any samples.

Antimony↗

Pentavalent antimonial inhibition of the osmotic effect of oxytocin on the isolated toad bladder.

The inhibition of osmotic stimulated water flow in the isolated toad bladder by 0.1 mM sodium stibogluconate (pentavalent antimony) is described. Pentavalent antimony on the serosal surface significantly inhibited oxytocin-induced water flow but when the drug was added to the mucosal surface only the effect of low oxytocin concentrations was reduced. The phosphodiesterase inhibitor pentoxifylline, when present on the serosal side, blocks the effect of pentavalent antimony on stimulated water flow. No effect was detected when indomethacin was present on the serosal side. It is suggested that phosphodiesterase activation might play a role in the mechanism of pentavalent antimonial inhibition of oxytocin-induced water flow in the isolated toad bladder. The effect obtained when sodium stibogluconate on the serosal side was replaced with antimony pentachloride (SbCl5) supports the view that the metal in the molecule is responsible for the inhibition of the effect of oxytocin.

Animals↗

Physiological disposition of antimony after administration of 124Sb-labelled tartar emetic to rats, mice and monkeys, and the effects of tris (p-aminophenyl) Carbonium pamoate on this distribution.

Tris (p-aminophenyl) carbonium (TAC) salts and certain antimonials have been shown to be more effective together against Schistosoma mansoni in mice than would be expected from the simple addition of their activities when given alone. Owing to the toxicity of antimonials, the therapeutic advantage of such synergistic effects would largely depend upon whether or not they occurred because the co-administration of TAC pamoate led to higher or more sustained levels of antimony in the blood or tissues. This study of the effect of TAC pamoate on the physiological disposition of (124)Sb was designed to give information on this important aspect.In general, co-administration of or pretreatment with TAC pamoate had no significant effect on the disposition of antimony. This indicates that the additive or synergistic effect of the two drugs against schistosomes is not due to higher or more sustained levels of antimony in the blood and tissues.

Animals↗

Laboratory studies on the joint effects of certain tris (p-aminophenyl) carbonium salts and antimonials as antischistosomal drugs.

Tris (p-aminophenyl) carbonium (TAC) pamoate and antimonials, such as tartar emetic and stibophen, have broad antischistosomal activity in animals and man, but both groups have important limitations. Thus the slow-acting TAC pamoate must be given for several weeks to obtain a high degree of effect and the fast-acting antimonials have a narrow therapeutic index.This study deals with whether TAC pamoate and antimonials together have a useful degree of joint action against Schistosoma mansoni without commensurate joint toxicity for the host.A marked degree of synergism in antischistosomal activity occurred with relatively low amounts of TAC pamoate and tartar emetic or stibophen in vitro and in infected mice, particularly when TAC pamoate was started ahead of the antimonial. Moreover, neither TAC pamoate nor tartar emetic affected appreciably the gross toxicity of the other for normal mice. An encouraging degree of joint antischistosomal action by TAC pamoate and tartar emetic also occurred in infected rhesus monkeys.The results suggest that the use of TAC pamoate and antimonials together may avoid some of their main limitations when used alone.

Animals↗

Dermatitis in workers exposed to antimony in a melting process.

An employee at a brazing rod manufacturing plant developed a generalized eruption of follicular papules and pustules. His job tasks included breaking up antimony ingots and melting the pieces in a crucible; he was exposed to antimony metal dust and to antimony trioxide fumes. Two fellow employees who later performed the same job tasks developed similar eruptions. The clinical and workplace evaluations suggested that the fumes from melting antimony were the cause of the dermatoses, and that the current Occupational Safety and Health Administration permissible exposure limit is not adequate to prevent cutaneous effects of antimony exposure.

Adult↗

Trivalent antimonials induce degradation of the PML-RAR oncoprotein and reorganization of the promyelocytic leukemia nuclear bodies in acute promyelocytic leukemia NB4 cells.

Acute promyelocytic leukemia (APL) is characterized by a specific t(15;17) chromosomal translocation that fuses the genes encoding the promyelocytic leukemia protein (PML) and the retinoic acid receptor (RAR). The resulting PML-RAR protein induces a block in the differentiation of the myeloid progenitor cells, which can be released by retinoic acid (RA) in vitro and in vivo. The RA-induced differentiation of APL blasts is paralleled by the degradation of the fusion protein and the relocation of wild-type PML from aberrant nuclear structures to its normal localization in nuclear bodies. Recently, arsenic trioxide (As2O3) treatment was proposed as an alternative therapy in APL, because it can induce complete remission in both RA-sensitive and -resistant APL patients. Intriguingly, As2O3 was also shown to induce degradation of the PML-RAR chimera and to reorganize PML nuclear bodies. Here we show that trivalent antimonials also have striking effects on RA-sensitive and RA-resistant APL cells. Treatment of the APL-derived NB4 cells and the RA-resistant subclone NB4R4 with antimony trioxide or potassium antimonyl tartrat triggers the degradation of the fusion protein and the concomitant reorganization of the PML nuclear bodies. In addition, as reported for As2O3, the antimonials provoke apoptosis of NB4 and NB4R4 cells. The mechanism of antimony action is likely to be similar to that of As2O3, notably both substances induce the attachment of the ubiquitin-like SUMO-1 molecule to the PML moiety of PML-RAR. From these data, we propose that, in analogy to As2O3, antimonials might have a beneficial therapeutic effect on APL patients, perhaps with less toxicity than arsenic.

Antimony↗

Potential of rice husks for antimony removal.

The adsorption behavior of rice husks for antimony ions from aqueous solutions has been investigated as a function of appropriate electrolyte, equilibration time, hydrogen ions, amount of adsorbent, concentration of adsorbate, effect of diverse ions and temperature. The best conditions in which this material can be used as adsorbent have been explored. The radiotracer technique was employed to determine the distribution of antimony (122Sb) using a batch method. Maximum adsorption was observed at 0.01 mol L(-1) acid solutions (HNO3, HCl, H2SO4 and HClO4) using 1.0 g of adsorbent for 1.92 x 10(-5) mol L(-1) antimony concentration in 10 min equilibration time. Studies show that the adsorption decreases with the increase in the concentrations of all the acids. The adsorption data follow the Freundlich isotherm over the range of 1.92 x 10(-5) to 2.05 x 10(-4) mol L(-1) antimony concentration. The characteristic Freundlich constants i.e., 1/n = 0.82 +/- 0.05 and K = 4.61 +/- 0.07 m mol g(-1) have been computed for the sorption system. The uptake of antimony increases with the rise in temperature (299-323 K). Thermodynamic quantities i.e., deltaG0, deltaS0 and deltaH0 have also been calculated for the system. The sorption process was found to be endothermic.

Journal Article↗

Electrocardiographic changes during low-dose, short-term therapy of cutaneous leishmaniasis with the pentavalent antimonial meglumine.

The pentavalent antimonial (Sb5+) meglumine is the drug of choice for the treatment of cutaneous leishmaniasis (CL) in Brazil. Although the cardiotoxicity of high-dose, long-term Sb5+ therapy is well known, the use of low-dose, short-term meglumine has been considered to be safe and relatively free from significant cardiac effects. In order to investigate the cardiotoxicity of low-dose, short-term therapy with meglumine in cutaneous leishmaniasis, 62 CL patients treated with meglumine were studied. A standard ECG was obtained before and immediately after the first cycle of treatment (15 mg Sb5+ kg-1 day-1). The electrocardiographic interpretation was carried out blindly by two investigators using the Minnesota Code. There were no significant differences in qualitative ECG variables before and after meglumine treatment. However, the corrected QT interval was clearly prolonged after antimonial therapy (420.0 vs 429.3 ms, P < 10(-6)). QTc augmentation exceeded 40 ms in 12 patients, 7 of whom developed marked QTc interval enlargement (500 ms) after meglumine therapy. This previously unrecognized cardiac toxicity induced by short-term, low-dose antimonial therapy has potentially important clinical implications. Since sudden death has been related to QTc prolongation over 500 ms induced by high-dose antimonial therapy, routine electrocardiographic monitoring is probably indicated even in CL patients treated with short-term, low-dose meglumine schedules. Until further studies are conducted to establish the interactions between pentavalent antimonials and other drugs, special care is recommended when using meglumine in combination with other medications, in particular with drugs that also increase the QTc interval.

Adult↗

NTP technical report on the toxicity studies of Toxicity Studies of Antimony Potassium Tartrate (CAS No. 28300-74-5) in F344/N Rats And B6C3F1 Mice (Drinking Water and Intraperitoneal Injection Studies).

Antimony potassium tartrate (APT) is a complex salt that until recently was used worldwide as an anti-schistosomal drug. APT was efficacious in humans only if administered intravenously at a near-lethal total dose of 36 mg/kg. Because unconfirmed epidemiologic studies suggested a possible association between APT treatment and bladder cancer, prechronic toxicity studies were initiated with APT to select a route of administration and appropriate doses in the event chronic studies were needed. To determine the most appropriate route for longer-term studies, toxicity and concentrations of tissue antimony were compared in F344/N rats and B6C3F1 mice that were administered APT in drinking water or by i.p. injection for 14 or 16 days. The animals were assigned to dose groups, 5/sex/species. Drinking water doses, estimated by water consumption, were 0, 16, 28, 59, 94, or 168 mg/kg in rats and 0, 59, 98, 174, 273, or 407 mg/kg in mice; i.p. doses were 0, 1.5, 3, 6, 11, or 22 mg/kg in rats and 0, 6, 13, 25, 50, or 100 mg/kg in mice. APT was poorly absorbed and relatively nontoxic when given orally. There was no mortality or histopathological lesions in rats or mice receiving doses of APT as high as 168 or 273 mg/kg, respectively. One mouse in the highest dose group (407 mg/kg) died, and there were treatment-related lesions in the liver and forestomach of most mice in this dose group. In contrast, i.p. administration of the drug was much more toxic, resulting in the deaths of rats administered 22 mg/kg; kidney and liver lesions were found in these rats. In mice, i.p. administration of APT caused deaths and liver lesions at dose levels one-fourth of those that caused similar effects by oral administration. All male and female mice injected with 100 mg/kg APT died; half of the female mice given 50 mg/kg APT died; additional deaths occurred with doses as low as 6 mg/kg. Hepatocellular necrosis and inflammation of the liver capsule were present in both sexes of mice in the 50 mg/kg dose groups. As a result of these findings, an i.p. dose regimen was selected for subsequent studies. Groups of ten male and female F344/N rats and B6C3F1 mice were given 0, 1.5, 3, 6, 12, or 24 mg/kg doses of APT 3 times per week for 13 weeks by i.p. injection. Rats were more sensitive than mice to the toxic effects of APT, exhibiting dose-related mortality and reduction in body weight. Four male rats in the 24 mg/kg dose died; body weights in both sexes of rats from this dose group and in male rats from the 12 mg/kg dose group were 10-20% below controls. No clinical signs of toxicity in the mice, nor gross or microscopic lesions, could be attributed to APT. Increased concentrations of antimony, considered to be dose-related, were detected in the blood, liver, kidney, spleen, and heart of rats, and in the liver and spleen of mice. In rats, hepatocellular degeneration and necrosis were associated with dose-related elevations in activities of the liver-specific serum enzymes, sorbitol dehydrogenase and alanine aminotransferase. By alternating the site of abdominal injection and the days of treatment, mesenteric inflammation at the site of administration was minimized in the rats and mice, indicating that the i.p. route would be suitable for chronic studies. Hepatotoxicity in rats occurred in dose groups where there was little evidence of renal toxicity and no cardiac toxicity; thus, serial measurement of liver-specific serum enzyme activities may be useful to monitor the presence and progression of hepatocellular degeneration in longer-term exposures. Synonyms: APT; Tartar emetic; tartrated antimony; tartarized antimony; potassium antimonyltartrate; Bis [μ-[2,3-dihydroxy- butanedioato(4-)-O1, O2:O3, O4]]-diantimonate dipotassium trihydrate (stereoisomer).

Journal Article↗

Imiquimod in combination with meglumine antimoniate for cutaneous leishmaniasis: a randomized assessor-blind controlled trial.

OBJECTIVE: To determine the efficacy and safety of imiquimod in combination with meglumine antimoniate in treating cutaneous leishmaniasis. DESIGN: Prospective, randomized, assessor-blind, parallel-design, placebo-controlled trial. SETTING: Two primary care health clinics. PATIENTS: One hundred nineteen patients (59 patients in the imiquimod group and 60 in the placebo group) were included in the study. INTERVENTIONS: Patients were randomly assigned to receive a combined 4-week course of imiquimod or placebo with meglumine antimoniate treatment (20 mg/kg of pentavalent antimony daily for 2 weeks) in an endemic area of Leishmania tropica. MAIN OUTCOME MEASURES: The primary end point was clinical cure, defined as more than 75% reduction in the size of lesions compared with baseline at week 8. RESULTS: At the end of the 4-week treatment period, clinical cure was similar in both groups (11 patients [18.6%] in the imiquimod-treated group vs 18 patients [30.0%] in the placebo group) (P = .15). Four weeks after the end of treatment, 26 patients (44.1%) and 29 patients (48.3%) in the imiquimod-treated and placebo groups, respectively, were cured (P = .64). Pruritus and burning sensation were reported by 3 patients treated with imiquimod and by no patients treated with placebo. CONCLUSION: This study showed no beneficial effect of combining a 4-week course of treatment with 5% imiquimod cream and a standard course of treatment with meglumine antimoniate in patients with cutaneous leishmaniasis in an endemic area of L tropica. TRIAL REGISTRATION: isrctn.org Identifier:ISRCTN77659407 and Cochrane Skin Group Identifier: CSG Trial No. 32.

Adjuvants, Immunologic↗

Relapse in Ethiopian visceral leishmaniasis (VL) patients after therapy with pentavalent antimonials: a ten year observation.

Relapse after chemotherapy using the pentavalent antimonials, sodium stibogluconate and meglumine antimoniate, was assessed in 135 patients diagnosed in the Aba Roba focus of south western Ethiopia during the period 1982-1991. Ten cases relapsed with a mean of 15.6 +/- 16.3 months following treatment. A 15-day course of 10 mg Sbv/kg b.wt. sodium stibogluconate used in 1982/1983 had a better outcome than a 15-day course of 17 mg Sbv/kg b.wt. of meglumine antimoniate used in 1990/1991. The relapse rate among patients treated with sodium stibogluconate 16-20 mg Sbv/kg b.wt. for 20 days in 1985-1990 was comparable to the relapse rate in patients treated with meglumine antimoniate 16-20 mg Sbv/kg b.wt. for 20 days in 1990/1991. Findings are discussed.

Adolescent↗

Pharmacokinetics of N-methylglucamine antimoniate after intravenous, intramuscular and subcutaneous administration in the dog.

The pharmacokinetic profile of antimony in dogs was defined by administering it intravenously, intramuscularly and subcutaneously as N-methylglucamine antimoniate at a dose of about 25.65 mg of antimony kg-1 bodyweight. The results showed a different half-life for the three routes of administration: 20.5, 42.1 and 121.6 minutes for the intravenous, intramuscular and subcutaneous routes, respectively; peak time values (Tmax) were also different for the intramuscular (90 to 120 minutes) and subcutaneous (210 to 240 minutes) injection. The apparent bioavailability of antimony was > 100 per cent for the intramuscular and 100 per cent for the subcutaneous routes. The data obtained showed a relevant difference in the behaviour of the drug in the dog in comparison to that in humans.

Animals↗

Improved targeting of antimony to the bone marrow of dogs using liposomes of reduced size.

A novel liposomal formulation of meglumine antimoniate (MA), consisting of vesicles of reduced size, has been evaluated in dogs with visceral leishmaniasis to determine its pharmacokinetics as well as the impact of vesicle size on the targeting of antimony to the bone marrow. Encapsulation of MA in liposomes was achieved through freeze-drying of empty liposomes in the presence of sucrose and rehydration with a solution of MA. The resulting formulation, with a mean vesicle diameter of about 400 nm, was given to mongrel dogs with visceral leishmaniasis as an i.v. bolus injection at 4.2 mgSb/kg of body weight. The pharmacokinetics of antimony were assessed in the blood and in organs of the mononuclear phagocyte system and compared to those achieved with the free drug and the drug encapsulated in large sized liposomes (mean diameter of 1200 nm). The targeting of antimony to the bone marrow was improved (approximately three-fold) with the novel liposomal formulation, when compared to the formulation of MA in large sized liposomes. This study provides the first direct experimental evidence that passive targeting of liposomes to the bone marrow of dogs is improved by the reduction of vesicle size from the micron to the nanometer scale.

Animals↗

Reduction of anti-leishmanial pentavalent antimonial drugs by a parasite-specific thiol-dependent reductase, TDR1.

The reason why Leishmania parasites are susceptible to organic antimonial drugs, the standard chemotherapeutic agents for over 50 years, apparently lies in the fact that the mammalian stage of the parasite reduces the pentavalent form of the administered drug to a trivalent form that causes parasite death. We have identified and characterized a parasite-specific enzyme that can catalyse the reduction of pentavalent antimonials and may therefore be central to the anti-parasite activity of the drug. The unusual protein, a trimer of two-domain monomers in which each domain has some similarity to the Omega class glutathione S-transferases, is a thiol-dependent reductase (designated TDR1) that converts pentavalent antimonials into trivalent antimonials using glutathione as the reductant. The higher abundance of the enzyme in the mammalian stage of the parasite could explain why this parasite form is more susceptible to the drug.

Amino Acid Sequence↗

Visceral leishmaniasis in the BALB/c mouse: antimony tissue disposition and parasite suppression after the administration of free stibogluconate.

BALB/c mice with an acute or chronic Leishmania donovani infection were treated with intravenous sodium stibogluconate solution and the parasite suppressions determined in the spleen, liver and femur bone marrow. Antimony concentrations in these and other tissues were determined by hydride generation-atomic absorption spectrophotometry. There was little correlation between tissue antimony levels one hour after treatment and drug efficacy. It would appear that the peak tissue antimony concentration achieved soon after dosing, rather than the lower concentrations which are readily sustained in most tissues, is the most important factor in the antileishmanial activity of stibogluconate. A high peak antimony concentration occurred in the liver, where parasites were significantly suppressed, and was not observed in the two other sites of infection, where the parasites were apparently less susceptible to stibogluconate therapy.

Acute Disease↗