Sulfur mustard intoxication, oxidative stress, and antioxidants.
Sulfur Mustard (SM) is a potent alkylating agent with electrophilic property which has been used as a chemical warfare agent in at least 12 conflicts. It has reemerged as a major threat in recent years. Medical attention is primarily concerned with its action on the skin, eyes, and respiratory tract which may be complicated by damage to ophthalmic, pulmonary, and gasterointestinal systems, followed by bone marrow depression. The cytotoxicity of SM and production of reactive oxygen substances (ROS) has been proposed to result from electrophilic or oxidative stress with depletion of cellular detoxifying thiol levels including glutathione. Also, ROS are transformed by iron-requiring reactions into highly toxic oxidants that cause a chain reaction with membrane phospholipids to form lipid peroxides, leading to loss of membrane function, membrane fluidity, and finally membrane integrity. Provision and availability of scavengers of ROS and electrophilic compounds such as glutathione, sulfhydryls compounds, antioxidants, and substances that will increase production of endogenous scavengers may be considered protective and useful. Thereby, the role of substances such as selenium, copper, zinc, and antioxidants including vitamin E, vitamin C, and compounds like beta-carotene against SM cytotoxicity and lipid peroxidation might be interesting to be investigated in experimental animal models.