Summary
14 patients with heavy metal poisoning received 2,3-dimercaptosuccinic acid (DMSA). 12 subjects were given 30 mg/kg/day for 5 days; 1 subject was started on a lower dose because of a history of atopy; another subject was treated for 15 days because of very high initial blood lead concentrations. In the 9 subjects who had lead poisoning, DMSA decreased blood lead concentrations by 35 to 81%, and induced a 4.5- to 16.9-fold increase in mean daily urinary excretion of the metal. In the acutely arsenic-poisoned case, the plasma arsenic concentration on day 7 was half the pretreatment value, while no clear decrease was observed in a chronically exposed subject. In 3 mercury cases, DMSA increased daily mercury urinary excretion 1.5-, 2.8- and 8.4-fold, respectively, while blood mercury concentrations remained below detection limits. No serious side effects were observed and 3 weeks after administration of the drug the clinical condition of all subjects was either stable or improved. These results indicate the efficacy of DMSA for lead poisoning in humans and provide a rationale for further investigating its usefulness in mercury and arsenic poisoning cases.
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References
Aaseth J, Friedheim EA. Treatment of methylmercury poisoning in mice with 2,3-dimercaptosuccinic acid and other complexing thiols. Acta Pharmacologica et Toxicologica 42: 248–252, 1978
Aposhian HV. DMSA and DMPS-water soluble antidotes for heavy metal poisoning. Annual Review of Pharmacology and Toxicology 23: 193–215, 1983
Clarkson TW, Magos L, Cox C, Greenwood MR, Amin-Zaki L, et al. Tests of the efficacy of antidotes for removal of methylmercury in human poisoning during the Iraq outbreak. Journal of Pharmacology and Experimental Therapeutics 218: 74–83, 1981
Douglas WW. Polypeptides-angiotensin, plasma kinin, and others. In Goodman AG et al. (Eds) The pharmacological basis of therapeutics, 7th ed., p. 651, MacMillan Publishing Company, New York, 1985
Friedheim E, Corvi C. Meso-dimercaptosuccinic acid, a chelating agent for the treatment of mercury poisoning. Journal of Pharmacy and Pharmacology 27: 624–626, 1975
Friedheim E, Graziano JH, Popovac D, Dragovic D, Kaul B. Treatment of lead poisoning by 2,3-dimercaptosuccinic acid. Lancet 2: 1234–1236, 1978
Graziano JH, Cuccia D, Friedheim E. The pharmacology of 2,3-dimercaptosuccinic acid and its potential use in arsenic poisoning. Journal of Pharmacology and Experimental Therapeutics 207: 1051–1055, 1978b
Graziano JH, Leong JK, Friedheim E. 2,3-Dimercaptosuccinic acid: a new agent for the treatment of lead poisoning. Journal of Pharmacology and Experimental Therapeutics 206: 696–700, 1978a
Graziano JH, Siris ES, Lolacono N, Silverberg SJ, Turgeon L. 2,3-Dimercaptosuccinic acid as an antidote for lead intoxication. Clinical Pharmacology and Therapeutics 37: 431–438, 1985
Graziano JH. Role of 2,3-dimercaptosuccinic acid in the treatment of heavy metal poisoning. Medical Toxicology 1: 155–162, 1986
Greenfield S, Jones IJL, Berry CT. High-pressure plasma as spectroscopic emission sources. Analyst 89: 713–720, 1964
Hryhorczuk DO, Rabinowitz MB, Hessl SM, Hoffman D, Hogan MM, et al. Elimination kinetics of blood lead in workers with chronic lead intoxication. American Journal of Industrial Medicine 8: 33–42, 1985
Klaassen CD. Heavy metals and heavy-metal antagonists. In Goodman AG et al. (Eds) The pharmacological basis of therapeutics, 7th ed., p. 1623, MacMillan Publishing Company, New York, 1985
Lenz K, Hruby K, Druml W, Eder A, Gaszner A, et al. 2,3-Dimercaptosuccinic acid in human arsenic poisoning. Archives of Toxicology 47: 241–243, 1981
Magos L. The effects of dimercaptosuccinic acid on the excretion and distribution of mercury in rats and mice treated with mercuric chloride and methylmercury chloride. British Journal of Pharmacology 56: 479–484, 1976
Planas-Bohne F. The effect of 2,3-dimercaptopropane-1-sulfonate and 2,3-dimercaptosuccinic acid on the distribution and excretion of mercuric chloride in rats. Toxicology 19: 275–278, 1981
Reed TB. Coupled plasma torch. Journal of Applied Physics 32: 821–824, 1961
Tadlock CH, Aposhian HV. Protection of mice against the lethal effect of sodium arsenite by 2,2-dimercapto-1-propane sulfonic acid and 2,3-dimercaptosuccinic acid. Biochemical and Biophysical Research Communications 94: 501–507, 1980
Thivolet J, Perrot H, François R. Glossite, stomatite et onychopathie provoquées par la pénicillamine. Bulletin de la Société Française de Dermatologie 75: 61–63, 1968
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Fournier, L., Thomas, G., Garnier, R. et al. 2,3-Dimercaptosuccinic Acid Treatment of Heavy Metal Poisoning in Humans. Med Toxicol Adverse Drug Exp 3, 499–504 (1988). https://doi.org/10.1007/BF03259898
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DOI: https://doi.org/10.1007/BF03259898