ABSTRACT
This chapter summarizes the toxic effects of mustard exposure on the lung, with a focus on mechanisms of injury and disease pathogenesis, and potential therapeutics. Vesicants, including sulfur mustard, are cytotoxic blistering agents that cause chemical burns when in contact with the body. Chemical casualties and incapacitating injuries to the lung, skin, and eyes during World War I were mainly due to sulfur mustard. Exposure to mustard is accompanied by the release of vasoactive and chemotactic mediators, which leads to the accumulation of inflammatory cells at sites of injury. Mustard-induced injury is also associated with increased expression of enzymes mediating the production of eicosanoids, including prostaglandins and leukotrienes. Acute lung edema, lung inflammation, and moist rales have been reported within the first few days following exposure to hot liquid containing 2–3% nitrogen mustard. Experimental animal models of mustard-induced lung injury have been helpful in delineating mechanisms of toxicity and in identifying potential therapeutics.
