ABSTRACT
IV. Chlorine ............................................................................................................................. 261 V. Phosgene............................................................................................................................ 261 VI. Lewisite ............................................................................................................................. 262 VII. Antidotes or Ameliorative Agents..................................................................................... 262
A. Lewisite ..................................................................................................................... 262 B. Mustard...................................................................................................................... 263
1. Effect of NAC on Signal Transduction ............................................................. 265 C. Antioxidant Liposomes ............................................................................................. 267 D. Chlorine..................................................................................................................... 269 E. Phosgene ................................................................................................................... 269
VIII. Oxidative Stress in Different Organ Systems ................................................................... 271 A. Lung .......................................................................................................................... 271
1. Monitoring Oxidative Stress in Live Cells ........................................................ 273 2. Hydrogen Peroxide and Superoxide Radical Generation
in Bronchoalveolar Fluids.................................................................................. 273 3. Antioxidant Status in Lung................................................................................ 273 4. Hydroxydeoxyguanosine, an Indicator of DNA Damage ................................. 273 5. Direct Measurements of Oxygen Free Radicals ................................................ 273 6. Exhaled Breath Condensate ............................................................................... 274 7. Analysis of Expired Air for Oxidation Products ............................................... 274
B. Skin .............................................................................................................................. 274 1. Role of Skin Mast Cells in Vesicant Toxicity...................................................... 274
C. Eyes .............................................................................................................................. 275 1. Vesicant-Induced Ocular Injury and Oxidative Stress ......................................... 276 2. Redox Proteomics ................................................................................................. 277
IX. Oxidative Stress: the Concept and the Effect on Gene Expression .................................... 277 A. Definition of Oxidative Stress ..................................................................................... 277 B. Molecules that Influence the Redox Potential ............................................................. 278
1. Nicotinamide Adenosine Dinucleotide Phosphate ............................................... 278 2. Thioredoxin........................................................................................................... 279
C. Apoptosis...................................................................................................................... 279 D. Gene Expression Controlled by Redox-State Transcription Factors ........................... 279
1. NF-kB ................................................................................................................... 280 2. Ref-1 ..................................................................................................................... 280 3. Activator Protein-1................................................................................................ 280 4. Heat Shock Transcription Factor .......................................................................... 280
X. Summary .............................................................................................................................. 280 A. Antidotes ...................................................................................................................... 281
References ..................................................................................................................................... 281
The primary treatment of vesicant exposure is decontamination and supportive therapies; there is only one vesicant that has an antidote. The paucity of the treatment options continues to confer their tactical advantage. The development of an ameliorative or antidote would accomplish, at a minimum, two goals: (1) effective treatment, if needed, and (2) decreased tactical advantage.
