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Diagnostic chelation challenge with DMSA: a biomarker of long-term mercury exposure?

机译:DMSA对螯合剂的诊断挑战:长期接触汞的生物标志物?

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摘要

Chelation challenge testing has been used to assess the body burden of various metals. The best-known example is EDTA challenge in lead-exposed individuals. This study assessed diagnostic chelation challenge with dimercaptosuccinic acid (DMSA) as a measure of mercury body burden among mercury-exposed workers. Former employees at a chloralkali plant, for whom detailed exposure histories were available (n = 119), and unexposed controls (n = 101) completed 24-hr urine collections before and after the administration of two doses of DMSA, 10 mg/kg. The urinary response to DMSA was measured as both the absolute change and the relative change in mercury excretion. The average 24-hr mercury excretion was 4.3 microg/24 hr before chelation, and 7.8 microg/24 hr after chelation. There was no association between past occupational mercury exposure and the urinary excretion of mercury either before or after DMSA administration. There was also no association between urinary mercury excretion and the number of dental amalgam surfaces, in contrast to recent published results. We believe the most likely reason that DMSA chelation challenge failed to reflect past mercury exposure was the elapsed time (several years) since the exposure had ended. These results provide normative values for urinary mercury excretion both before and after DMSA challenge, and suggest that DMSA chelation challenge is not useful as a biomarker of past mercury exposure.
机译:螯合挑战测试已用于评估各种金属的身体负担。最著名的例子是暴露于铅的个体中的EDTA挑战。这项研究评估了二巯基琥珀酸(DMSA)对螯合剂的诊断挑战,以衡量接触汞的工人体内汞的负担。氯碱工厂的前雇员可以得到详细的接触史(n = 119),而未接触的对照组(n = 101)则在两次剂量的10 mg / kg DMSA施用前后都完成了24小时尿液收集。 DMSA的尿液反应以汞排泄的绝对变化和相对变化来衡量。螯合前平均24小时汞排泄为4.3微克/ 24小时,螯合后平均为7.8微克/ 24小时。 DMSA施用之前或之后,过去的职业汞暴露与尿中的汞排泄之间没有关联。与最近发表的结果相反,尿中汞的排泄与牙科用汞合金表面的数量也没有关联。我们认为,DMSA螯合挑战未能反映过去的汞暴露的最可能原因是自暴露结束以来经过的时间(数年)。这些结果为DMSA攻击之前和之后的尿中汞排泄提供了标准值,并表明DMSA螯合攻击不能用作过去汞暴露的生物标志物。

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