학술논문

The vitamin B12 analog cobinamide is an effective hydrogen sulfide antidote in a lethal rabbit model.
Document Type
article
Source
Clinical toxicology (Philadelphia, Pa.). 52(5)
Subject
Animals
Rabbits
Disease Models
Animal
Hydrogen Sulfide
Sulfides
Cobamides
Hydroxocobalamin
Hemoglobins
Antidotes
Spectroscopy
Near-Infrared
Infusions
Intravenous
Injections
Intramuscular
Injections
Intravenous
Survival Rate
CNS/Psychological
Heart
Lung
Muscle
Disease Models
Animal
Spectroscopy
Near-Infrared
Infusions
Intravenous
Injections
Intramuscular
Toxicology
Pharmacology and Pharmaceutical Sciences
Language
Abstract
Background and purposeHydrogen sulfide (H2S) is a highly toxic gas for which no effective antidotes exist. It acts, at least in part, by binding to cytochrome c oxidase, causing cellular asphyxiation and anoxia. We investigated the effects of three different ligand forms of cobinamide, a vitamin B12 analog, to reverse sulfide (NaHS) toxicity.MethodsNew Zealand white rabbits received a continuous intravenous (IV) infusion of NaHS (3 mg/min) until expiration or a maximum 270 mg dose. Animals received six different treatments, administered at the time when they developed signs of severe toxicity: Group 1-saline (placebo group, N = 9); Group 2--IV hydroxocobalamin (N = 7); Group 3--IV aquohydroxocobinamide (N = 6); Group 4--IV sulfitocobinamide (N = 6); Group 5--intramuscular (IM) sulfitocobinamide (N = 6); and Group 6-IM dinitrocobinamide (N = 8). Blood was sampled intermittently, and systemic blood pressure and deoxygenated and oxygenated hemoglobin were measured continuously in peripheral muscle and over the brain region; the latter were measured by diffuse optical spectroscopy (DOS) and continuous wave near infrared spectroscopy (CWNIRS).ResultsCompared with the saline controls, all cobinamide derivatives significantly increased survival time and the amount of NaHS that was tolerated. Aquohydroxocobinamide was most effective (261.5 ± 2.4 mg NaHS tolerated vs. 93.8 ± 6.2 mg in controls, p < 0.0001). Dinitrocobinamide was more effective than sulfitocobinamide. Hydroxocobalamin was not significantly more effective than the saline control.ConclusionsCobinamide is an effective agent for inhibiting lethal sulfide exposure in this rabbit model. Further studies are needed to determine the optimal dose and form of cobinamide and route of administration.