Liu Jie, Shi Jing-Zheng, Yu Li-Mei, Goyer Robert A, Waalkes Michael P
Inorganic Carcinogenesis Section, NCI at NIEHS, Mail Drop F0-09, Research Triangle Park, NC 27709, USA.
Exp Biol Med (Maywood). 2008 Jul;233(7):810-7. doi: 10.3181/0712-MR-336. Epub 2008 Apr 29.
Mercury is a major toxic metal ranked top in the Toxic Substances List. Cinnabar, which contains mercury sulfide, has been used in Chinese traditional medicines for thousands of years as an ingredient in various remedies, and 40 cinnabar-containing traditional medicines are still used today. Little is known about toxicology profiles or toxicokinetics of cinnabar and cinnabar-containing traditional medicines, and the high mercury content in these Chinese medicines raises justifiably escalations of public concern. This minireview, by searching the available database of cinnabar and by comparing cinnabar with common mercurials, discusses differences in their bioavailability, disposition, and toxicity. The analysis showed that cinnabar is insoluble and poorly absorbed from the gastrointestinal tract. Absorbed mercury from cinnabar is mainly accumulated in the kidneys, resembling the disposition pattern of inorganic mercury. Heating cinnabar results in release of mercury vapor, which in turn can produce toxicity similar to inhalation of these vapors. The doses of cinnabar required to produce neurotoxicity are 1000 times higher than methyl mercury. Following long-term use of cinnabar, renal dysfunction may occur. Dimercaprol and succimer are effective chelation therapies for general mercury intoxication including cinnabar. Pharmacological studies of cinnabar suggest sedative and hypnotic effects, but the therapeutic basis of cinnabar is still not clear. In summary, cinnabar is chemically inert with a relatively low toxic potential when taken orally. In risk assessment, cinnabar is less toxic than many other forms of mercury, but the rationale for its inclusion in traditional Chinese medicines remains to be fully justified.
汞是一种主要的有毒金属，在有毒物质清单中排名第一。含有硫化汞的朱砂，作为各种药物的成分，已在中国传统药物中使用了数千年，如今仍有40种含朱砂的传统药物在使用。关于朱砂及含朱砂传统药物的毒理学特征或毒代动力学知之甚少，这些中药中高含量的汞引发了公众合理的担忧升级。本综述通过检索现有的朱砂数据库，并将朱砂与常见汞化合物进行比较，讨论了它们在生物利用度、处置和毒性方面的差异。分析表明，朱砂不溶于水，从胃肠道吸收较差。从朱砂中吸收的汞主要积聚在肾脏，类似于无机汞的处置模式。加热朱砂会导致汞蒸气释放，进而产生类似于吸入这些蒸气的毒性。产生神经毒性所需的朱砂剂量比甲基汞高1000倍。长期使用朱砂后，可能会出现肾功能障碍。二巯丙醇和二巯基丁二酸是治疗包括朱砂在内的一般汞中毒的有效螯合疗法。朱砂的药理学研究表明有镇静和催眠作用，但其治疗基础仍不清楚。总之，朱砂化学性质不活泼，口服时毒性相对较低。在风险评估中，朱砂的毒性低于许多其他形式的汞，但其被纳入传统中药的理由仍有待充分论证。
