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口服二巯基丁二酸疗法对自闭症谱系障碍儿童的安全性和有效性:A部分——医学结果

Safety and efficacy of oral DMSA therapy for children with autism spectrum disorders: Part A--medical results.

作者信息

Adams James B, Baral Matthew, Geis Elizabeth, Mitchell Jessica, Ingram Julie, Hensley Andrea, Zappia Irene, Newmark Sanford, Gehn Eva, Rubin Robert A, Mitchell Ken, Bradstreet Jeff, El-Dahr Jane

机构信息

Division of Basic Medical Sciences, Southwest College of Naturopathic Medicine, Tempe, AZ, USA.

出版信息

BMC Clin Pharmacol. 2009 Oct 23;9:16. doi: 10.1186/1472-6904-9-16.

Abstract

BACKGROUND

This study investigated the effect of oral dimercapto succinic acid (DMSA) therapy for children with autism spectrum disorders ages 3-8 years.

METHODS

Phase 1 involved 65 children who received one round of DMSA (3 days). Participants who had high urinary excretion of toxic metals were selected to continue on to phase 2. In phase 2, 49 participants were randomly assigned in a double-blind design to receive an additional 6 rounds of either DMSA or placebo.

RESULTS

DMSA greatly increased the excretion of lead, substantially increased excretion of tin and bismuth, and somewhat increased the excretion of thallium, mercury, antimony, and tungsten. There was some increase in urinary excretion of essential minerals, especially potassium and chromium. The Phase 1 single round of DMSA led to a dramatic normalization of RBC glutathione in almost all cases, and greatly improved abnormal platelet counts, suggesting a significant decrease in inflammation.

CONCLUSION

Overall, DMSA therapy seems to be reasonably safe, effective in removing several toxic metals (especially lead), dramatically effective in normalizing RBC glutathione, and effective in normalizing platelet counts. Only 1 round (3 days) was sufficient to improve glutathione and platelets. Additional rounds increased excretion of toxic metals.

摘要

背景

本研究调查了口服二巯基丁二酸(DMSA)对3至8岁自闭症谱系障碍儿童的治疗效果。

方法

第一阶段涉及65名接受一轮DMSA治疗(3天)的儿童。选择有毒金属尿排泄量高的参与者继续进入第二阶段。在第二阶段,49名参与者被随机分配到双盲设计中,接受另外6轮DMSA或安慰剂治疗。

结果

DMSA大大增加了铅的排泄,显著增加了锡和铋的排泄,并略微增加了铊、汞、锑和钨的排泄。必需矿物质的尿排泄量有所增加,尤其是钾和铬。第一阶段的一轮DMSA治疗几乎在所有情况下都使红细胞谷胱甘肽显著恢复正常,并大大改善了异常血小板计数,表明炎症显著减轻。

结论

总体而言,DMSA治疗似乎相当安全,在清除几种有毒金属(尤其是铅)方面有效,在使红细胞谷胱甘肽恢复正常方面效果显著,在使血小板计数恢复正常方面也有效。仅一轮(3天)就足以改善谷胱甘肽和血小板。额外的疗程增加了有毒金属的排泄。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cf5/2774660/74a5573c34b4/1472-6904-9-16-1.jpg

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