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新临床试验及数百万患者常规使用后对依地酸钙钠螯合作用的再评价:初步发现和风险/获益评估综述。

EDTA chelation reappraisal following new clinical trials and regular use in millions of patients: review of preliminary findings and risk/benefit assessment.

机构信息

Born Preventive Health Care Clinic, Grand Rapids and Michigan State University College of Osteopathic Medicine, East Lansing, MI, USA.

出版信息

Toxicol Mech Methods. 2013 Jan;23(1):11-7. doi: 10.3109/15376516.2012.730562. Epub 2012 Oct 19.

DOI:10.3109/15376516.2012.730562
PMID:22991933
Abstract

EDTA chelation therapy is regularly used in thousands of patients worldwide. An FDA approval of more than 50 years ago for heavy metal detoxification prompted many physicians to use EDTA as an alternative medicine for many categories of patients. Recently, NIH initiated the so-called Trial to Assess Chelation Therapy (TACT), which has been designed to evaluate whether EDTA and high dose oral vitamins and mineral therapy could offer clinical, quality of life, and economic benefits for patients with a previous myocardial infraction. A 50% reduction of urinary Pb and improvement of systolic blood pressure was observed in 33 cardiovascular patients following 20 iv administrations. In another study involving 15 patients of different categories, EDTA also has been shown to be an effective and nontoxic chelator for the removal of xenobiotic metals such as Pb, Cd, Ni and Al. Administration of iv EDTA on weekly basis appears to be a sufficient and nontoxic protocol for treating patients with suspected overload and toxicity of xenobiotic metals especially Pb and Cd. The causative effect of xenobiotic metals in cancer, cardiovascular, neurodegenerative, renal and other diseases needs further investigation. Similarly, the use of EDTA chelation therapy in other conditions, which are not related to xenobiotic metal toxicity needs further investigation and confirmation of therapeutic use from controlled randomized clinical trials. Metal balance and drug interaction studies are required to clarify the risk/benefit assessment for the long term use of EDTA in patients with excess xenobiotic metal toxicity and in other conditions.

摘要

EDTA 螯合疗法在全球数千名患者中得到了广泛应用。50 多年前,FDA 批准 EDTA 用于重金属解毒,这促使许多医生将 EDTA 作为替代医学方法用于治疗许多类别的患者。最近,NIH 启动了所谓的螯合疗法评估试验(TACT),旨在评估 EDTA 和高剂量口服维生素和矿物质疗法是否能为既往心肌梗死患者带来临床、生活质量和经济效益。33 名心血管患者接受 20 次静脉注射后,尿液中的 Pb 减少了 50%,收缩压得到改善。在另一项涉及 15 名不同类别的患者的研究中,EDTA 也被证明是一种有效的、无毒的螯合剂,可用于去除异源金属,如 Pb、Cd、Ni 和 Al。每周静脉注射 EDTA 的给药方案似乎是治疗疑似异源金属(尤其是 Pb 和 Cd)过载和毒性患者的充分和无毒方案。异源金属在癌症、心血管、神经退行性、肾脏和其他疾病中的致病作用需要进一步研究。同样,EDTA 螯合疗法在其他与异源金属毒性无关的疾病中的应用也需要进一步研究和通过对照随机临床试验来确认其治疗用途。需要进行金属平衡和药物相互作用研究,以明确 EDTA 在异源金属毒性过剩患者和其他情况下长期使用的风险/效益评估。

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