S-腺苷-L-蛋氨酸对铅中毒的有益作用。临床治疗的另一种方法。

Beneficial effect of S-adenosyl-L-methionine in lead intoxication. Another approach to clinical therapy.

作者信息

Paredes S R, Juknat de Geralnik A A, Batlle A M, Conti H A

出版信息

Int J Biochem. 1985;17(5):625-9. doi: 10.1016/0020-711x(85)90295-2.

Abstract

Five patients with chronic lead intoxication were treated with S-adenosyl-L-methionine (12 mg/kg body weight, daily), given intravenously, over a period of 22 days. A significant recovery of erythrocytic ALA-D was observed in all cases, after therapy. Blood lead content significantly pathologic at the beginning of SAM administration, rapidly decreased within 24-48 h of initiating treatment, reaching nearly control values at the end of the trial. A good correlation between recovery of ALA-D activity and decreased concentration of lead in RBC was found. GSH content in blood was diminished in lead poisoned patients, increasing to normal levels after SAM administration. Other biochemical parameters such as Deaminase activity in RBC, ALA, PBG, porphyrins and lead in urine and serum gamma-GT were measured, showing no important deviations from control values before, during or after treatment. Both biochemical and clinical improvement was observed, indicating that SAM therapy is beneficial in the treatment of lead intoxication. No untoward signs were observed. The mechanism of action of SAM is not yet clear; however, a chelating effect could be excluded, and very likely its action can be attributed to glutathione availability.

摘要

五名慢性铅中毒患者接受了静脉注射S-腺苷-L-蛋氨酸（12毫克/千克体重，每日）治疗，为期22天。治疗后，所有病例的红细胞δ-氨基-γ-酮戊酸脱水酶（ALA-D）均有显著恢复。在开始给予S-腺苷-L-蛋氨酸时血铅含量显著异常，在开始治疗后的24 - 48小时内迅速下降，在试验结束时接近对照值。发现ALA-D活性的恢复与红细胞中铅浓度的降低之间存在良好的相关性。铅中毒患者血液中的谷胱甘肽（GSH）含量降低，给予S-腺苷-L-蛋氨酸后升至正常水平。还测量了其他生化参数，如红细胞中的脱氨酶活性、尿和血清γ-谷氨酰转移酶中的δ-氨基-γ-酮戊酸（ALA）、胆色素原（PBG）、卟啉和铅，结果显示在治疗前、治疗期间或治疗后与对照值相比均无重要偏差。观察到生化和临床方面均有改善，表明S-腺苷-L-蛋氨酸疗法对铅中毒治疗有益。未观察到不良体征。S-腺苷-L-蛋氨酸的作用机制尚不清楚；然而，可以排除螯合作用，其作用很可能归因于谷胱甘肽的可用性。