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支持发现和开发针对眼和皮肤化学损伤的医疗对策。

Supporting discovery and development of medical countermeasures for chemical injury to eye and skin.

机构信息

Department of Health and Human Services, National Eye Institute/National Institutes of Health (NEI/NIH), 6700B Rockledge Drive, Bethesda, MD, 20817, United States.

Department of Health and Human Services, National Institute of Arthritis & Musculoskeletal & Skin Diseases/National Institutes of Health (NIAMS/NIH), 6701 Democracy Boulevard, Bethesda, MD, 20892, United States.

出版信息

Exp Eye Res. 2022 Aug;221:109156. doi: 10.1016/j.exer.2022.109156. Epub 2022 Jun 15.

Abstract

Vesicants, from vesica (Latin for blister), can cause local and systemic toxicity. They include the chemotherapy drug nitrogen mustard and chemical warfare agents sulfur mustard, Lewisite, and phosgene oxime. These agents are commonly released in vapor form and consequently, eyes and skin are the most vulnerable. The ocular and cutaneous injuries can be acute, subacute, or chronic, and can predispose casualties to secondary deleterious effects. Underlying these broad organ responses are shared and tissue-specific cellular and molecular biological cascades that attempt to counteract such chemical injuries. Depending on the severity of the chemical insult, biological responses often lead to inadequate wound healing and result in long-term pathology instead. Exposure to other toxic industrial chemicals such as acrolein, chloropicrin, and hydrogen fluoride, can also cause prominent eye and skin damage. There are currently no FDA-approved drugs to counteract these injuries. Hence, the possibility of a mass casualty emergency involving these chemicals is a major public health concern. Recognizing this critical challenge, the United States Department of Health and Human Services (HHS) is committed to the development of medical countermeasures to advance national health and medical preparedness against these highly toxic chemicals. Here, we provide an overview of various HHS funding and scientific opportunities available in this space, emphasizing parallels between eye and skin response to chemical injury. We also discuss a main limitation of existing data and suggest ways to overcome it.

摘要

糜烂剂,来源于拉丁语中的 vesica(膀胱),可导致局部和全身毒性。它们包括化疗药物氮芥和化学战剂芥子气、路易氏剂和氯膦。这些药剂通常以蒸气形式释放,因此眼睛和皮肤是最易受伤害的部位。眼部和皮肤损伤可以是急性、亚急性或慢性的,并且会使伤员易受继发有害影响。在这些广泛的器官反应下,存在着共同的和组织特异性的细胞和分子生物学级联反应,试图对抗这种化学损伤。根据化学损伤的严重程度,生物反应通常导致伤口愈合不足,从而导致长期的病理变化。接触丙烯醛、氯化苦和氢氟酸等其他有毒工业化学品也会导致明显的眼睛和皮肤损伤。目前没有 FDA 批准的药物来对抗这些损伤。因此,涉及这些化学物质的大量人员伤亡紧急情况是一个主要的公共卫生问题。认识到这一关键挑战,美国卫生与公众服务部(HHS)致力于开发医疗对策,以推进国家对这些高度有毒化学物质的健康和医疗准备。在这里,我们提供了该领域内各种 HHS 资助和科学机会的概述,强调了眼睛和皮肤对化学损伤反应的相似之处。我们还讨论了现有数据的主要局限性,并提出了克服这些局限性的方法。

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