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Open AccessReview

Arsenic Toxicity: Molecular Targets and Therapeutic Agents

1
Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, 09124 Monserrato-Cagliari, Italy
2
Department of Toxicology “Akademik Danilo Soldatović”, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
3
Norwegian Institute of Public Health, 0213 Oslo, Norway
4
Council for Nutritional and Environmental Medicine, 8610 Mo i Rana, Norway
5
Research Department, Innlandet Hospital Trust, 2380 Brumunddal, Norway
6
IM Sechenov First Moscow State Medical University (Sechenov University), Bolshaya Pirogovskaya St., 19-1, 119146 Moscow, Russia
*
Authors to whom correspondence should be addressed.
Biomolecules 2020, 10(2), 235; https://doi.org/10.3390/biom10020235
Received: 29 November 2019 / Revised: 30 January 2020 / Accepted: 30 January 2020 / Published: 4 February 2020
(This article belongs to the Special Issue Toxic and Essential Metals in Human Health and Disease)
: High arsenic (As) levels in food and drinking water, or under some occupational conditions, can precipitate chronic toxicity and in some cases cancer. Millions of people are exposed to unacceptable amounts of As through drinking water and food. Highly exposed individuals may develop acute, subacute, or chronic signs of poisoning, characterized by skin lesions, cardiovascular symptoms, and in some cases, multi-organ failure. Inorganic arsenite(III) and organic arsenicals with the general formula R-As2+ are bound tightly to thiol groups, particularly to vicinal dithiols such as dihydrolipoic acid (DHLA), which together with some seleno-enzymes constitute vulnerable targets for the toxic action of As. In addition, R-As2+-compounds have even higher affinity to selenol groups, e.g., in thioredoxin reductase that also possesses a thiol group vicinal to the selenol. Inhibition of this and other ROS scavenging seleno-enzymes explain the oxidative stress associated with arsenic poisoning. The development of chelating agents, such as the dithiols BAL (dimercaptopropanol), DMPS (dimercapto-propanesulfonate) and DMSA (dimercaptosuccinic acid), took advantage of the fact that As had high affinity towards vicinal dithiols. Primary prevention by reducing exposure of the millions of people exposed to unacceptable As levels should be the prioritized strategy. However, in acute and subacute and even some cases with chronic As poisonings chelation treatment with therapeutic dithiols, in particular DMPS appears promising as regards alleviation of symptoms. In acute cases, initial treatment with BAL combined with DMPS should be considered.
Keywords: arsenic; drinking water; arsenic poisoning; lipoic acid; BAL; DMPS arsenic; drinking water; arsenic poisoning; lipoic acid; BAL; DMPS
MDPI and ACS Style

Nurchi, V.M.; Djordjevic, A.B.; Crisponi, G.; Alexander, J.; Bjørklund, G.; Aaseth, J. Arsenic Toxicity: Molecular Targets and Therapeutic Agents. Biomolecules 2020, 10, 235.

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