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Lower Airway Complications of Sulfur Mustard Exposure

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Basic and Clinical Toxicology of Mustard Compounds

Abstract

The pulmonary complications of sulfur mustard (SM) exposure is the most mortal and morbid complication in exposed cases. In acute phase after exposure, all symptoms can because of airways and alveolar injuries and cell necrosis. Thus, treatment in this phase should be supportive and sometimes critical cares may be mandatory. In the chronic phase, productive cough, thick sputum and dyspnea are more frequent symptoms. Although chronic pulmonary sequels are common in exposed patients, the mechanism of these complications was not clearly described. Although corticosteroids extensively prescribed for treatment in chronic phase, its efficacy is short-term and its complications are serious. Imbalance in apoptosis and repair is seems to justify these symptoms. Therefore, treatments include antioxidant, bronchodilators, and mucolytics in this phase. Lung carcinogenicity of a single exposure to SM was not confirmed. Future studies may be helpful for assessing the genome mutation to resolve prolong symptoms.

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Acknowledgment

We would like to thanks chief and personnel’s of chemical injuries research center, Baqiyatallah University of medical sciences, Tehran, Iran. Also, we thank “Informa Healthcare” for their permission to use their journal content in this chapter. Moreover, we acknowledge Dr. Amini-Harandi and Dr. Amin Abbasi in addition to “Resaneh Takhassosi” publication for permission to use their book contents for this manuscript.

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Authors and Affiliations

  1. Chemical Injuries Research Center and Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran

    Mostafa Ghanei & Amin Saburi

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  1. Mostafa Ghanei
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  2. Amin Saburi
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Correspondence to Mostafa Ghanei .

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Editors and Affiliations

  1. Medical Toxicology Research Centre, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Mahdi Balali-Mood

  2. Department of Toxicology and Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad Abdollahi

Glossary

Alveoli

Cystic structures at the end of respiratory tree that have a thin layer of cell which charged with the task of gas exchange.

Antioxidant

A molecule which can prevent oxidation and cell injuries.

Apoptosis

Is a gradual process of cell death due to programmed inter and intra cellular signaling.

ARDS

Or acute respiratory distress syndrome which is a complex syndrome due to severe injury to the terminal components of airways and alveoli and pulmonary edema and respiratory failure are its two important sequels.

Bronchiolitis obliterans

The inflammatory involvement of terminal respiratory airways.

Bronchitis

The inflammation in the bronchi that can present with dyspnea and productive cough.

Chemical Warfare agents

Every chemical material which use for military and terroristic propose.

Chest tightness

A sense of heavy on the chest during the respiration

COPD

Or Chronic Obstructive Pulmonary Diseases which includes two main territories; emphysema and chronic bronchitis.

Corticosteroids

Synthetic hormone-like medications using for inflammatory suppression.

Dyspnea

Sensing the breathing that leads to increase the respiration attempts.

Fibrosis

A process in a damaged tissue that is characterized by gathering fibroblasts and collagen deposition.

Hemoptysis

Coughing up the blood that can because of a lesion in upper or lower respiratory tract.

Inflammation

Is a biological interaction between immune cells, threatened cells and pathogens that can present as an interaction complex containing warmness, pain, and swelling.

Interleukin

A class of cytokine family that usually in related to the immune systems cells.

Mutation

A change in normal sequence of genome.

N-Acetyl cysteine

Is a medication with mucolytics, antioxidative and immunomolulating properties.

Necrosis

Is a form of cell injury that leads to the premature and unprogrammed cells death.

Respiratory Airways

Include Upper respiratory tract and Lower respiratory tract which are responsible for providing a pathway to reach oxygen to the alveoli.

Sputum

Liquid secret from mucus cells of airways

Sulfur Mustard

An Alkylating chemical component which is used as a blistering chemical warfare agent that affect lung, eye and skin more than other organs.

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Ghanei, M., Saburi, A. (2015). Lower Airway Complications of Sulfur Mustard Exposure. In: Balali-Mood, M., Abdollahi, M. (eds) Basic and Clinical Toxicology of Mustard Compounds. Springer, Cham. https://doi.org/10.1007/978-3-319-23874-6_7

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