Limiting Tissue Damage Aim of Mustard Gas Study

Limiting tissue damage by controlling the body’s inflammatory response after exposure to mustard gas is the goal of a new study at the Houston VA Medical Center. Funded by the Department of Defense, the study’s findings are also expected to benefit other patients with acute inflammatory problems.

First used as a means of chemical warfare in 1917 during World War I, sulfur mustard was most recently used in the Iraq/Iran war in the mid 1980s. Considered a weapon of terror, it is relatively easy to obtain.

“Mustard gas, or sulfur mustard, initially blisters or burns the skin and mucosal surfaces, often affecting the throat, airways, lungs, and eyes,” said John Sweeney, M.D., Houston VA Medical Center staff surgeon and associate professor of surgery at Baylor College of Medicine. “Little can be done to prevent the initial injury to the skin and tissues underlying it.”

After initial exposure, the body triggers an inflammatory response in the affected areas. In sulfur mustard injury, the response goes haywire, causing the cells that normally fight infection and attack damaged tissues to destroy normal tissues as well.

“The body’s neutrophils, cells that act as “foot soldiers” fighting inflammation, respond to the injury but begin to indiscriminately kill healthy tissue, resulting in serious secondary injury,” Sweeney said. “In the worst case, this secondary injury can involve the entire body and result in death.”

Sweeney is looking at neutrophil function in response to six or seven biological mediators released in the area of the sulfur mustard injury. These mediators signal the neutrophils to perform in various ways.

“We’re looking at the effect of each of these mediators on neutrophil function to determine which ones cause the neutrophils to have harmful effects on the injury,” he said.

After determining which mediators have a negative impact on neutrophil function, Sweeney’s research will attempt to identify a mechanism that will allow physicians to control or modulate the response, and thereby limit additional injury.

The ability to control inflammatory response will benefit all patients, Sweeney said.

“Whether the patient has pneumonia, surgical complications, or a sulfur mustard injury, the same mechanism might be used to control inflammatory responses gone awry,” he said.

In the future, Sweeney hopes to compare inflammatory response in traditional surgery patients with the response of patients undergoing minimally invasive surgery.

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©2006 Texas Medical Center

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