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New Drug Therapy May Lessen Pain and Damage in Spinal Cord Injuries and Diseases

During World War II, a drug called 2,3-dimercaptopropanol was created by British scientists as an antidote to an arsenic-based warfare agent called lewisite. The WWII antidote has lately been used primarily to treat Wilson’s disease (a genetic disorder that causes people to retain copper) or to treat heavy metal poisoning with arsenic, mercury, lead, antimony, or gold. But recently, scientists have been uncovering other ground-breaking uses for this drug: it may help reduce the pain and severity of spinal cord injuries and diseases.

Dimercaprol is a chemical that contains two thiol groups, which makes it an excellent neutralizing agent for acrolein, a neurotoxin that’s produced by the body whenever nerve cells are damaged. Acrolein is the bad guy. It increases pain and triggers an array of biochemical events inside the body that can ultimately worsen the extent of an injury or a disease process. Dimercaprol can scavenge for and then remove acrolein by using its two thiol groups. According to recent research, once dimercaprol and acrolein make contact inside the body, acrolein becomes neutralized and it can then be safely removed. Removing acrolein from the body during disease or following trauma to the spinal column could result in far less extensive damage to the spine and nerves.

Extensive research has shown that acrolein has a toxic effect on the body. Following a spinal cord injury, acrolein levels increase significantly, causing secondary damage to nearby tissues and spinal tissues that are already traumatized. It’s been shown to play a pathological role in several disease processes including multiple sclerosis. Scientists have been experimenting with acrolein scavengers for some time now, trying to find new and innovative approaches that could lessen the symptoms and tissue damage that results from spinal cord injuries and neuropathic diseases.

Spinal surgeons who work with gun-shot wounds may already be familiar with dimercaprol as a chelating agent to remove lead after gun-shot victims are exposed to this heavy metal. Lead poisoning can lead to various symptoms such as paresthesias in the limbs due to demyelination of motor axons, memory loss, attentional deficits, or even death. Dimercaprol has already been approved for use by the Food and Drug Administration in the United States, so scientists are planning the next phase of their research into how dimercaprol might help diminish trauma to the spinal cord in a variety of situations including disease, injury, and surgery.

The Food and Drug Administration has approved other compounds for use as acrolein scavengers, but Dimercaprol has certain advantages over these other offerings. Hydralazine and phenelzine are two drugs that both contain a hydrazine group which can cause them to have undesirable side effects, particularly in high doses. But dimercaprol has fewer side effects and it can be excreted by the kidneys and leaves the body in the urine. Because it doesn’t build up inside the body, doctors are hoping that this drug will help curb secondary tissue damage caused by trauma to the spinal cord. Future research will tell, but dimercaprol could make a vital improvement in spinal cord care following disease, injury, or even surgery.