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Clinical Toxicology Volume 55, 2017 - Issue 2
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Clinical Research

Modeling the effect of succimer (DMSA; dimercaptosuccinic acid) chelation therapy in patients poisoned by lead

Jan C. H. van EijkerenNational Institute for Public Health and the Environment, Bilthoven, The Netherlands; View further author information
,
J. Daniël N. OlieNational Poisons Information Center, University Medical Center Utrecht, Utrecht, The Netherlands; ;Department of Pharmacology and Toxicology, University of Nijmegen, Nijmegen, The Netherlands; View further author information
,
Sally M. BradberryCity Hospital, National Poisons Information Service (Birmingham Unit), Birmingham, UK; ;School of Biosciences, University of Birmingham, Birmingham, UK; View further author information
,
J. Allister ValeCity Hospital, National Poisons Information Service (Birmingham Unit), Birmingham, UK; ;School of Biosciences, University of Birmingham, Birmingham, UK; View further author information
,
Irma de VriesNational Poisons Information Center, University Medical Center Utrecht, Utrecht, The Netherlands; View further author information
,
Harvey J. Clewell IIIScitoVation, Research Triangle Park, Durham, NC, USA; View further author information
,
Jan MeulenbeltNational Poisons Information Center, University Medical Center Utrecht, Utrecht, The Netherlands; ;Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands; ;Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The NetherlandsView further author information
&
Claudine C. HunaultNational Poisons Information Center, University Medical Center Utrecht, Utrecht, The Netherlands; Correspondence[email protected]
View further author information
 show all
Pages 133-141 | Received 19 May 2016, Accepted 16 Nov 2016, Published online: 05 Dec 2016

References

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  • Bradberry S, Vale A. Dimercaptosuccinic acid (succimer; DMSA) in inorganic lead poisoning. Clin Toxicol. 2009;47:617–631.
  • Bradberry S, Vale A. A comparison of sodium calcium edetate (edetate calcium disodium) and succimer (DMSA) in the treatment of inorganic lead poisoning. Clin Toxicol. 2009;47:841–858.
  • Kosnett MJ. Chelation for heavy metals (arsenic, lead, and mercury): protective or perilous? Clin Pharmacol Ther. 2010;88:412–415.
  • Canfield RL, Henderson CR Jr, Cory-Slechta DA, et al. Intellectual impairment in children with blood lead concentrations below 10 μg per deciliter. N Engl J Med. 2003;348:1517–1526.
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  • Environmental Protection Agency. Review of adult lead models evaluation of models for assessing human health risks associated with lead exposures at non-residential areas of superfund and other hazardous waste sites [Internet]. Washington; 2001. [cited 2016 May 18]. Available from: http://www.epa.gov/superfund/lead/products/adultreview.pdf.
  • White PD, Van Leeuwen P, Davis BD, et al. The conceptual structure of the integrated exposure uptake biokinetic model for lead in children. Environ Health Perspect. 1998;106:1513–1530.
  • O'Flaherty EJ. Physiologically based models for bone-seeking elements. V. Lead absorption and disposition in childhood. Toxicol Appl Pharmacol. 1995;131:297–308.
  • O'Flaherty EJ. A physiologically based kinetic model for lead in children and adults. Environ Health Perspect. 1998;106:1495–1503.
  • van Eijkeren JCH, Olie JDN, Bradberry SM, et al. Modelling dimercaptosuccinic acid (DMSA) plasma kinetics in humans. Clin Toxicol. 2016;54:833–839.
  • Asiedu P, Moulton T, Blum CB, et al. Metabolism of meso-2,3-dimercaptosuccinic acid in lead-poisoned children and normal adults. Environ Health Perspect. 1995;103:734–739.
  • Aposhian HV, Aposhian MM. Meso-2, 3-dimercaptosuccinic acid: chemical, pharmacological and toxicological properties of an orally effective metal chelating agent. Annu Rev Pharmacol Toxicol. 1990;30:279–306.
  • Maiorino RM, Aposhian MM, Xu ZF, Li Y, et al. Determination and metabolism of dithiol chelating agents. XV. The meso-2, 3-dimercaptosuccinic acid-cysteine (1:2) mixed disulfide, a major urinary metabolite of DMSA in the human, increases the urinary excretion of lead in the rat. J Pharmacology Exp Ther. 1993;267:1221–1226.
  • Bradberry S, Sheehan T, Vale A. Use of oral dimercaptosuccinic acid (succimer) in adult patients with inorganic lead poisoning. QJM. 2009;102:721–732.
  • Harrell FE Jr, editor. Regression modeling strategies with applications to linear models, logistic regression, and survival analysis. In: Overview of maximum likelihood estimation. New York: Springer-Verlag New York Inc; 2001. p. 179–213.

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