Alteration in inflammatory mediators in seriously eye-injured war veterans, long-term after sulfur mustard exposure

Ghasemi, Hassan; Javadi, Mohammad Ali; Ardestani, Sussan K.; Mahmoudi, Mahmoud; Pourfarzam, Shahryar; Mahdavi, Mohammad; Yarmohammadi, Mohammad Ebrahim; Baradaran‐Rafii, Alireza; Jadidi, Khosrow; Shariatpanahi, Shamsa; Rastin, Maryam; Heidary, Fatemeh; Safavi, Maliheh; Mirsharif, Ensie Sadat; Nasiri, Zahra; Ghazanfari, Tooba

doi:10.1016/j.intimp.2019.105897

Cited by 6 publications

(6 citation statements)

References 36 publications

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“…It also stimulates cyclooxygenase-2 and matrix metalloproteinases (MMP), leading to the release of inflammatory mediators, cytokines, prostaglandins, and serine proteases. 10,11…”

Section: Resultsmentioning

confidence: 99%

“…It also stimulates cyclooxygenase-2 and matrix metalloproteinases (MMP), leading to the release of inflammatory mediators, cytokines, prostaglandins, and serine proteases. 10,11 Serum concentrations of interleukin-1a and Fas ligand in SM-exposed veterans with severe eye injuries were remarkably elevated compared with the healthy control group. Serum and tear levels of tumor necrosis factor-alpha were lower in cases than in controls.…”

Section: Tissue Inflammationmentioning

confidence: 96%

“…Serum and tear levels of tumor necrosis factor-alpha were lower in cases than in controls. 10,11 A study on eye injuries secondary to SM showed the association of alterations in serum immunoglobulin levels, especially IgG1 and IgG2, with some ocular abnormalities. 12 Ghazanfari et al 13 stated that the level of interleukin-8/CXCL8 in tear film was associated with the intensity of ocular surface injuries.…”

Section: Tissue Inflammationmentioning

confidence: 99%

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Mustard Gas–Induced Ocular Surface Disorders: An Update on the Pathogenesis, Clinical Manifestations, and Management

Soleimani

Momenaei

Baradaran‐Rafii

et al. 2022

Cornea

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Purpose: Mustard gas (MG) is a potent blistering and alkylating agent that has been used for military and terrorism purposes. Ocular surface injuries are common after exposure to MG. This review provides an update on the pathophysiology, ocular surface complications, and treatment options for MG-related ocular injuries.Methods: Required information was obtained by reviewing various databases such as Cochrane Library, Google Scholar, and PubMed until March 2022. Data were collected by using keywords: "mustard gas" OR "sulfur mustard" AND "eye" OR "cornea" OR "ocular complication" OR "keratitis" OR "keratopathy" OR "limbal stem cell deficiency" OR "dry eye."Results: Chronic intracellular toxicity, inflammation, and ischemia have been shown to play an essential role in the pathogenesis of MG injury. Ocular surface injuries can have acute, chronic, and most distinctly a delayed-onset presentation leading to various degrees of limbal stem cell deficiency. To date, no treatment has been agreed on as the standard treatment for chronic/delayed-onset MG keratopathy. Based on the authors' experience, we propose a management algorithm for MG-related ocular surface injuries involving optimization of ocular health, anti-inflammatory therapy, and if needed surgical interventions. The management of chronic and delayedonset presentation remains challenging.Conclusions: MG keratopathy is a unique form of chemical injury which can lead to a range of ocular surface pathologies. Long-term anti-inflammatory therapy even in patients with seemingly mild disease may potentially reduce the likelihood of the development of more severe delayed-onset disease.

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“…It also stimulates cyclooxygenase-2 and matrix metalloproteinases (MMP), leading to the release of inflammatory mediators, cytokines, prostaglandins, and serine proteases. 10,11…”

Section: Resultsmentioning

confidence: 99%

Section: Tissue Inflammationmentioning

confidence: 96%

Section: Tissue Inflammationmentioning

confidence: 99%

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Mustard Gas–Induced Ocular Surface Disorders: An Update on the Pathogenesis, Clinical Manifestations, and Management

Soleimani

Momenaei

Baradaran‐Rafii

et al. 2022

Cornea

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“…This damage is exacerbated by secondary conditions that develop in these patients, such as dry eye disease and limbal stem cell deficiency ( 22 ). Some studies showed the role of inflammation in delayed corneal damage caused by mustard gas ( 17 , 23 , 24 ). However, in our study, none of our specimens demonstrated evidence of inflammation or immune cell infiltration.…”

Section: Discussionmentioning

confidence: 99%

Histopathology Study of Patients with Delayed Mustard Gas Keratopathy 30 Years After Exposure

Daryabari¹,

Aghamollaei

Amoli

et al. 2022

Iran J Pathol

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Scan to discover onlineBackground & Objective: Delayed mustard gas keratopathy (DMGK) is the main chronic outcome in eye-chemical injured patients. The aim of this study was the histopathological evaluation of mustard-exposed cornea after more than 30 years.Methods: Fourteen corneas after Lamellar keratoplasty were evaluated in this study. Corneal tissues were prepared by histologic methods and stained by H&E. Results:The main histopathological findings in these cases were the presence of severe stromal edema and corneal scar. In the sections with visible superficial epithelium, subepithelial bullae formation was observed. Focal or diffuse disruption of Bowman's membrane and replacement with fibrosis were also seen. There was no evidence of stromal vascularization and inflammation in all specimens. Conclusion:After more than 30 years, an extensive corneal scar is seen in sulfur mustard exposed patients. Scar tissue without vascularization and fibroblastic proliferation is the main finding in the sulfur mustard exposed cornea. This pathology result is different from other scars. No evidence of inflammation or immune cell infiltration should be considered in managing DMGK.

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“…Serum levels of FasL were significantly higher in cases with severe ocular involvement than in the controls ( p = 0.03). Serum levels of IL-1α and FasL were reported to cause different ocular surface abnormalities in sulfur mustard-exposed patients [ 25 ]. The SM-exposure could alter immunoglobulins level compared with healthy controls and the changes of IgG2 and IgG1 levels were associated with some ocular problems [ 26 ].…”

Section: Sulfur Mustardmentioning

confidence: 99%

Occupational Exposures and Environmental Health Hazards of Military Personnel

Geretto

Ferrari

Angelis

et al. 2021

IJERPH

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Background: Military personnels are frequently exposed to environmental pollutants that can cause a variety of diseases. Methods: This review analyzed publications regarding epidemiological and biomonitoring studies on occupationally-exposed military personnels. Results: The exposures include sulfur mustard, organ chlorines, combustion products, fuel vapors, and ionizing and exciting radiations. Important factors to be considered are the lengths and intensities of exposures, its proximity to the sources of environmental pollutants, as well as confounding factors (cigarette smoke, diet, photo-type, healthy warrior effect, etc.). Assessment of environmental and individual exposures to pollutants is crucial, although often omitted, because soldiers have often been evaluated based on reported health problems rather than on excessive exposure to pollutants. Biomarkers of exposures and effects are tools to explore relationships between exposures and diseases in military personnels. Another observation from this review is a major problem from the lack of suitable control groups. Conclusions: This review indicates that only studies which analyzed epidemiological and molecular biomarkers in both exposed and control groups would provide evidence-based conclusions on exposure and disease risk in military personnels.

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Alteration in inflammatory mediators in seriously eye-injured war veterans, long-term after sulfur mustard exposure

Cited by 6 publications

References 36 publications

Mustard Gas–Induced Ocular Surface Disorders: An Update on the Pathogenesis, Clinical Manifestations, and Management

Mustard Gas–Induced Ocular Surface Disorders: An Update on the Pathogenesis, Clinical Manifestations, and Management

Histopathology Study of Patients with Delayed Mustard Gas Keratopathy 30 Years After Exposure

Occupational Exposures and Environmental Health Hazards of Military Personnel

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