Bismuth encephalopathy- a rare complication of long-standing use of bismuth subsalicylate

Borbinha, Cláudia; Serrazina, Filipa; Salavisa, Manuel; Viana-Baptista, Miguel

doi:10.1186/s12883-019-1437-9

Cited by 37 publications

(16 citation statements)

References 26 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been reported that prolonged high level exposure to certain bismuth compounds can lead to altered neurofunction. Bismuth-induced neurotoxicity (or encephalopathy) is a rare side effect that has been reported in patients taking high and/or prolonged doses of bismuth subnitrate, subgallate, or subsalicylate. − However, generally withdrawal of the bismuth drug leads to complete recovery in short time periods . An in vitro study from 2005 reports the reduced viability of testicular macrophages upon exposure to concentrations of bismuth citrate as low as 6.25 μM bismuth content .…”

Section: Introductionmentioning

confidence: 99%

Is Bismuth Really the “Green” Metal? Exploring the Antimicrobial Activity and Cytotoxicity of Organobismuth Thiolate Complexes

Stephens

Munuganti

Moran³

et al. 2020

Inorg. Chem.

View full text Add to dashboard Cite

Antimicrobial resistance is becoming an ever-increasing threat for human health. Metal complexes and, in particular, those that incorporate bismuth offer an attractive alternative to the typically used organic compounds to which bacteria are often able to develop resistance determinants. Herein we report the synthesis, characterization, and biological evaluation of a series of homo-and heteroleptic bismuth(III) thiolates incorporating either one (BiPh 2 L), two (BiPhL 2 ), or three (BiL 3 ) sulfur-containing azole ligands where LH = tetrazolethiols or triazolethiols (thiones). Despite bismuth typically being considered a nontoxic heavy metal, we demonstrate that the environment surrounding the metal center has a clear influence on the safety of bismuth-containing complexes. In particular, heteroleptic thiolate complexes (BiPh 2 L and BiPhL 2 ) display strong antibacterial activity yet are also nonselectively cytotoxic to mammalian cells. Interestingly, the homoleptic thiolate complexes (BiL 3 ) were shown to be completely inactive toward both bacterial and mammalian cells. Further biological analysis of the complexes revealed the first insights into the biological mode of action of these particular bismuth thiolates. Scanning electron microscopy images of methicillin-resistant Staphylococcus aureus (MRSA) cells have revealed that the cell membrane is the likely target site of action for bismuth thiolates against bacterial cells. This points toward a nonspecific mode of action that is likely to contribute to the poor selectivity's demonstrated by the bismuth thiolate complexes in vitro. Uptake studies suggest that reduced cellular uptake could explain the marked difference in activity between the homo-and heteroleptic complexes.

show abstract

Section: Introductionmentioning

confidence: 99%

Is Bismuth Really the “Green” Metal? Exploring the Antimicrobial Activity and Cytotoxicity of Organobismuth Thiolate Complexes

Stephens

Munuganti

Moran³

et al. 2020

Inorg. Chem.

View full text Add to dashboard Cite

show abstract

“…Wei Bi Mei is a new bismuth-containing drug with heavy magnesium carbonate, sodium bicarbonate, and multiple Chinese herbal medicinal ingredients to treat H. pylori infection. As a heavy metal element, bismuth has the potential to damage human organs, such as the kidneys, bone joints, and central nervous system [18][19][20]. us, it is vital to evaluate the safety of Wei Bi Mei by studying the pharmacokinetics of bismuth in human body.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, bismuth mainly acts locally in the gut, and systemic absorption does not appear to be necessary for efficacy [17]. As a heavy metal element, high levels of bismuth may result in damage to the kidneys, bone joints, and central nervous system once entering into the human body [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetics of Bismuth following Oral Administration of Wei Bi Mei in Healthy Chinese Volunteers

Zhang

Liu

Meng

et al. 2020

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

Background. Bismuth-containing quadruple therapy achieves higher eradication rate of Helicobacter pylori. High level of bismuth in blood may result in damage of many organs. Wei Bi Mei is a new bismuth-containing drug combining chemicals and Chinese medicine portions. The present research is to study the pharmacokinetics of bismuth to evaluate the safety and rational use of Wei Bi Mei granules. Material and Methods. Seven healthy Chinese adult subjects were enrolled in this research, which included a single-dose study and a multiple-dose study. Wei Bi Mei granules were administered orally to the subjects at corresponding time. Blood and urine were collected. All samples were analyzed by inductively coupled plasma mass spectrometry (ICP-MS). Results. For single-dose Wei Bi Mei granules administration, the mean time to peak concentration (tmax) of bismuth was 2.29 ± 0.76 h, and the mean peak concentration (Cmax) of bismuth was 0.85 ± 0.55 ng/mL. For multiple-dose Wei Bi Mei granules administration, the Cmax was 2.25 ± 1.18 ng/mL at day two, and the volume of distribution (Vd) was (22.97 ± 9.82) × 103 L. The urinary excretion of bismuth was the fastest during the first two days, with a mean excretion rate of 3.84 ± 1.23 ng/h. The bismuth concentration in urine was significantly reduced at day 16. Conclusion. Bismuth has a washout period of approximately two months. The concentration of bismuth in blood was far less than the “safe level.” Thus, Wei Bi Mei is a highly safe therapeutic medicine, with a good clinical application value. Wei Bi Mei should be recommended more widely for use in bismuth-containing quadruple therapy for the treatment of Helicobacter pylori infection.

show abstract

“…Overall, 57% patients showed complete response, 21% had partial response, and 21% had no response. In this context, it is noteworthy that long-term use of this drug is associated with the risk of neurotoxicity ( Borbinha et al, 2019 ). Nevertheless, to determine the true benefit of bismuth subsalicylate, well-powered, prospective, placebo-controlled studies stratified by disease severity and subtypes need to be performed.…”

Section: Treatmentmentioning

confidence: 99%

Microscopic colitis: Etiopathology, diagnosis, and rational management

Nielsen

Fernández‐Bañares

Sato

et al. 2022

eLife

View full text Add to dashboard Cite

Microscopic colitis is an inflammatory bowel disease divided into two subtypes: collagenous colitis and lymphocytic colitis. With an increasing incidence of microscopic colitis exceeding those of ulcerative and Crohn’s disease among elderly people in some countries, microscopic colitis is a debilitating life experience. Therefore, physicians should be familiar with its clinical features and management strategies because the disease deserves the same attention as the classical inflammatory bowel diseases. Here, state-of-the-art knowledge of microscopic colitis is provided from a global perspective with reference to etiopathology and how to establish the diagnosis with the overall aim to create awareness and improve rational management in clinical practice. The immune system and a dysregulated immune response seem to play a key role combined with risk factors (e.g. cigarette smoking) in genetically predisposed individuals. The symptoms are characterized by recurrent or chronic nonbloody, watery diarrhea, urgency, weight loss, and a female preponderance. As biomarkers are absent, the diagnosis relies on colonoscopy with a histological assessment of biopsy specimens from all parts of the colon. Although the disease is not associated with a risk of colorectal cancer, a recent nationwide, population-based cohort study found an increased risk of lymphoma and lung cancer. Budesonide is the first-line therapy for management, whereas immunomodulatory drugs (including biologics) and drugs with antidiarrheal properties may be indicated in those failing, dependent, or intolerant to budesonide. In microscopic colitis induced by checkpoint inhibitors, a drug class used increasingly for a wide range of malignancies, a more aggressive therapeutic approach with biologics introduced early seems reasonable. However, particular attention needs to be drawn to the existence of incomplete forms of microscopic colitis with the risk of being overlooked in routine clinical settings.

show abstract

Bismuth encephalopathy- a rare complication of long-standing use of bismuth subsalicylate

Cited by 37 publications

References 26 publications

Is Bismuth Really the “Green” Metal? Exploring the Antimicrobial Activity and Cytotoxicity of Organobismuth Thiolate Complexes

Is Bismuth Really the “Green” Metal? Exploring the Antimicrobial Activity and Cytotoxicity of Organobismuth Thiolate Complexes

Pharmacokinetics of Bismuth following Oral Administration of Wei Bi Mei in Healthy Chinese Volunteers

Microscopic colitis: Etiopathology, diagnosis, and rational management

Contact Info

Product

Resources

About