从对氨基水杨酸钠治疗锰、铅中毒看应用基础医学研究

Basic medical research on the treatment of manganese and lead poisoning with sodium paraaminosalicylate

重金属中毒是全球性的重大公共卫生问题之一,中毒治疗一直是医学界亟待解决的难题。1986年以来,笔者一直从事对氨基水杨酸钠(PAS-Na)治疗锰中毒研究,并由此衍生出PAS-Na对染铅大鼠海马神经炎症干预机制的探讨,从职业卫生、临床调查(描述毒理学)到毒理学体内、外研究(机制毒理学),积累了一些宝贵的经验。与一般金属络合剂(如CaNa2-EDTA)不同,PAS-Na可透过血脑屏障,络合铅、锰,促使其从体内排出,且有抗炎作用。笔者既往研究发现,PAS-Na对锰中毒有明显的治疗效果;PAS-Na可使铅中毒大鼠学习和记忆障碍得以恢复或改善,推测可能与其促排海马铅和抗炎作用有关。该研究可能为铅、汞、铜、铊等中毒性脑病的治疗提供科学依据和新的思路,具有较好的临床医学应用前景。因此认为,只有把科学研究工作与医学实际需要相结合,才能获得较好的研究结果,产生更好的临床医学意义及应用前景。

Heavy metal poisoning is one of the major public health problems worldwide,and treatment of such poisoning remains a big challenge for the medical community.The author has been engaged in the research on the treatment of manganese poisoning with sodium para-aminosalicylate(PAS-Na)since 1986,and the intervention mechanism of PAS-Na on hippocampal nerve inflammation in lead-exposed rats was derived from the study.Some valuable experience has been gained from occupational hygiene,clinical investigation(descriptive toxicology),and in vitro and in vivo toxicology(mechanotoxicology).The difference between PAS-Na and general metal complexing agents(such as CaNa2-EDTA)is that PAS-Na can pass through the blood-brain barrier and produce complexing,promoting manganese and lead excretion.What’s more,PAS-Na has an anti-inflammatory effect.The author’s previous studies have shown that PAS-Na has a significant treatment effect on manganese poisoning.Additionally,it can restore or improve learning and memory impairment induced by lead in rats,which may be related to its ability to promote hippocampal lead excretion and its anti-inflammatory effect.This study may provide a scientific basis or a new idea for the treatment of toxic encephalopathy such as lead,mercury,copper and thallium,generating promising prospects for clinical applications.Therefore,it is believed that only by combining scientific research work with the practical needs of medicine can better research results be obtained and better clinical significance or application prospects be produced.