Medical Aspects of Chemical Warfare (2008) - The Black Vault

Medical Diagnosticsisolation of the globin from the RBCs, the globin isreacted with pentafluorophenyl isothiocyanate to forma thiohydantoin compound, which is further derivatizedbefore analysis (Figure 22-10). The derivatizedcompound can then be analyzed using negative ionchemical ionization GC-MS (Exhibit 22-3). 113,114Human serum albumin was found to be alkylatedby sulfur mustard at the cysteine-34 position. Fol-Table 22-10Published Reports (1995–2006) of Laboratory Analysis of Human Urine Samples forHydrolysis Metabolites Following Suspected Exposure to Sulfur MustardPatient Sample Glucuronidase Glucuronidase IncubationInformation* Incubation † TiCl 3Reduction ‡ TDG-sulfoxide & TiCl 3Reduction §Iranian casualties, 3 of 5 nm patient C1: 69 ng/ml nm nmindividuals, treated at P patient C2: 28 ng/mLGhent hospital, P patient C5: 33 ng/mLcollected 10 days after Ccontrol: 11 ng/mLincident (March 9,1984) 1Kurdish casualties, 2 nm patient L1: 11 ng/ml nm nmindividuals, treated at P patient L2: 11 ng/mLLondon hospital, C control: 11 ng/mLcollected 13 days afterincident (March 17,1988) 1Accidental exposure to Patient S1: 2 ng/mL Patient S1: 77 ng/mL Patient S1: 69 ng/mL NMWWI munition, 2 Patient S2: 2 ng/mL Patient S2: 54 ng/mL Patient S2: 45 ng/mLindividuals, collected C control: 4.5 ng/mL Control: 5 ng/mL2–3 days after incident(1992) 2Accidental laboratory Maximum excretion NM nm nmexposure, 1 individual, rate: 20 µg/day oncollected 2–14 days day 3; concentrationafter incident (1990) 3 > 10 ng/mL for 1week postexposureAccidental exposure to Patient D1: 24, 9, 5, 14, nm nm patient D1: 50, 17, 11, 28, 24,WWI munition, 2 11, 6, 2, 2, 1.5, 1.2 14, 4.5, 9, 5, 6 ng/mL forindividuals, collected ng/mL for days 2 days 2 to 11 after exposure,2–42 days after incident to 11 after exposure, respectively(July 19, 2004) 4 respectivelypatient D2: not nm nm patient D2: 1.8, 3, 4.4 ng/mLdetected days 2, 4, 7for days 2, 4, 7, respectively*These are the known details of the incident and sample collection time after suspected exposure.† Assay measures TDG (free plus glucuronide-bound).‡ Assay measures free TDG, free TDG-sulfoxide, and acid-labile esters of both.§ Assay measures TDG (free plus bound), TDG-sulfoxide (free plus bound), and acid-labile esters of both.NM: not measuredTDG: thiodiglycolTiCl 3: titanium trichlorideWWI: World War IData sources: (1) Black RM, Read RW. Improved methodology for the detection and quantitation of urinary metabolites of sulphur mustardusing gas chromatography-tandem mass spectrometry. J Chromatogr B Biomed Appl. 1995;665:97–105. (2) Black RM, Read RW. Biological fateof sulphur mustard, 1,1’-thiobis(2-chloroethane): identification of beta-lyase metabolites and hydrolysis products in human urine. Xenobiotica.1995;25:167–173. (3) Jakubowski EM, Sidell FR, Evans RA, et al. Quantification of thiodiglycol in human urine after an accidentalsulfur mustard exposure. Toxicol Methods. 2000;10:143–150. (4) Barr JR, Young CL, Woolfit AR, et al. Comprehensive quantitative tandemMS analysis of urinary metabolites and albumin adducts following an accidental human exposure to sulfur mustard. In: Proceedings of the53rd Conference of the American Society of Mass Spectrometry. San Antonio, Tex: June 5–9, 2005.719