Spring 1982 - Athletic Training History

Because of the penetrative properties of DimethylSulfoxide this substance has been used to protect variousanimal tissues and cells during cold storage.Industrial Uses of Dimethyl SulfoxideDimethyl Sulfoxide is a solvent in the manufacture ofsynthetic fibers such as rayon and orlon. Polyurethaneand acrylic fibers are soluble in Dimethyl Sulfoxide. It is asolvent for acetylene, sulphur dioxide and other gases.Dimethyl Sulfoxide is used as an antifreeze or hydraulicfluid when mixed with water. It can be used also as a paintand varnish remover. Dimethyl Sulfoxide dissolves somehydrocarbons more than others. It has been used as acarrier for insecticides. The DMSO aids in transportingthe insecticide to the internal structure of the insects.Sports Medicine Uses of Dimethyl Sulfoxide—MembranePenetrationDimethyl Sulfoxide readily crosses most membranes ofthe body of the patient without destroying the integrity ofthese membranes. In its passage, DMSO permits a numberof compounds to move along with it. The phenomenonis reversible. Dimethyl Sulfoxide will not rapidlypenetrate the nails or the enamel of the teeth.Kligman has shown that when various dyes, steroids,and antiperspirants are dissolved in solutions of DimethylSulfoxide at 70 percent or greater they exhibit enhancedpenetration through human skin. 15Mailbach and Feldman studied the percutaneouspenetration of hydrocortisone and testosterone inDimethyl Sulfoxide in man. Maximal excretion of bothsteroids occurred within 36 hours. The authors concludedthat there was a threefold increase in dermal penetrationby these steroids dissolved in DMSO. 20Sulzberger and his associates studied the penetration ofDimethyl Sulfoxide into human skin employing methyleneblue, iodine, and iron dyes as visual tracers. Biopsiesshowed that the stratum corneum (outer layer) was completelystained with each tracer applied to the skin surfacewith DMSO. There was little or no staining below thislayer. They concluded that Dimethyl Sulfoxide carriedsubstances rapidly and deeply into the horny layer. Theysuggested that the usefulness of DMSO as a vehicle fortherapeutic agents in inflammatory dermatitis and superficialskin infections such as pyodermas. 31Perlman and Wolf demonstrated that allergens of smallmolecular weight such as penicillin G potassium mixed in90 percent DMSO were readily carried through the intacthuman skin. Allergens having molecular weights of 3000or greater dissolved in Dimethyl Sulfoxide did notpenetrate the human skin. 23 Smith and Herge hadpreviously recorded that antibodies to bovine albumindeveloped when a mixture of Dimethyl Sulfoxide andbovine serum albumin was applied to the skin of rabbits. 23In addition to permitting the passage through the skin,Dimethyl Sulfoxide will carry substances such ashydrocortisone or hexachlorophene into the deeper layersof the stratum corneum producing a reservoir whichremains for at least 16 days and resists depletion bywashing of the skin with soap and water or alcohol. 20Anti-InflammationGorog and Kovaks studied the anti-inflammatoryproperties of Dimethyl Sulfoxide in rats. They recordedthat carrageenin induced rat paw edema was improved byoral and topical application of DMSO. In the granulomapouch method of producing inflammation in rats, in whichmyobacterium butyricum is used as the irritant, DimethylSulfoxide was found to reduce the inflammatory exudateand the development of granulation tissue. Arthritis inducedby Myobacterium adjuvant was inhibited by oraland more strongly by topical application of DMSO.Similarly, powerful inhibition with topical DimethylSulfoxide was observed in experimental arthritisproduced in rats by feeding with 6 sulfanilamidoindazole. 7In understanding the mechanism of action of DimethylSulfoxide, particularly its anti-inflammatory effects, thework of Weismann, Sessa, and Bevans deserves special attention.These authors document that lysosomes can bestabilized against a variety of injurious agents by cortisone.When dissolved in Dimethyl Sulfoxide, the concentrationsof these agents necessary to stabilize thelysosomes is reduced from tenfold to one thousand fold.The possibility was suggested that DMSO might rendersteroids more available to their targets within tissues (themembranes of cells or their organeles). 32Analgesia (Nerve Blockage)Immersion of the sciatic nerve in 6 percent DimethylSulfoxide decreases the conduction velocity by 40 percent.This effect is reversible by washing the nerve in a bufferfor one hour. Shealy studied feline peripheral small fibersafter discharge. Concentrations of 5 percent to 10 percentDMSO eliminated the activity of C fibers within oneminute. After washing away the Dimethyl Sulfoxide theactivity of the C fibers returned. Shealy believed thatmeasuring the activity in the peripheral small fibers afterdischarge in cats is a good model for determining the efficiencyof analgesics. 28Cholinesterase InhibitionSams, Carrol, and Crantz studied the effects of concentrationsof .6 percent to 6 percent Dimethyl Sulfoxideon skeletal, smooth, and cardiac muscle. DMSO strikinglydepressed the response of the diaphragm to both direct(muscle) and indirect (nerve) electrical stimulation andcaused spontaneous skeletal muscle fasiculations. DMSOincreased the response of smooth muscle of the stomach toboth muscle and nerve stimulation. The vagal thresholdwas lowered 50 percent by the use of a 6 percent solutionof Dimethyl Sulfoxide. Cholinesterase inhibition couldreasonably explain fasiculation of skeletal muscle, increasedtonus of smooth muscle, and the lowered vagalthreshold observed in these experiments. In vitro essaysshowed that .8 to 8 percent DMSO inhibits bovineerythrocyte Cholinesterase 16 percent to 18 percentrespectively. 26Effect on CollagenIn biopsy specimens taken from the skin before treatmentand at three weekly intervals in patients withscleroderma it has been found that there is a dissolution ofcollagen with the elastic fibers remaining intact. Gries,Bublitz, and Linder studied rabbit skin before and after 24hours in vitro with 100 percent Dimethyl Sulfoxide. Afterimmersion with DMSO the collagen fraction extractablewith neutral salt solution decreased significantly. Theauthors recorded that topical DMSO in man exerted asignificant effect on the pathological deposition of collagein human postirradiation subcutaneous fibrosis, but didnot appear to change the equilibrium of metabolism ofcollagen in normal tissue. In patients with scleroderma increasedhydroxyproline content of the urine has beendemonstrated after topical treatment with DMSO.Keloids biopsied in man before and after DMSO therapyshowed histological improvement toward normal. 8 The1980 NIAMDD study was not available until late 1981. 33VasodilationAdamson applied Dimethyl Sulfoxide to a three to onepedicle flap raised on the back of rats. The anticipatedslough was decreased by 60 percent to 70 percent. It wassuggested that the primary action of DMSO on pedicleflap circulation was to provoke a histimine like response. 1Kligman had previously demonstrated that DMSOpossessed potent histimine liberating properties. 15Athletic Training • Spring 1982 27