Denver's CounterACT program was formed to develop models of sulfur mustard (SM) toxicity to lung and skin, understand injury pathogenesis, and evaluate novel antioxidants to rescue SM-mediated injuries. SM analog CEES (2-chloroethyl ethylsulfide) caused inflammation, DNA damage (8-hydroxydeoxy-guanosine accumulation;comet assay;ATM/ATR activation and downstream signaling) and lipid peroxidation (4- hydroxynonenal) in tissues, as well as inflammation. In lung, CEES caused bronchial vascular injury/leak. Airway obstructive fibrin-containing casts formed after inhalation exposures to CEES or SM, and similar lesions were apparent after chlorine (400 ppm). Catalytic antioxidant AEOL10150, which scavenges superoxide, hydrogen peroxide, lipid peroxides, and peroxynitrite, rescued: a) upper (nasal) and lower airway injuries by CEES;b) lower airway injury by SM;c) oxidative stress, inflammation and methacholine reactivity due to chlorine;and d) skin injuries by CEES such as inflammation and neutrophil infiltration. A natural dietary supplement silibinin also rescued skin injuries by CEES. New data showed: a) AEOL10150 efficacy to limit injury by escalated CEES and SM exposures, as well as acute lung injury by higher (250 ppm) chlorine concentrations, b) coagulation activation in the CEES inhalation and chlorine models, and c) efficacy of tPA (tissue-type plasminogen activator) in late rescue, starting 4h after CEES inhalation. Next cycle, Denver CounterACT will: a) establish early anticoagulant and/or late fibrinolytic agent efficacies in airways obstruction by CEES, SM and chlorine, b) evaluate AEOL10150 in profound airway injuries by these agents (both alone and combined with anticoagulant and/or fibrinolytic approaches), and c) evaluate AEOL10150 and flavonoid silibinin to rescue skin injuries by CEES, nitrogen mustard (NM), and SM. Effective anticoagulant and/or fibrinolytic agents will be cross-checked to verify lack of exacerbation of skin injuries. Endpoints of oxidative stress, inflammation, increased permeability, and, for lungs, airway obstruction, will be evaluated. Agent(s) found effective for CEES/NM would be evaluated in skin injury by SM. These approaches will identify promising rescue agents for skin and lung injury by toxic gases.

Public Health Relevance

The purpose of the CounterACT Program is to develop specific medical countermeasures that can be used to rescue victims of civilian disaster, acts of terrorism, military attack after exposures to toxic inhaled gases, vesicants, or nerve agents. This proposal is to develop for testing agents that can be used as rescue agents when given one to several hours after exposure to vesicants or toxic gases. These will include antioxidants, anticoagulants, anti-inflammatories, etc, that show promise in model systems of these processes.

National Institute of Health (NIH)
National Institute of Environmental Health Sciences (NIEHS)
Specialized Center--Cooperative Agreements (U54)
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Special Emphasis Panel (ZRG1-MDCN-J (54))
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Nadadur, Srikanth
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University of Colorado Denver
Schools of Medicine
United States
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Rancourt, Raymond C; Rioux, Jacqueline S; Veress, Livia A et al. (2018) Methyl isocyanate inhalation induces tissue factor-dependent activation of coagulation in rats. Drug Chem Toxicol :1-7
McGraw, Matthew D; Osborne, Christopher M; Mastej, Emily J et al. (2017) Editor's Highlight: Pulmonary Vascular Thrombosis in Rats Exposed to Inhaled Sulfur Mustard. Toxicol Sci 159:461-469
Summerhill, Eleanor M; Hoyle, Gary W; Jordt, Sven-Eric et al. (2017) An Official American Thoracic Society Workshop Report: Chemical Inhalational Disasters. Biology of Lung Injury, Development of Novel Therapeutics, and Medical Preparedness. Ann Am Thorac Soc 14:1060-1072
Ghosh, Moumita; Ahmad, Shama; White, Carl W et al. (2017) Transplantation of Airway Epithelial Stem/Progenitor Cells: A Future for Cell-Based Therapy. Am J Respir Cell Mol Biol 56:1-10
McElroy, Cameron S; Min, Elysia; Huang, Jie et al. (2016) From the Cover: Catalytic Antioxidant Rescue of Inhaled Sulfur Mustard Toxicity. Toxicol Sci 154:341-353
White, Carl W; Rancourt, Raymond C; Veress, Livia A (2016) Sulfur mustard inhalation: mechanisms of injury, alteration of coagulation, and fibrinolytic therapy. Ann N Y Acad Sci 1378:87-95
Tewari-Singh, Neera; Agarwal, Rajesh (2016) Mustard vesicating agent-induced toxicity in the skin tissue and silibinin as a potential countermeasure. Ann N Y Acad Sci 1374:184-92
McElroy, Cameron S; Day, Brian J (2016) Antioxidants as potential medical countermeasures for chemical warfare agents and toxic industrial chemicals. Biochem Pharmacol 100:1-11
Houin, Paul R; Veress, Livia A; Rancourt, Raymond C et al. (2015) Intratracheal heparin improves plastic bronchitis due to sulfur mustard analog. Pediatr Pulmonol 50:118-26
Veress, Livia A; Anderson, Dana R; Hendry-Hofer, Tara B et al. (2015) Airway tissue plasminogen activator prevents acute mortality due to lethal sulfur mustard inhalation. Toxicol Sci 143:178-84

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