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Michael E. DeBakey VA Medical Center - Houston, Texas

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Houston VA Study Seeks to Limit Secondary Injuries Due to Mustard Gas Exposure

July 29, 2002

Houston VA Study Seeks to Limit Secondary Injuries Due to Mustard Gas Exposure
Released: 2002/07/29

Findings will also benefit critical care of patients with acute inflammatory problems . . .

by Katherine Hoffman, Houston VA Medical Center Research and Development

HOUSTON, TX - Researchers at the Houston VA Medical Center (HVAMC) are developing methods to control the inflammatory response to mustard gas injury in order to limit secondary tissue damage after exposure. The study has shown these same techniques will benefit other patients with acute inflammatory problems.

"Mustard gas, or sulfur mustard, initially blisters or burns the skin and mucosal surfaces, often affecting the throat, airways, lungs, and eyes," said Dr. John Sweeney, HVAMC staff surgeon and associate professor of surgery at Baylor College of Medicine. "Little can be done to prevent the initial injury to the skin and tissues underlying it."

The injuries often produce disfiguring scars, and if severe enough, can be life threatening.

Sweeney's research, funded by the Department of Defense, seeks to understand the secondary inflammatory response to sulfur mustard injury and find ways to control the additional damage to normal healthy tissues.

First used as a means of chemical warfare in 1917 during World War I, sulfur mustard was most recently used in the Iraq/Iran war in the mid 1980s. Considered a weapon of terror, it is relatively easy to obtain.

"After initial exposure, the body triggers an inflammatory response in the affected areas," Sweeney said. "In sulfur mustard injury, the response goes haywire causing the cells that normally fight infection and attack damaged tissues to destroy normal tissues as well."

The body's neutrophil, often called the foot soldier of inflammatory response, responds to the injury but begins to indiscriminately kill healthy tissue resulting in serious secondary injury. In the worst case, this secondary injury can involve the entire body and result in death.

Sweeney is looking at neutrophil function in response to six or seven mediators released in the area of the sulfur mustard injury. These mediators signal the neutrophil to perform in various ways.

"We're looking at the effect of each of these mediators on neutrophil function to determine which ones cause the neutrophil to have harmful effects on the injury," he said.

After determining which mediators have a negative impact on neutrophil function, Sweeney's research will attempt to identify a mechanism that would allow physicians to control or modulate the response, and thereby limit additional injury.

The ability to control inflammatory response will benefit all patients, Sweeney says.

"Whether the patient has pneumonia, surgical complications, or a sulfur mustard injury, the same mechanism might be used to control inflammatory responses gone awry," he said.

In the future, Sweeney hopes to compare inflammatory response in traditional surgery patients with the response of patients undergoing minimally-invasive surgery.

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Point of Contact: VHAHOU Public Affairs

04/21/04 08:25