Chelating Drug Therapy: An Update

Purpose: To study the clinical effects of metal toxicity and current recommendations for management, including chelation therapy, are reviewed. Summary: Metals are essential to many biological processes, but excess of it becomes hazardous to life. These are necessary for cell growth, electron transport chain, several enzymatic activities and response of immune systems. They also serve as a cofactor for several enzymes. Chelation therapy is used for clinical management of the excess of metal. However, each metal requires a specific chelation agent. A chelate is a compound form between metal and a compound that contains two or more potential ligands. A promising Fe chelator is Desferrioxamine (Desferal). Penicillamine and Trientine are uses for copper chelation. Meso-2,3-Dimercaptosuccinic Acid (DMSA) and 2,3-Dimercapto-Propanesulphonate (DMPS) can be used as effective chelator of mercury. Dimercaprol, edetate calcium disodium, and succimer are the three agents primarily used for chelation of lead. Conclusion: Metal toxicity remains a significant public health concern. Elimination of elevated metal ions can be achieved by proper chelation agents. An inappropriate protocol of chelation therapy has the severe side effect which must be taken into consideration before chelation therapy.

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