Effective treatment of lead poisoning: A Synthesis of Findings from 22 Studies

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Original Abstract of the Article

Major Research Findings

Research on effective treatments for lead poisoning has explored the efficacy and risks of various therapeutic approaches. 13 compared the effectiveness of sodium calcium edetate and succimer in treating inorganic lead poisoning, assessing their impact on urine lead excretion, blood and tissue lead concentrations, symptom resolution, and survival rates. The study also summarized pharmacokinetic and pharmacodynamic aspects, as well as adverse effects of treatment. 10 investigated the binding characteristics of N-acetylcysteine (NAC) and N-acetylcysteine amide (NACA) to lead(II), crucial for treating lead poisoning. It found that NACA binds more strongly to lead(II) than NAC. 19 focused on controlling lead dust exposure in homes of children with moderate lead poisoning through professional cleaning, demonstrating significant reductions in dust lead loadings after cleaning. 15 presented a case report of a 22-year-old man working in a lead-acid battery manufacturing unit who suffered from lead poisoning. Chelation therapy, along with environmental interventions, improved his condition. 4 investigated the efficacy of D-penicillamine in treating adult lead poisoning in an outpatient setting, suggesting it as a viable alternative treatment. 22 systematically reviewed clinical and laboratory findings of lead poisoning across the globe, highlighting hazardous pollution sources, management strategies, and symptoms. 16 reported a case of lead poisoning due to the use of herbal remedies for infertility treatment. discussed treatment approaches for lead poisoning. 7 focused on developing alginate gel beads that can adsorb lead ions in gastric pH, potentially applicable for gastric lavage after lead poisoning. 18 compared the effectiveness of an immobilized chelator with conventional therapy for treating lead poisoning. The study found that the immobilized chelator, "Lead-Hemopurifier", effectively reduced blood lead levels. 17 provided an overview of treatment and prevention strategies for lead poisoning. 11 investigated the therapeutic efficiency of combining succimer with calcium and ascorbic acid in treating mild lead poisoning in mice and preschool children. The combination therapy proved more effective in mobilizing bone lead compared to succimer alone. was a corrigendum to a previous publication. 14 evaluated the effectiveness of allicin, a component of garlic, in treating experimentally induced subacute lead poisoning in sheep, showing its potential to reduce blood lead levels, kidney lead content, and lead levels in bone and ovaries. 21 investigated the role of calcium supplementation in reducing blood lead levels in moderately poisoned children, but found no conclusive evidence for its effectiveness. 9 emphasized the importance of thorough medical evaluation and environmental intervention in diagnosing, evaluating, and treating lead poisoning in the general population. 8 discussed the role of chelation therapy in treating lead poisoning, specifically focusing on the "Treatment of Lead-Exposed Children Trial (TLC)". 6 synthesized and characterized new 1-hydroxy-2-pyridinethione derivatives that form lead complexes and demonstrated their efficacy in treating acute lead poisoning in rats. provided information on lead poisoning treatment. 20 examined lead mobilization during calcium disodium ethylenediaminetetraacetate chelation therapy for chronic lead poisoning, showing that EDTA reduced lead deposits in organs like the brain and kidney but not in bones. 2 presented a case report of lead poisoning resulting from Ayurvedic treatment. 1 compared the efficacy and cost-effectiveness of succimer versus a combination of D-penicillamine and garlic for treating lead poisoning, suggesting the latter as a more cost-effective option. 5 evaluated the effectiveness of edetate calcium disodium and dimercaptosuccinic acid in treating lead poisoning in adults, finding both treatments effective. 12 presented a case report of a patient with wrist drop due to lead poisoning, effectively treated with D-penicillamine chelation therapy. reported rare cases of severe, life-threatening lead poisoning due to accidents or chronic occupational exposure to lead and manganese, highlighting the importance of diagnosis, treatment, and prognosis in such situations.

Treatment Summary

Chelation therapy is a common treatment approach for lead poisoning. It involves administering chelating agents that bind to lead in the body, facilitating its excretion through urine. 13 compared sodium calcium edetate and succimer, both showing effectiveness, but succimer was favored for its lower side effect profile. 6 presented promising results with new 1-hydroxy-2-pyridinethione derivatives in treating lead poisoning. 18 introduced "Lead-Hemopurifier", a device with an immobilized chelator, demonstrating its ability to reduce blood lead levels. 15 reported a case where D-penicillamine chelation therapy effectively treated wrist drop caused by lead poisoning. 4 suggested D-penicillamine as a potential alternative treatment for adult lead poisoning. 1 compared the efficacy and cost-effectiveness of succimer with a combination of D-penicillamine and garlic, finding the latter more cost-effective. 11 showed that combining succimer with calcium and ascorbic acid proved more effective in mobilizing bone lead compared to succimer alone. The choice of treatment for lead poisoning depends on factors like the extent of lead exposure and the severity of the condition. Consulting a physician is crucial for selecting the most appropriate treatment.

Benefits and Risks

Benefits Summary

Lead poisoning treatment can effectively reduce blood lead levels and potentially improve symptoms associated with lead poisoning. 13 highlighted the effectiveness of sodium calcium edetate and succimer in treating lead poisoning. 18 demonstrated the effectiveness of "Lead-Hemopurifier" in lowering blood lead levels. 15 reported successful treatment of wrist drop due to lead poisoning with D-penicillamine chelation therapy.

Risks Summary

Chelation therapy carries potential side effects, including kidney strain, hypocalcemia, and allergic reactions. 13 compared the side effects of sodium calcium edetate and succimer, finding succimer to have a better safety profile. 20 indicated that while EDTA effectively reduces lead levels in the brain and kidney, it does not significantly reduce lead levels in bones. Therefore, careful monitoring and adherence to medical guidance are crucial when undergoing chelation therapy.

Comparison Across Studies

Commonalities

Multiple studies have consistently demonstrated the effectiveness of chelation therapy in treating lead poisoning. They also consistently identified potential side effects, such as kidney stress, associated with chelation therapy.

Differences

Research findings vary across studies regarding specific chelating agents, their effectiveness, and side effect profiles. For instance, 13 found succimer to be more effective and have fewer side effects compared to sodium calcium edetate. In contrast, 1 suggested that a combination of D-penicillamine and garlic is a more cost-effective treatment option than succimer. These discrepancies highlight the need for more research to provide a more comprehensive understanding of treatment options.

Consistency and Contradictions in Results

Research findings regarding the effectiveness and side effects of chelation therapy for lead poisoning have not always been consistent. This can be attributed to factors like variations in research methods and participant populations. For example, 20 observed that EDTA reduced lead levels in the brain and kidney, but not in bone. On the other hand, 11 showed that combining succimer with calcium and ascorbic acid effectively mobilized lead from bone. Addressing these inconsistencies requires further investigation.

Real-World Applications and Precautions

Preventing lead poisoning requires avoiding exposure to lead. For those living in older homes, be cautious of peeling lead paint and lead-containing dust. It is also important to avoid consuming lead-contaminated food and water. Seek medical attention promptly if any symptoms of lead poisoning are experienced.

Limitations of Current Research

Current research has limitations in providing comprehensive data on long-term effects of chelation therapy and its impact on neurodevelopmental issues associated with lead poisoning. Moreover, lead poisoning treatment needs to be tailored to individual patients as their lead exposure levels and severity of the condition vary significantly.

Future Research Directions

Further research is needed to better understand the long-term effects of chelation therapy, its impact on neurodevelopmental issues associated with lead poisoning, and to develop more personalized treatment approaches considering individual patient factors like lead exposure levels and severity of the condition.

Conclusion

Lead poisoning can significantly impact health. Avoiding lead exposure is crucial for prevention. Seek medical attention immediately if lead poisoning is suspected. Chelation therapy is a common treatment option, but it carries potential side effects. Close monitoring and adherence to medical guidance are essential for safe and effective treatment.

Treatment List

Chelation therapy, sodium calcium edetate, succimer, D-penicillamine, garlic, allicin, N-acetylcysteine (NAC), N-acetylcysteine amide (NACA)

Literature analysis of 22 papers
Positive Content
17
Neutral Content
1
Negative Content
4
Article Type
3
0
1
1
22
1.

Efficacy and expenses of succimer vs. d-penicillamine plus garlic in the treatment of lead poisoning: a retrospective cross-sectional study.

Author: VahabzadehMaryam, Balali-MoodMahdi, Banagozar MohammadiAli, MoshiriMohammad

Lead poisoning treatment

Combination therapy with D-penicillamine and Garlic was as effective as Succimer in treating lead poisoning in 79 male patients. Succimer was 28.6 times more expensive.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : English

2.

Lead poisoning from Ayurvedic treatment: a further case.

Author: CiocanCatalina, MansourIhab, BeneduceAlessandro, Corgiat LoiaRiccardo, MilanesioNicolò, DeclementiMichael, GodonoAlessandro, GarzaroGiacomo, PiraEnrico

Lead intoxication

This case report describes a 30-year-old sailor who presented with microcytic anemia and lead intoxication. The patient had been taking Ayurvedic medicines, leading to the investigation and confirmation of lead poisoning. The case highlights the potential risks of heavy metals in traditional medicine practices.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Rare cases of severe life-threatening lead poisoning due to accident or chronic occupational exposure to lead and manganese: Diagnosis, treatment, and prognosis.

Author: DuXuqin, ZhengWei, YeQiao

Mn poisoning
Pb poisoning

This study focuses on severe life-threatening lead (Pb) poisoning due to accidental or chronic occupational exposure to Pb and manganese (Mn). It highlights the need for awareness and preventative measures to reduce the risk of these types of exposures, which are rarely reported.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

A comparative study of edetate calcium disodium and dimercaptosuccinic acid in the treatment of lead poisoning in adults.

Author: SakthithasanKirushanthi, LévyPierre, PouponJoël, GarnierRobert

Lead poisoning treatment
Unknown risks

Both edetate calcium disodium (CaNa2EDTA) and succimer were effective in reducing blood lead levels and clinical symptoms associated with lead poisoning.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Development of alginate gel beads with a potential use in the treatment against acute lead poisoning.

Author: TahtatDjamel, BouaichaMalika Nawel, BenamerSamah, Nacer-KhodjaAssia, MahlousMohamed

Remove lead

This study developed alginate beads for adsorbing lead ions in gastric pH, with the potential for use in gastric lavage following lead poisoning. The study investigated the swelling properties and lead adsorption kinetics of the beads.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Role of chelation in the treatment of lead poisoning: discussion of the Treatment of Lead-Exposed Children Trial (TLC).

Author: McKayCharles A

Reduced lead levels
No cognitive improvement
Short term effect

The Treatment of Lead-Exposed Children Trial found that succimer, a drug used to treat lead exposure, effectively reduced blood lead concentrations in the short term but did not improve cognitive or behavioral function. The most important treatment strategy for lead exposure is to identify and eliminate major sources of lead.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., IntramuralFunding provided by the NIH for research projects within the NIH.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

10.

Characterizing N-acetylcysteine (NAC) and N-acetylcysteine amide (NACA) binding for lead poisoning treatment.

Author: ChenWeiqing, ErcalNuran, HuynhTien, VolkovAnatoliy, ChusueiCharles C

Antioxidant complex formation
Lead poisoning treatment

NACA, an antioxidant, was found to have a higher binding affinity to Pb(II) than NAC, suggesting it may be a more effective chelator for treating lead poisoning.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

11.

Therapeutic efficiency of succimer used with calcium and ascorbic acid in the treatment of mild lead-poisoning.

Author: JinYaping, YuFei, LiaoYingjun, LiuShaoxia, LiuMeimei, XuJianhong, YangJun

Improved ALAD activity
Reduced blood lead
Reduced bone lead

Succimer, used with calcium and ascorbic acid, was more effective in treating mildly lead-poisoned mice and preschool children than succimer alone. The combined treatment group showed significantly greater reduction in blood lead levels and a higher percentage of children with blood lead levels less than 10 μg/dL at the end of therapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Evaluation and treatment of wrist drop in a patient due to lead poisoning: case report.

Author: DsouzaHerman Sunil, DsouzaSebestina Anita, MenezesGeraldine, ThuppilVenkatesh

Lead poisoning diagnosis
Lead poisoning

A 32-year-old male worker in a lead-based industry developed severe lead poisoning, resulting in wrist drop. Chelation therapy with D-Penicillamine reduced his blood lead levels. The case highlights the importance of occupational history and proper medical evaluation for lead poisoning.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

A comparison of sodium calcium edetate (edetate calcium disodium) and succimer (DMSA) in the treatment of inorganic lead poisoning.

Author: BradberrySally, ValeAllister

Lead poisoning treatment
Inorganic lead poisoning

The article reviews the efficacy of sodium calcium edetate and succimer in treating inorganic lead poisoning, comparing their effects on urine lead excretion, blood and tissue lead concentrations, clinical outcomes, and survival.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Evaluation of allicin for the treatment of experimentally induced subacute lead poisoning in sheep.

Author: Najar-NezhadV, AslaniM R, Balali-MoodM

Lead poisoning treatment

Allicin, a component of garlic, effectively reduced lead levels in sheep, suggesting its potential as a treatment for lead poisoning.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Lead poisoning as a result of infertility treatment using herbal remedies.

Author: GeraldineMenezes, HermanD'souza Sunil, VenkateshThuppil

Lead poisoning

Lead poisoning remains a significant health problem. The study emphasized the need for increased awareness of lead poisoning among healthcare professionals and the availability of blood lead level testing at primary health centers.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Treatment of lead poisoning with an immobilized chelator comparison with conventional therapy.

Author: AmbrusC M, AnthoneS, StadlerA, CameronM S, WellsK, StadlerI, AmbrusJ L

Lead detoxification

Lead poisoning is a global health problem. This abstract describes a new detoxification method called 'Lead-Hemopurifier' (L-HP), which uses an immobilized chelator to safely remove lead from the body. In vivo studies in dogs showed the method's efficiency and safety compared to Versenate treatment.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

19.

Assessment of cleaning to control lead dust in homes of children with moderate lead poisoning: treatment of lead-exposed children trial.

Author: EttingerAdrienne S, BornscheinRobert L, FarfelMark, CampbellCarla, RaganN Beth, RhoadsGeorge G, BrophyMerrill, WilkensSherry, DockeryDouglas W

Lead exposure reduction
Lead dust exposure

This study looked at the effectiveness of professional cleaning in reducing lead dust exposure in homes of children with moderately elevated blood lead levels. Cleaning reduced dust lead levels by an average of 32% for floors, 66% for windowsills, and 93% for window wells. However, a single professional cleaning was not enough to bring all dust levels below federal standards. More intensive cleaning and lead hazard reduction strategies are needed.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

21.

A randomized trial of calcium supplementation for childhood lead poisoning.

Author: MarkowitzMorri E, SinnettMark, RosenJohn F

Reduced BPbs

This study investigates the potential role of supplemental calcium in reducing blood lead levels (BPbs) in children with moderate lead poisoning, given the documented interactions between calcium and lead.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

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