Clinical Evaluation of a Lead Mobilization Test Using the Chelating Agent Dimercaptosuccinic Acid

The lead mobilization test reflects the mobilizable and likely toxicologically active fraction of the lead body burden. We propose a safe and convenient protocol for this test, to assess concomitant copper and zinc excretion and to determine the size of the chelatable lead pool in nonoccupationally...

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Veröffentlicht in:Clinical chemistry (Baltimore, Md.) Md.), 2006-01, Vol.52 (1), p.88-96
Hauptverfasser: Hoet, Perrine, Buchet, Jean-Pierre, Decerf, Laurence, Lavalleye, Benoit, Haufroid, Vincent, Lison, Dominique
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container_issue 1
container_start_page 88
container_title Clinical chemistry (Baltimore, Md.)
container_volume 52
creator Hoet, Perrine
Buchet, Jean-Pierre
Decerf, Laurence
Lavalleye, Benoit
Haufroid, Vincent
Lison, Dominique
description The lead mobilization test reflects the mobilizable and likely toxicologically active fraction of the lead body burden. We propose a safe and convenient protocol for this test, to assess concomitant copper and zinc excretion and to determine the size of the chelatable lead pool in nonoccupationally exposed adults. The study population included 80 white adults: 40 controls [median blood lead concentration (PbB), 25 microg/L] and 40 lead-exposed individuals (315 microg/L). After collection of 4- and 24-h baseline urine specimens and a blood sample, dimercaptosuccinic acid (DMSA) was administered orally (1 g), and additional 4- and 24-h urine specimens were obtained. Determinants of the chelatable urinary lead (DMSA-PbU) were traced by linear regression analysis. Urinary DMSA and lead excretion peaked within 2-3 h after DMSA administration. The amounts of DMSA, lead, copper, and zinc recovered in the 4-h urinary collections were highly correlated with those in 24-h collections (r = 0.857, 0.859, 0.958, and 0.757, respectively). At PbB concentrations >300 microg/L, the relationship between DMSA-PbU and PbB showed a steep increase and a widespread dispersion of DMSA-PbU around the regression line. After DMSA, copper and zinc excretion rates were increased up to 91- and 33-fold, respectively. No side effects were reported after DMSA. Determination of DMSA-PbU in a 4-h collection after DMSA is convenient, apparently safe, and inexpensive. An upper reference limit value of 22 microg/4 h is proposed for Belgian reference individuals. The diagnostic value of DMSA-PbU is likely to be contributive for PbB >300 microg/L.
doi_str_mv 10.1373/clinchem.2005.051128
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subjects Adult
Analytical, structural and metabolic biochemistry
Biological and medical sciences
Blood levels
Body burden
Chelating agents
Chelating Agents - pharmacokinetics
Copper
Copper - urine
Environmental Pollutants - urine
Excretion
Female
Fundamental and applied biological sciences. Psychology
Humans
Investigative techniques, diagnostic techniques (general aspects)
Lead - urine
Lead Poisoning - urine
Male
Medical sciences
Middle Aged
Occupational Diseases - urine
Regression analysis
Succimer - pharmacokinetics
Zinc
Zinc - urine
title Clinical Evaluation of a Lead Mobilization Test Using the Chelating Agent Dimercaptosuccinic Acid
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