Halogen gas exposure: toxic effects on the parturient.
Halogen gas exposure: toxic effects on the parturient.
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DOI：
10.1080/15376516.2020.1736702
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发表时间：
2021-05
影响因子：
3.2
通讯作者：
Matalon S
中科院分区：
文献类型：
--
作者：
Addis DR;Lambert JA;Ford DA;Jilling T;Matalon S
元素卤素包括氯、溴和光气。卤素气体可以直接武器化，并用于战争或恐怖主义。工业储存或卤素运输可能成为恐怖主义袭击的目标，也可能成为意外释放的源头，造成潜在的大规模伤亡事件的风险。孕妇和产后妇女是人口中很大的脆弱群体，她们在受到攻击或意外接触时可能面临特别的风险。我们回顾了卤素暴露对产妇的影响，重点是溴毒性。溴是妊娠背景下研究最广泛的药物，迄今为止，小鼠模型构成了目前大多数知识的基础。妊娠加重卤素暴露后急性肺损伤。此外，卤素暴露在小鼠中会引起先兆子痫样综合征。这种表型的特征在于全身性和肺动脉高压、内皮功能障碍、心输出量减少、胎盘损伤和胎儿生长受限。这一现象导致了溴暴露后观察到的孕产妇和胎儿死亡率增加。血管生成不平衡与血管内皮生长因子受体1的可溶性fms样酪氨酸激酶-1（sFlt-1）形式的过度表达有关，这让人联想到人类先兆子痫。需要进行更多的研究，以进一步探索怀孕期间卤素气体暴露的影响，并制定治疗干预措施，以减轻这一独特人群的风险。
The elemental halogens include chlorine, bromine, and phosgene. Halogen gas can be directly weaponized and employed in warfare or terrorism. Industrial stockpiles or halogen transport can provide targets for terrorist attack as well as an origin for accidental release creating a risk for potential mass-casualty incidents. Pregnant and post-partum women represent a substantial and vulnerable subset of the population who may be at particular risk during an attack or accidental exposure. We review the effects of halogen exposure on the parturient with a focus on bromine toxicity. Bromine is the most extensively studied agent in the context of pregnancy and to-date murine models form the basis for the majority of current knowledge. Pregnancy potentiates the acute lung injury after halogen exposure. In addition, halogen exposure precipitates a preeclamptic-like syndrome in mice. This phenotype is characterized by systemic and pulmonary hypertension, endothelial dysfunction, decreased cardiac output, placental injury and fetal growth restriction. This constellation contributes to increased maternal and fetal mortality observed after bromine exposure. Angiogenic imbalance is noted with overexpression of the soluble fms-like tyrosine kinase-1 (sFlt-1) form of the vascular endothelial growth factor receptor 1 reminiscent of human preeclampsia. Additional research is needed to further explore the effect of halogen gas exposure in pregnancy and to develop therapeutic interventions to mitigate risk to this unique population.
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