In contrast, several toxic heavy metals, such as arsenic, mercury, copper, and lead, may be referred to as sulfur-seekers, having a higher affinity to endogenous sulfur than oxygen groups. These metal cations may be bound and inactivated by the two vicinal thiol groups on the therapeutic agent BAL.
However, today, the clinical use of BAL is limited due to its high toxicity. Its less toxic derivatives, meso-2,3-dimercaptosuccinic acid (DMSA) and D, L-2,3-dimercapto- 1-propane sulfonic acid (DMPS), have now entered the clinical arena and superseded dimercaprol in most cases of heavy metal poisonings. These latter dithiols are nowadays available for oral administration, as tablets, as well as for parenteral administration.
The present book also gives guidelines for clinicians who are responsible for the diagnosis and treatment of metal poisonings and overload diseases. Also, some guidelines for further research are precipitated in the last chapter.Chelation Therapy in the Treatment of Metal Intoxication