Human casualties sulfur mustard

Recently, sulfur mustard has been shown to alkylate a cysteine residue in human serum albumin (10). The site of alkylation was identified in a tryptic digest of albumin from blood exposed to [14C]sulfur mustard. A sensitive method for its analysis was developed based on Pronase digestion of alkylated albumin to the tripeptide S-[2-[(hydroxyethyl)thio]ethyl-Cys-Pro-Phe, and detection using micro-LC-MS-MS. In vitro exposure of human blood to > 10 nM sulfur mustard could be detected employing this method. The analytical procedure was successfully applied to albumin samples from Iranian casualties of the Iraq-Iran war. 

The ELISA for detection of the DNA adduct was successfully applied to blood samples from two casualties of the Iraq-Iran conflict. These samples were collected 22 and 26 days following the alleged exposure to sulfur mustard (13). Concentrations found in lymphocytes and granulocytes were equivalent to similar levels found in human blood after treatment in vitro with 0.015-0.43 xM sulfur mustard. 

The analytical procedure for S-[2-[(hydroxyethyl) thio]ethyl-Cys-Pro-Phe was successfully applied to blood samples from nine Iranian casualties of the Iraq-Iran war, all exhibiting skin injuries compatible with exposure to sulfur mustard. The blood samples were collected 8-9 days after the alleged exposure and stored at — 70 °C. The albumin adduct was detected in all cases, at levels estimated as corresponding to those after in vitro exposure of human blood to mustard concentrations ranging from 0.4-1.8 xM. 

Application to Human Exposure (Urine Samples). Vycudihk (1985, 1987) analyzed urine samples from multiple casualties of the Iran-Iraq War in the 1980s that were hospitalized for treatment of suspected sulfur mustard exposure. Urine samples from eight of the patients produced positive results for sulfur mustard using GC-MS. Concentrations found ranged from 1 to 30 ng/mL. The method could not distinguish between sulfur mustard and its hydroxyethyl metabohtes that were present in the urine samples. 

Application to Human Exposure (Blood Samples). Blood samples following a suspected human exposure to sulfur mustard have only rarely become available for laboratory analysis. Three of the five known reports involve the analysis of samples that were taken from casualties of the Iran-Iraq War, frozen for several years and then analyzed to verify exposure as methods were developed. The other two published reports are on the analysis of blood samples obtained from three individuals that were casualties of accidental exposures to WWI munitions. 

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