Sulfur mustard Iranian casualties

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. 

Figure 8. GC/MS/MS/MRM chromatograms showing the detection of f5-lyase metabolites in urine from two casualties of sulfur mustard poisoning (Cl, 220ng/ml and C4, 5ng/ml), their absence in urine from an unexposed subject, and the internal standard (is). Samples Cl and C4 were from two Iranian subjects undergoing treatment in Ghent in 1984, collected 10 days after the exposure...

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. 

The blood from two Iranian casualties that were believed to have been exposed to sulfur mustard in 1988 was analyzed using both the ELISA method for DNA adducts and the GC-MS method for the analysis of the N-terminal valine of hemoglobin (Benschop et al., 1997). Samples were collected 22 and 26 days following the suspected exposure to sulfur mustard. One of the casualties had injuries to the skin that were consistent with an exposure to sulfur mustard, but the second casualty had injuries that were described as only vaguely compatible with sulfur mustard exposure. Both individuals had approximately the same level of hemoglobin valine adduct that was equivalent to the amount observed from a 900 nM in vitro sulfur mustard exposure in whole blood. ELISA DNA adduct levels observed in the granulocytes were also similar for both individuals, 150-160 nM. The individual with the skin injuries consistent with sulfur mustard exposure had observed ELISA DNA adduct levels in the lymphocytes that were only about half that observed in the individual with injuries that were less pronounced, 220 and 430 nM, respectively. 

Blood samples obtained from nine Iranian casualties of sulfur mustard exposure were analyzed... 

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