Trichothecene mycotoxins decontamination

Reactive Skin Decontamination Lotion (RSDL) has recently been approved for procurement by the U.S. military (F-Z-EM 2007). RSDL is currently marketed by E-Z-EM, Inc. and is a patented, broad spectrum, skin decontamination lotion that is used to remove or neutralize chemical threat agents and biological warfare agents such as trichothecene mycotoxin (T2 toxin), which can cause severe skin and eye irritation. RSDL was originally developed by the Canadian Defense Research Establishment and consists of 1.25 molar potassium 2,3-butanedione monoximate in poly-etheylene glycol monoethyl ethers with 10% w/v water (Sabourin et al. 2001 Lukey et al. 2004). 

Decontamination of personnel and equipment after a biological warfare attack is a lesser concern than after a chemical warfare attack because most biological warfare agents are not dermally active (the trichothecene mycotoxins are an exception). Still, decontamination remains an effective way to decrease the spread of infection from potential secondary aerosolization. 

Symptomatic measures for the treatment of exposure to trichothecene mycotoxins are modeled after the care of casualties of mustard poisoning.85 Irrigation of the eyes with large volumes of isotonic saline may assist in the mechanical removal of trichothecene mycotoxins, but would have limited useful therapeutic effects. After the skin has been decontaminated, some erythema may appear, accompanied by burning and itching. Most casualties whose skin has been treated with soap and water within 12 hours of exposure will have mild dermal effects these should be relieved by calamine and other lotion or cream, such as 0.25% camphor and methanol. 

No specific therapy for trichothecene mycotoxin poisoning is currently available. Skin decontamination with soap and water or the hypochlorite- (M258A1) or resin-based (M291) military decontamination kits can effectively remove toxin up to six hours after exposure, although none of them neutralize the toxin. Treatment of respiratory, dermal, and GI effects currently must be symptom based and supportive in nature. Superactive activated charcoal, for example, a common treatment for many orally taken poisons, has been shown to bind 0.48 mg T-2/gm charcoal in mice and improve survival rates significantly. 

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