Phosgene: toxicology, animal models, and medical countermeasures.

Phosgene is a gas crucial to industrial chemical processes with widespread production (∼1 million tons/year in the USA, 8.5 million tons/year worldwide). Phosgene's high toxicity and physical properties resulted in its use as a chemical warfare agent during the First World War with a designation of CG ('Choky Gas'). The industrial availability of phosgene makes it a compound of concern as a weapon of mass destruction by terrorist organizations. The hydrophobicity of phosgene exacerbates its toxicity often resulting in a delayed toxidrome as the upper airways are moderately irritated; by the time symptoms appear, significant damage has occurred. As the standard of care for phosgene intoxication is supportive therapy, a pressing need for effective therapeutics and treatment regimens exists. Proposed toxicity mechanisms for phosgene based on human and animal exposures are discussed. Whereas intermediary components in the phosgene intoxication pathways are under continued discussion, generation of reactive oxygen species and oxidative stress is a common factor. As animal models are required for the study of phosgene and for FDA approval via the Animal Rule; the status of existing models and their adherence to Haber's Rule is discussed. Finally, we review the continued search for efficacious therapeutics for phosgene intoxication; and present a rapid post-exposure response that places exogenous human heat shock protein 72, in the form of a cell-penetrating fusion protein (Fv-HSP72), into lung tissues to combat apoptosis resulting from oxidative stress. Despite significant progress, additional work is required to advance effective therapeutics for acute phosgene exposure.

Development of an acute, short-term exposure model for phosgene.

Phosgene is classified as a chemical warfare agent, yet data on its short-duration high concentration toxicity in a nose-only exposure rat model is sparse and inconsistent. Hence, an exposure system for short-term/high concentration exposure was developed and characterized. Herein, we report the median lethal concentration (LC50) for a 10-min nasal exposure of phosgene in a 24-h rat survival model. Male Wistar rats (Envigo) weighing 180-210 g on the day of exposure, were exposed to phosgene gas via nose-only inhalation using a system specifically designed to allow the simultaneous exposure and quantification of phosgene. After 24 h, the surviving rats were euthanized, the lung/body mass ratio determined, and lung tissues analyzed for histopathology. Increased terminal airway edema in the lungs located primarily at the alveoli (resulting in an increased lung/body mass ratio) coincided with the observed mortality. An LC50 value of 129.2 mg/m3 for a 10-min exposure was determined. Furthermore, in agreement with other highly toxic compounds, this study reveals a LC50 concentration value supportive of a nonlinear toxic load model, where the toxic load exponent is >1 (ne = 1.17). Thus, in line with other chemical warfare agents, phosgene toxicity is predicted to be more severe with short-duration, high-concentration exposures than long-duration, low-concentration exposures. This model is anticipated to be refined and developed to screen novel therapeutics against relevant short-term high concentration phosgene exposures expected from a terrorist attack, battlefield deployment, or industrial accident.

Resistive and Capacitive γ-Ray Dosimeters Based On Triggered Depolymerization in Carbon Nanotube Composites.

We report γ-ray dosimeters using carbon nanotubes wrapped with metastable poly(olefin sulfone)s (POSs) that readily depolymerize when exposed to ionizing radiation. New POSs, designed for wrapping single-walled carbon nanotubes (SWCNTs), are synthesized and characterized. The resulting POS-SWCNT composites serve as the active transducer in a novel class of γ-ray dosimeters. In our devices, polymer degradation results in immediate changes in the electronic potential of the POS-SWCNT active layers by decreasing the electron tunneling barriers between individualized tubes and by creating enhanced cofacial π-π electron contacts. By incorporating the SWCNT-POS composites into small resistive device platforms, we establish a rare example of real-time detection and dosimetry of radioactive ionizing radiation using organic-based materials. We show that the sensitivity of our platform closely depends on the intrinsic stability of the polymer matrix, the opacity toward γ-rays, and the dispersion efficiency (i.e., the individualization and isolation of the individual SWCNT charge carriers). Resistance decreases up to 65% after irradiation with a 40 krad dose demonstrates the high sensitivity of this novel class of γ-ray sensors. In addition, the detection mechanism was evaluated using a commercial capacitive device platform. The ease of fabrication and low power consumption of these small and inexpensive sensor platforms combined with appealing sensitivity parameters establishes the potential of the poly(olefin sulfone)-SWCNT composites to serve as a new transduction material in γ-ray sensor applications.

Implications of Thermal Annealing on the Benzene Vapor Sensing Behavior of PEVA-Graphene Nanocomposite Threads.

The effect of thermal treatments, on the benzene vapor sensitivity of polyethylene (co-)vinylacetate (PEVA)/graphene nanocomposite threads, used as chemiresistive sensors, was investigated using DC resistance measurements, differential scanning calorimetry (DSC), and scanning electron microscopy (SEM). These flexible threads are being developed as low-cost, easy-to-measure chemical sensors that can be incorporated into smart clothing or disposable sensing patches. Chemiresistive threads were solution-cast or extruded from PEVA and <10% graphene nanoplatelets (by mass) in toluene. Threads were annealed at various temperatures and showed up to 2 orders of magnitude decrease in resistance with successive anneals. Threads heated to ≥80 °C showed improved limits of detection, resulting from improved signal-noise, when exposed to benzene vapor in dry air. In addition, annealing increased the speed of response and recovery upon exposure to and removal of benzene vapor. DSC results showed that the presence of graphene raises the freezing point, and may allow greater crystallinity, in the nanocomposite after annealing. SEM images confirm increased surface roughness/area, which may account for the increase response speed after annealing. Benzene vapor detection at 5 ppm is demonstrated with limits of detection estimated to be as low as 1.5 ppm, reflecting an order of magnitude improvement over unannealed threads.

Prediction of Radiation Esophagitis in Non-Small Cell Lung Cancer Using Clinical Factors, Dosimetric Parameters, and Pretreatment Cytokine Levels.

Radiation esophagitis (RE) is a common adverse event associated with radiotherapy for non-small cell lung cancer (NSCLC). While plasma cytokine levels have been correlated with other forms of radiation-induced toxicity, their association with RE has been less well studied. We analyzed data from 126 patients treated on 4 prospective clinical trials. Logistic regression models based on combinations of dosimetric factors [maximum dose to 2 cubic cm (D2cc) and generalized equivalent uniform dose (gEUD)], clinical variables, and pretreatment plasma levels of 30 cytokines were developed. Cross-validated estimates of area under the receiver operating characteristic curve (AUC) and log likelihood were used to assess prediction accuracy. Dose-only models predicted grade 3 RE with AUC values of 0.750 (D2cc) and 0.727 (gEUD). Combining clinical factors with D2cc increased the AUC to 0.779. Incorporating pretreatment cytokine measurements, modeled as direct associations with RE and as potential interactions with the dose-esophagitis association, produced AUC values of 0.758 and 0.773, respectively. D2cc and gEUD correlated with grade 3 RE with odds ratios (ORs) of 1.094/Gy and 1.096/Gy, respectively. Female gender was associated with a higher risk of RE, with ORs of 1.09 and 1.112 in the D2cc and gEUD models, respectively. Older age was associated with decreased risk of RE, with ORs of 0.992/year and 0.991/year in the D2cc and gEUD models, respectively. Combining clinical with dosimetric factors but not pretreatment cytokine levels yielded improved prediction of grade 3 RE compared to prediction by dose alone. Such multifactorial modeling may prove useful in directing radiation treatment planning.

Radiation-induced lung toxicity in non-small-cell lung cancer: Understanding the interactions of clinical factors and cytokines with the dose-toxicity relationship.

BACKGROUND AND PURPOSE: Current methods to estimate risk of radiation-induced lung toxicity (RILT) rely on dosimetric parameters. We aimed to improve prognostication by incorporating clinical and cytokine data, and to investigate how these factors may interact with the effect of mean lung dose (MLD) on RILT. MATERIALS AND METHODS: Data from 125 patients treated from 2004 to 2013 with definitive radiotherapy for stages I-III NSCLC on four prospective clinical trials were analyzed. Plasma levels of 30 cytokines were measured pretreatment, and at 2 and 4weeks midtreatment. Penalized logistic regression models based on combinations of MLD, clinical factors, and cytokine levels were developed. Cross-validated estimates of log-likelihood and area under the receiver operating characteristic curve (AUC) were used to assess accuracy. RESULTS: In prognosticating grade 3 or greater RILT by MLD alone, cross-validated log-likelihood and AUC were -28.2 and 0.637, respectively. Incorporating clinical features and baseline cytokine levels increased log-likelihood to -27.6 and AUC to 0.669. Midtreatment cytokine data did not further increase log-likelihood or AUC. Of the 30 cytokines measured, higher levels of 13 decreased the effect of MLD on RILT, corresponding to a lower odds ratio for RILT per Gy MLD, while higher levels of 4 increased the association. CONCLUSIONS: Although the added prognostic benefit from cytokine data in our model was modest, understanding how clinical and biologic factors interact with the MLD-RILT relationship represents a novel framework for understanding and investigating the multiple factors contributing to radiation-induced toxicity.

Targeted heat shock protein 72 for pulmonary cytoprotection.

Heat shock protein 72 (HSP72) is perhaps the most important member of the HSP70 family of proteins, given that it is induced in a wide variety of tissues and cells to combat stress, particularly oxidative stress. Here, we review independent observations of the critical role this protein plays as a pulmonary cytoprotectant and discuss the merits of developing HSP72 as a therapeutic for rapid delivery to cells and tissues after a traumatic event. We also discuss the fusion of HSP72 to a cell-penetrating single-chain Fv antibody fragment derived from mAb 3E10, referred to as Fv-HSP70. This fusion construct has been validated in vivo in a cerebral infarction model and is currently in testing as a clinical therapeutic to treat ischemic events and as a fieldable medical countermeasure to treat inhalation of toxicants caused by terrorist actions or industrial accidents.

Preconcentration and detection of chlorinated organic compounds and benzene.

Remote and automated detection of organic compounds in subsurface aquifers is crucial to superfund monitoring and environmental remediation. Current monitoring techniques use expensive laboratory instruments and trained personnel. The use of a filled tubular preconcentrator combined with a chemicapacitive detector array presents an attractive option for the unattended monitoring of these compounds. Five preconcentrator materials were exposed to common target compounds of subsurface remediation projects (1,1,2-trichloroethane, trichloroethylene, t-1,2-dichloroethylene, benzene, and perchloroethylene). Rapid heating of the tube caused the collected, concentrated effluent to pass over the surface of a chemicapacitive detector array coated with four different sorbent polymers. A system containing a porous ladder polymer and the sensor array was subsequently used to sample the analytes injected onto sand in a laboratory test, simulating a subsurface environment. With extended collection times, effective detection limits of 5 ± 3 ppbV for 1,1,2-trichloroethane and 145 ± 60 ppbV for benzene were achieved. Effects of the preconcentrator material structure, the collection time, and sensor material on the system performance were observed. The resultant system presents a solution for remote, periodic monitoring of chlorinated organic compounds and other volatile organic compounds in a soil matrix.

Detection of methyl salicylate using polymer-filled chemicapacitors.

Methyl salicylate (MeS) is used as a chemical warfare agent simulant to test chemical protective garments and other individual personal protective gear. The accurate and real-time detection of this analyte is advantageous for various testing regimes. This paper reports the results of MeS vapor exposures on polymer-filled capacitance-based sensors at temperatures ranging from 15 degrees C to 50 degrees C under dry and humid conditions. Multiple capacitors were arranged in an array on a silicon chip each having a different sorptive polymer. The sensors used parallel-plate electrode geometry to measure the dielectric permittivity changes of each polymer when exposed to water and MeS vapor. Of the four polymers tested against MeS, the optimal polymer displayed near or sub-parts-per-million detection limits at 35 degrees C (0-80%RH).