Meso-2,3-Dimercaptosuccinic Acid

(DMSA)
A chemical derivative of dimercaprol which has
gained attention, is meso-2,3-dimercaptosuccinic
acid (DMSA).
a dithiol compound (two –SH, groups) and an
analogue of dimercaprol
The drug is 95 % plasma protein bound, most likely
by virtue of binding on one of its sulfhydryl groups
to a cysteine residue on albumin, leaving the other
–SH available to chelate metals
Least toxic among dithiol compounds
No significant loss of essential metals like zinc, 2,3-
iron, calcium and magnesium * (except Cu and Hg) Dimercaprol
Drawback with DMSA is its extracellular (BAL)
distribution, since it is unable to cross the cell
membrane.
Limitations of DMSA in the treatment of mercury toxicity
Benefits and Drawbacks
Of Chelation therapy
COPPER (Cu)
Copper is an essential element in living systems,
forming a large number of metalloproteins. Among
the functions of the copper proteins are: electron
transfer with either an outersphere mechanism, or
functioning as an inner-sphere reductase, both
involving the Cu(I)/Cu(II) couple;

mono- terminal-oxidases, which form either water

or hydrogen peroxide from dioxygen; oxygenases,
which incorporate an oxygen atom into a substrate;
superoxide degradation to form dioxygen and
peroxide; and oxygen transport.
The blue copper proteins have a
beautiful blue colour, far more
intense than that of the Cu(II) ion in
water,
Caeruloplasmin has several of
these functions, and is a blue
colour, hence the recently acquired
description as a "moonlighting'
protein.
Original Paper
Oncogene (2004) 23, 2367–2378. doi:10.1038/sj.onc.1207376 Published online 23 February 2004
Bacterial cupredoxin azurin as an inducer of apoptosis and regression in human breast cancer
Copper Deficiency
Copper Overload and Wilson’s disease