Selected problems related to environmental heave metals exposure and chelation therapy
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Department of Internal Medicine and Hypertension Wroclaw University of Medicine Head: prof. Ryszard Andrzejak, MD, PhD
Anna Skoczynska   

Wrocław University of Medicine Pasteur 4, PL 50-367 Wrocław, Poland
Med Srod. 2010;13(3):62–67
Exposure to heavy metals leads to functional and metabolic disturbances and many of them are included in pathogenesis of common diseases (arterial hypertension, atherosclerosis, neurodegenerative processes). In this context new therapeutic and prophylactic strategies are necessary. Patients diagnosed with chronic heavy metals intoxication usually require chelation to increase mobilisation of metals from tissues and elimination of them via urine. Acute poisoning with toxic metal may be difficult to diagnosis, especially in case of accidental intoxication or suicidal intention. Patients also require chelation after causative factor is identified.

To describe some problems connected with toxicity of metals poisoning and to review pharmacologic therapies that could have a role in poisoning with metals.

A review of the literature was carried out and expert opinion expressed.

Chelation is a common therapy in case of poisoning with toxic metals but it is satisfied only partially. A combined therapy with structurally different chelators or long-term acting chelators could become viable alternatives in the future. A combined therapy with an antioxidant plus chelator may be a good choice in patients chronically poisoned with metals. Exposure to lead should be taken into account during estimation of global cardiovascular risk.

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