Efficient protection of human bronchial epithelial cells against sulfur and nitrogen mustard cytotoxicity using drug combinations
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Updated: Aug 6, 2026

Assessment of the Cytotoxic and Immunomodulatory Effects of Substances in Human Precision-cut Lung Slices
Published on: May 9, 2018
S Rappeneau1, A Baeza-Squiban, F Marano
1Laboratoire de Cytophysiologie et Toxicologie Cellulaire, Université Paris VII Denis-Diderot, Tour 53-54, E3 case 7073, 2 place Jussieu, 75251 Paris cedex 05, France. rappeneau@paris7.jussieu.fr
Abstract:
The aim of this study was to test the efficacy of several candidate molecules against sulfur mustard (SM) and nitrogen mustard (HN2) using a human bronchial-epithelial cell line (16HBE14o-). Candidate molecules were chosen on the basis of the known cytotoxicity mechanisms of mustards or their efficacy previously observed on other cellular models. It included the sulfhydryl-containing molecules N-acetyl-cysteine (NAC) and WR-1065, the nucleophile hexamethylenetetramine (HMT), the energy-level stabilizer niacinamide (NC), the antioxidant dimethylthiourea (DMTU), L-arginine analogues such as L-thiocitrulline (L-TC) and L-nitroarginine methyl ester (L-NAME), and the anti-gelatinase doxycycline (DOX). Their efficacy was determined using 2-(4-[3-iodophenyl)-3-(4-nitrophenyl)-5-(2, 4-disulfophenyl)-2Htetrazolium (WST-1) reduction by viable cells 24 h after initial exposure to 100 microM HN2 or SM. On individual immediate cotreatment, some molecules exhibited selective protection against only one mustard, such as DMTU and WR-1065 against HN2 and DOX against SM, whereas NAC and L-TC were effective against both SM and HN2 cytotoxicity. However, as the level of protection against SM was always weak compared to HN2, several combinations were investigated against SM to improve the protection. The effective combinations (L-TC + DOX, NAC + DOX, NAC + DMTU, NAC + HMT, NC + DOX) combined agents, reducing the bioavailability of the mustard with compounds possibly acting on the consequences of alkylation. One of these combinations, NAC + DOX, appeared to be the most interesting, as these agents are already used in human therapy. It exhibited good efficacy in delayed cotreatment (up to 90 min) against SM.
Insights
Researchers tested molecules to protect against sulfur mustard (SM) and nitrogen mustard (HN2) using lung cells. Combinations like N-acetyl-cysteine (NAC) and doxycycline (DOX) showed promise, especially for delayed protection against SM.
Area of Science:
- Chemical warfare agent countermeasures
- Cellular toxicology and protection mechanisms
Background:
- Sulfur mustard (SM) and nitrogen mustard (HN2) are cytotoxic chemical warfare agents.
- Understanding mustard cytotoxicity mechanisms is crucial for developing effective antidotes.
- Previous studies explored various molecules for mustard decontamination and protection.
Purpose of the Study:
- To evaluate the efficacy of candidate molecules in protecting human bronchial epithelial cells (16HBE14o-) against SM and HN2.
- To identify effective single agents and combinations for immediate and delayed post-exposure treatment.
- To find promising therapeutic strategies, particularly those using agents with existing human therapy applications.
Main Methods:
- Human bronchial epithelial cells (16HBE14o-) were exposed to 100 microM HN2 or SM.
- Candidate molecules including N-acetyl-cysteine (NAC), WR-1065, hexamethylenetetramine (HMT), niacinamide (NC), dimethylthiourea (DMTU), L-thiocitrulline (L-TC), L-nitroarginine methyl ester (L-NAME), and doxycycline (DOX) were tested.
- Cell viability was assessed 24 hours post-exposure using the WST-1 assay; combination therapies and delayed treatments were also investigated.
Main Results:
- Individual agents showed selective efficacy: DMTU and WR-1065 protected against HN2, DOX against SM, while NAC and L-TC were effective against both.
- Combinations were necessary to improve protection against SM, with (L-TC + DOX), (NAC + DOX), (NAC + DMTU), (NAC + HMT), and (NC + DOX) showing effectiveness.
- The combination of NAC + DOX demonstrated significant efficacy in delayed cotreatment (up to 90 minutes) against SM.
Conclusions:
- N-acetyl-cysteine (NAC) and doxycycline (DOX) combination therapy shows significant potential for treating sulfur mustard exposure, even with delayed administration.
- This NAC + DOX combination is particularly promising due to the established use of these agents in human medicine.
- Further research into combined therapeutic strategies is warranted for effective countermeasures against mustard agents.
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