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Related Experiment Videos

Mercury exposure in protein A immunoadsorption.

Ludwig Kramer1, Edith Bauer, Martin Jansen

  • 1Department of Medicine IV, University of Vienna Medical School, Vienna, Austria. ludwig.kramer@akh-wien.ac.at

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|January 23, 2004
PubMed
Summary

Protein A immunoadsorption may increase systemic mercury levels due to thiomersal priming, potentially causing toxicity. Alternative methods or thiomersal-free systems are recommended to mitigate mercury exposure risks.

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Area of Science:

  • Nephrology and Immunology
  • Toxicology

Background:

  • Immunoadsorption is a treatment for antibody-mediated autoimmune diseases.
  • Protein A-Sepharose columns are preserved with thiomersal (ethyl mercury thiosalicylate) to prevent microbial growth.
  • Potential systemic mercury exposure from thiomersal-primed columns requires investigation.

Purpose of the Study:

  • To test the hypothesis of systemic mercury exposure in patients undergoing protein A immunoadsorption.
  • To quantify mercury levels in patients undergoing different apheresis procedures.

Main Methods:

  • Whole blood mercury levels were measured using atomic absorption spectroscopy.
  • Measurements were taken before and after protein A immunoadsorption, anti-IgG immunoadsorption, and LDL apheresis.
  • Patient groups included 11 for protein A, 8 for anti-IgG, and 9 for LDL apheresis.

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Main Results:

  • Protein A immunoadsorption significantly increased blood mercury levels from 5.9 to 32.3 microg/l (P<0.001).
  • Elevated baseline mercury levels were observed in protein A patients, but not significantly different from controls.
  • No mercury release was detected in anti-IgG immunoadsorption or LDL apheresis treatments; one patient showed neurological toxicity at 107 microg/l.

Conclusions:

  • Protein A immunoadsorption columns primed with thiomersal may lead to sustained increases in systemic mercury concentrations.
  • Mercury levels can exceed safety recommendations, posing a risk of mercury-induced toxicity.
  • Reducing systemic mercury exposure through chelators or thiomersal replacement is advised.