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Increased ethyl mercury load in protein a immunoadsorption.

Andreja Marn-Pernat1, Jadranka Buturović-Ponikvar, Martina Logar

  • 1University Medical Center Ljubljana, Department of Nephrology, University of Ljubljana, Ljubljana, Slovenia. andreja.marn@kclj.si

Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
|June 22, 2005
PubMed
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This study investigated mercury release during immunoadsorption treatment for autoimmune diseases. Despite using N-acetylcysteine, mercury levels in patients

Area of Science:

  • Nephrology
  • Toxicology
  • Immunology

Background:

  • Immunoadsorption therapy utilizes protein A columns to remove autoantibodies in autoimmune diseases.
  • Protein A columns are preserved with thiomersal, a mercury-containing compound, posing a risk of mercury release during treatment.
  • Ethyl mercury from thiomersal may accumulate and cause toxicity.

Purpose of the Study:

  • To evaluate the efficacy of N-acetylcysteine as a mercury scavenger in reducing thiomersal-related mercury release during immunoadsorption.
  • To quantify changes in blood ethyl mercury and total mercury levels before and after immunoadsorption treatment.

Main Methods:

  • Thirteen patients underwent 17 immunoadsorption treatments using protein A columns.
  • A modified rinsing solution with 600 mg of N-acetylcysteine was used to rinse columns.

Related Experiment Videos

  • Blood samples were analyzed for ethyl mercury and total mercury levels using atomic fluorescence and absorption spectrometry, respectively.

    • Main Results:

    • Ethyl mercury levels increased significantly from 0.148 ± 0.402 ng/g to 2.026 ± 1.944 ng/g (P < 0.001).
    • Total blood mercury levels rose from 2.447 ± 3.065 ng/g to 20.437 ± 28.603 ng/g (P = 0.02).
    • Post-treatment mercury levels exceeded the safety threshold in all treatments, though no clinical toxicity was observed.

    Conclusions:

    • N-acetylcysteine did not prevent mercury release from thiomersal-primed columns during immunoadsorption.
    • Significant increases in blood mercury levels were observed, indicating mercury release.
    • Further strategies are needed to mitigate mercury exposure risks associated with immunoadsorption therapy.