Abstract

To identify effective therapies against sulfur mustard (SM)-induced skin injuries, various animals have been used to assess the cutaneous pathology and related histopathological changes of SM injuries. However, these efforts to establish relevant skin injury endpoints for efficacy studies have been limited mainly due to the restricted assess of SM. Therefore, we employed the SM analog nitrogen mustard (NM), a primary vesicating and bifunctional alkylating agent, to establish relevant endpoints for efficient efficacy studies. Our published studies show that NM (3.2 mg) exposure for 12–120 h in both the hairless SKH-1 and haired C57BL/6 mice caused clinical sequelae of toxicity similar to SM exposure in humans. The NM-induced cutaneous pathology-related structural changes were further analyzed in this study and quantified morphometrically (as percent length or area of epidermis or dermis) of skin sections in mice showing these lesions. H&E stained skin sections of both hairless and haired mice showed that NM (12–120 h) exposure caused epidermal histopathological effects such as increased epidermal thickness, epidermal-dermal separation, necrotic/dead epidermis, epidermal denuding, scab formation, parakeratosis (24–120 h), hyperkeratosis (12–120 h), and acanthosis with hyperplasia (72–120 h). Similar NM exposure in both mice caused dermal changes including necrosis, edema, increase in inflammatory cells, and red blood cell extravasation. These NM-induced cutaneous histopathological features are comparable to the reported lesions from SM exposure in humans and animal models. This study advocates the usefulness of these histopathological parameters observed due to NM exposure in screening and optimization of rescue therapies against NM and SM skin injuries.

Highlights

  • IntroductionOnly 20% of sulfur mustard (SM) is absorbed, leading to acute and chronic skin lesions [1]

  • Upon cutaneous exposure, only 20% of sulfur mustard (SM) is absorbed, leading to acute and chronic skin lesions [1]

  • This study demonstrates that nitrogen mustard (NM) cutaneous exposure resulted in epidermal thickness, epidermal-dermal separation, necrolytic/ dead epidermis, epidermal denudation and ulceration, scab formation, parakeratosis, hyperkeratosis, and acanthosis associated with hyperplasia in both haired and hairless mice

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Summary

Introduction

Only 20% of sulfur mustard (SM) is absorbed, leading to acute and chronic skin lesions [1]. Depending upon the dose and time of SM exposure, within hours, edema develops and blister formation occurs This is followed by ulceration, necrosis, desquamation, and pigmentation changes, dry skin after weeks and even years of exposure [5,6]. In addition to epidermal necrosis, dermal necrosis is observed with infiltration of inflammatory cells, perivascular edema, vascular dilation, and extravasated erythrocytes [4,8]. Animal models showing these toxic lesions by SM are crucial to understand the mechanisms underlying these effects, and to identify and develop effective treatments for SM-induced skin injuries

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