Abstract
Thiosulfate in the form of sodium thiosulfate (STS) is a major oxidation product of hydrogen sulfide (H2S), an endogenous signaling molecule and the third member of the gasotransmitter family. STS is currently used in the clinical treatment of acute cyanide poisoning, cisplatin toxicities in cancer therapy, and calciphylaxis in dialysis patients. Burgeoning evidence show that STS has antioxidant and anti-inflammatory properties, making it a potential therapeutic candidate molecule that can target multiple molecular pathways in various diseases and drug-induced toxicities. This review discusses the biochemical and molecular pathways in the generation of STS from H2S, its clinical usefulness, and potential clinical applications, as well as the molecular mechanisms underlying these clinical applications and a future perspective in kidney transplantation.
Highlights
Sodium thiosulfate (STS) is an odorless, inorganic, and water-soluble compound with the chemical formula Na2 S2 O3 and a molecular weight of 158.11g/mol
It possesses therapeutic properties such as antioxidant, anti-inflammatory, and antihypertensive properties [3,4,5,6,7]. It is approved by Food and Drugs Administration (FDA) and is currently clinically useful in the treatment of acute cyanide poisoning, carbon monoxide toxicity, cisplatin toxicities in cancer therapy, and calcific uremic arteriolopathy in dialysis patients [8,9,10,11]
Administration of high-dose cisplatin over the last 2 h of STS infusion prevented possible cisplatin-induced nephrotoxicity, as there were no observed changes in elimination rate constant, volume distribution and total body clearance compared to patients who received low-dose cisplatin without STS [52]
Summary
Sodium thiosulfate (STS) is an odorless, inorganic, and water-soluble compound with the chemical formula Na2 S2 O3 and a molecular weight of 158.11g/mol It is a major oxidation production of hydrogen sulfide (H2 S) and is typically available as a white crystalline or powdered substance in the form of pentahydrate (Na2 S2 O3 ·5H2 O) [1]. On the World Health Organization’s list of essential medicines, STS has several other uses including as a common food preservative, a water dechlorinator, a photographic fixative, and a bleaching agent for paper pulp [2] It possesses therapeutic properties such as antioxidant, anti-inflammatory, and antihypertensive properties [3,4,5,6,7].
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