The Association between Ocular Problems and Serum Testosterone, Prolactin and Thyroglobulin Concentrations in Delayed Phase of Sulfur Mustard Exposure

Hassan Ghasemi,Soghrat Faghihzadeh,Sakine Moaiedmohseni,Nayere Askari,Elham Faghihzadeh,Sussan Kaboudanian Ardestani ,Tooba Ghazanfari

doi:10.30699/ijp.13.1.63

Abstract

Aside from direct toxic effects, Sulfur Mustard (SM) induced serum hormone abnormalities may aggravate ocular complaints, including Ocular Surface Discomfort (OSD) (burning, itching, and redness), dry eye sensation, photophobia, blurred vision, foreign body sensation, and pain. The aim of the current study was to investigate the possible association of ocular complaints with serum hormone concentrations in chronic phase of Sulfur Mustard (SM) exposure. As a part of Sardasht Iran Cohort Study (SICS), 372 SM-exposed patients and 128 non-exposed participants were enrolled. Ocular complaints and ocular surface biomicroscopic conditions and serum hormones were compared. The exposed with tearing group had significantly higher mean serum levels of testosterone and prolactin (ng/mL) than controls (5.75 vs. 4.75, P=0.031; 11.71 vs. 8.42, P=0.009). The exposed with OSD group had significantly higher mean serum levels of prolactin than controls (12.48 vs. 6.90, P=0.002). The exposed with photophobia group had significantly higher mean serum levels of testosterone than the matched exposed (6.25 vs. 5.65, P=0.013). The exposed with blurred vision group had significantly higher mean serum levels of Thyroglobulin (Tg) (ng/mL) than the matched exposed (65.73 vs. 32.6, P=0.003). Higher mean serum levels of testosterone (in exposed with tearing and photophobia) and prolactin (in exposed with tearing and OSD) may play protective roles against SM effects. Higher mean serum levels of Tg may deteriorate the tear film integrity and optical surface, which causes blurred vision. In the chronic phase of SM toxicity, some ocular surface problems are associated with alterations in the serum concentrations of testosterone, prolactin, and Tg.

Highlights

Mustards in the forms of liquid or vapor are very persistent agents and in acute phase of exposure cause ocular problems, such as irritation, photophobia and decreased visual acuity, pulmonary edema and respiratory distress, and skin lesions similar to first- or second-degree burns
The exposed with tearing group had significantly higher mean serum levels of testosterone and prolactin than controls (5.75 vs. 4.75, P=0.031; 11.71 vs. 8.42, P=0.009)
The exposed with Ocular Surface Discomfort (OSD) group had significantly higher mean serum levels of prolactin than controls (12.48 vs. 6.90, P=0.002)

Summary

Introduction

Mustards in the forms of liquid or vapor are very persistent agents and in acute phase of exposure cause ocular problems, such as irritation, photophobia and decreased visual acuity, pulmonary edema and respiratory distress, and skin lesions similar to first- or second-degree burns. Limited effective medications have enforced researchers to test a variety of different treatments, such as immunological, chemical and/or herbal interventions [4,5,6,7]. Aside from these serious sideeffects, Sulfur Mustard (SM) causes many alterations in serum hormone concentrations during different phases of exposure [8]. Serum hormones influence the integrity of ocular surface and their abnormalities may cause ocular complaints, such as tearing, OSD) (burning, itching, and redness), dry eye sensation, photophobia, blurring of vision, foreign body sensation, and pain

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