Matt Prater

Chelation therapy

In recent years, it has been common practice to use chelation therapy when mercury, lead,
or cadmium poisoning occurred. Several different chelating agents exist which offer different
binding abilities for these different metals. Four of the medicines that have been applied
include

dimercaptosuccinic

acid

(DMSA),

dimercaptopropanesulfonic

acid

(DMPS)1,

ethylenediamminetretraacetate (EDTA), and British anti-lewisite (BAL) whose structures appear

in figure 1. Chelation therapy involves giving chelating agents orally or intravenously in order to
reduce the concentration of specific metals in the body due to overexposure from a variety of
causes.

Figure 1. Four common chelating agents.2

Mercury is a very well-known metal that causes metal poisoning. DMSA and DMPS are
commonly used for mercury poisoning and have replaced the formerly used British anti-Lewisite
(BAL) which was originally made as an antidote against arsenical war gas Lewisite.1 While
BAL has a bad odor and isnt very water soluble, DMSA is very soluble and does not smell. The
vicinal thiols bind to the mercury giving mercury a coordination number of 2 which matches the
idea that because it is already electron rich it will have a low coordination number. These

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chelating agents can be used to remove mercury from the environment which can be both a good
and a bad thing as some metal ions are needed for the ecosystems to remain at a pseudoequilibrium.
For lead poisoning, an intravenous mixture of EDTA and BAL is administered with high
success for acute lead poisoning.3 For chronic lead poisoning, lead often finds its way into the
bone; perhaps as a substitutional alloy-like substance which weakens the bone. For that case,
chelation therapy does not work as it needs to be in the blood stream to function. These chelating
agents can also be used for the environment but then they do not break down very well in the
environment.
Cadmium poisoning is less common than the two above and the toxicity is tested by
using either biological complexes (Cd2+) or chelating complexes. The Cadmium ion has soft ion
properties and often binds to soft ligands very well (high stability), yet it is considered a hard ion
overall. It transiently binds to small bidentate ligands and binds very strongly to larger bidentate
ligands along with large proteins. EDTA, although a hexadentate ligand binds very tightly to
Cd2+ ions (perhaps a 1:3 ratio); it was shown that the presence of EDTA in the diet of a subject
reduced the amount of Cadmium in the Gastrointestinal tract (GI tract).4 Cadmium is expected to
have a low coordination number due to the number of electrons in the D subshell similar to the
result seen for mercury. Chelating agents may work well to help cure metal poisoning; but for the
environment, the chelating agents stay in the environment which can cause serious biological
problems to plants and animals.
Overall, chelation therapy can be used to clean both the environment and the bloodstream
from different metal ions that are found in higher concentrations than those desired. Chelation
therapy involves transition-metal complexes that render metal ions inert in their environments.

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(1)
George, G. N.; Prince, R. C.; Gailer, J.; Buttigieg, G. A.; Denton, M. B.; Harris, H. H.;
Pickering, I. J. Mercury Binding to the Chelation Therapy Agents DMSA and DMPS and the
Rational Design of Custom Chelators for Mercury. Chemical Research in Toxicology, 2004, 17,
9991006.
(2)
File:Medta.png - New World Encyclopedia
http://www.newworldencyclopedia.org/entry/File:Medta.png (accessed Jan 26, 2015).
(3)
CHELATION THERAPY FOR PATIENTS WITH LEAD POISONING Jennifer A.
Lowry, MD Division of Clinical Pharmacology and Medical Toxicology The Childrens Mercy
Hospitals and Clinics Kansas City, MO 64108 Tel: (816) 234-3059 Fax (816) 855-1958
December 2010.
(4)
Anderson, O. Environ. Health Perspect. 1984, 249266.