Treatment for sulfur mustard lung injuries; new therapeutic approaches from acute to chronic phase

This review was done by reviewing all papers found by searching following key words sulfur mustard; lung; chronic; acute; COPD; treatment.Mustard lung has an ongoing pathological process and is active disorder even years after exposure to SM. Different drug classes have been studied, nevertheless there are no curative modalities for mustard lung.Complementary studies on one hand regarding pharmacokinetic of drugs and molecular investigations are mandatory to obtain more effective treatments.A biofunctional mustard agent i.e., sulfur mustard, bis(2-chloroethyl) sulfide (SM), was used in several conflicts since the first World War and has caused more than 80% of all documented chemical war gas casualties [1-3].It is well known that chemical agents have been used against military personnel during conventional warfare, however, due to the increasing threat of terrorist activities, the focus has now broadened to encompass the threat posed to civilians. It maintains to be a major threat for use in battlefields and terrorist activities against either military and civilian targets [4]. It has been estimated that more than 100,000 Iranians were exposed to chemical warfare agents during the 8-year Iraq-Iran war, and around 50,000 mustard gas-affected individuals are suffering from of chronic respiratory, eye and/or dermatological complications [5]. Most victims (approximately 30,000) have been manifested different degree of long-term lung injuries [6]. Ever since, SM has been remained as a potent military and civilian threat [7], thus efficient prophylactic/therapeutic measures of acute and chronic pulmonary complications may be the most important challenge and intriguing goal in these setting. Most of acute lung injury survivors are confined to the upper respiratory tract (pharyngeal, palatal, tracheal lesions) and/or lower respiratory tract that had caused to fatal consequences due to airways complications [8]. Over many years, several surveys on long-term effects of SM, we