Extracorporeal Nerve Agent Detoxification: A Novel Approach Combining 2 High-Priority DOD Medical Programs for Battlefield Medicine
Abstract
Recent world events have shown that our near-peer adversaries are willing and able to deploy CWNAs. Consideration of how to fight in a complex kinetic environment intermixed with chemical threats is paramount to winning in future MDO against key belligerents. CWNAs are extremely toxic compounds that bind to and inhibit acetylcholinesterase(13). This inhibition causes an excess of the neurotransmitter acetylcholine at the synapse, resulting in a cholinergic crisis. Symptoms of CWNA exposure include hypersecretions, miosis, loss of consciousness, flaccid paralysis, and seizures. CWNAs complicate battlefield trauma and no current technologies in the US medical treatment arsenal are designed to treat combined injury (trauma and CWNAs). Current treatments for CWNA exposure by itself include administration of atropine to control peripheral secretions, pralidoxime chloride to reactivate acetylcholinesterase, and diazepam or midazolam to control the occurrence of seizures. Although timely administration of these countermeasures can increase survival, they do not ameliorate all seizure activity and cannot prevent nerve agent-induced neuronal and cardiac damage. In addition, field treatment for CWNA exposure requires re-administration of these three therapeutics based on clinical signs and symptoms. Current development for prolonged protection against CWNA exposure utilizes a protein-based scavenger in circulation to either bind (stoichiometric) or hydrolyze (catalytic) CWNAs. But, the circulatory stability of bioscavengers, immunogenicity of catalytic bioscavengers, and large bioavailable concentrations needed for stoichiometric bioscavengers would limit their utility during direct field intravenous application.
Document Details
- Document Type
- Technical Report
- Publication Date
- Aug 01, 2023
- Accession Number
- AD1219075
Entities
People
- Andriy I. Batchinsky
Organizations
- Geneva Foundation