Background and Purpose—: An urgent need exists to develop therapies for stroke that have high efficacy, long therapeutic time windows, and acceptable toxicity. We undertook preclinical investigations of a novel therapeutic approach involving supplementation with carnosine, an endogenous pleiotropic dipeptide. Methods—: Efficacy and safety of carnosine treatment was evaluated in rat models of permanent or transient middle cerebral artery occlusion. Mechanistic studies used primary neuronal/astrocytic cultures and ex vivo brain homogenates. Results—: Intravenous treatment with carnosine exhibited robust cerebroprotection in a dose-dependent manner, with long clinically relevant therapeutic time windows of 6 hours and 9 hours in transient and permanent models, respectively. Histological outcomes and functional improvements including motor and sensory deficits were sustained on 14th day poststroke onset. In safety and tolerability assessments, carnosine did not exhibit any evidence of adverse effects or toxicity. Moreover, histological evaluation of organs, complete blood count, coagulation tests, and the serum chemistry did not reveal any abnormalities. In primary neuronal cell cultures and ex vivo brain homogenates, carnosine exhibited robust antiexcitotoxic, antioxidant, and mitochondria protecting activity. Conclusions—: In both permanent and transient ischemic models, carnosine treatment exhibited significant cerebroprotection against histological and functional damage, with wide therapeutic and clinically relevant time windows. Carnosine was well tolerated and exhibited no toxicity. Mechanistic data show that it influences multiple deleterious processes. Taken together, our data suggest that this endogenous pleiotropic dipeptide is a strong candidate for further development as a stroke treatment.

Hydrogen sulfide (H₂S), the gas with the odor of rotten eggs, was formally discovered in 1777, over 239 years ago. For many years, it was considered an environmental pollutant and a health concern only in occupational settings. Recently, however, it was discovered that H₂S is produced endogenously and plays critical physiological roles as a gasotransmitter. Although at low physiological concentrations it is physiologically beneficial, exposure to high concentrations of H₂S is known to cause brain damage, leading to neurodegeneration and long‐term neurological sequelae or death. Neurological sequelae include motor, behavioral, and cognitive deficits, which are incapacitating. Currently, there are concerns about accidental or malicious acute mass civilian exposure to H₂S. There is a major unmet need for an ideal neuroprotective treatment, for use in the field, in the event of mass civilian exposure to high H₂S concentrations. This review focuses on the neuropathology of high acute H₂S exposure, knowledge gaps, and the challenges associated with development of effective neuroprotective therapy to counteract H₂S‐induced neurodegeneration.

Hydrogen sulfide (H₂S) poisoning remains a significant source of occupational fatalities and is the second most common cause of toxic gas-induced deaths. It is a rapidly metabolized systemic toxicant targeting the mitochondria, among other organelles. Intoxication is mostly acute, but chronic or in-between exposure scenarios also occur. Some genetic defects in H₂S metabolism lead to lethal chronic H₂S poisoning. In acute exposures, the neural, respiratory, and cardiovascular systems are the primary target organs resulting in respiratory distress, convulsions, hypotension, and cardiac irregularities. Some survivors of acute poisoning develop long-term sequelae, particularly in the central nervous system. Currently, treatment for H₂S poisoning is primarily supportive care as there are no FDA-approved drugs. Besides hyperbaric oxygen treatment, drugs in current use for the management of H₂S poisoning are controversial. Novel potential drugs are under pre-clinical research development, most of which target binding the H₂S. However, there is an acute need to discover new drugs to prevent and treat H₂S poisoning, including reducing mortality and morbidity, preventing sequalae from acute exposures, and for treating cumulative pathology from chronic exposures. In this paper, we perform a comprehensive review of H₂S poisoning including perspectives on past, present, and future.

Dried blood spots (DBS) on filter paper have been used in human medicine since the 1960s, predominantly for screening in-borne metabolic disorders and more recently, for toxicology. Despite its 50-year existence, this technology has not been adopted by veterinarians for routine diagnoses and research. We have validated a novel DBS analytical procedure for the routine measurement of toxic heavy metals using 50 µL of whole blood on a single DBS by inductively coupled plasma mass spectrometry (ICP-MS). Targeted heavy metals are arsenic, cadmium, mercury, lead, selenium and thallium. The limits of quantitation (LOQ) on DBS are: arsenic 1.7 µg/L, cadmium 4.0 µg/L, mercury 13.7 µg/L, lead 13.3 µg/L, selenium 6.3 µg/L and thallium 1.5 µg/L. These LOQs suffice for routine diagnoses of heavy metal intoxication in domesticated and wildlife species as well as for basic, applied and epidemiological studies. The technique is ideal for population studies involving investigations of wildlife exposure to heavy metals and other environmental pollutants. The small blood volume involved (50 µL) makes it feasible to study small animals (birds, reptiles, amphibians and small mammals) that were previously excluded, or difficult to study due to the relatively large sample volumes required by current gold standard blood collection techniques.