RESUMO
Lead is one of the most important elements that contribute to the impact on human health from many variable sources. It most commonly affects peoples living in developing countries where, chelating agents [main line of treatment] are not easily available. The aim of the present study was to evaluate the role of some antioxidants [garlic and silymarin] together with supplementary therapy in management of lead poisoned cases. This study was carried out in Zagazig University Hospitals in the period from January 2007 to December 2008. The study included 30 patients of both sexes and different ages, who presented as families with symptoms suggesting lead poisoning mainly abdominal colic and severe constipation. From the history they all share the same source of exposure, which was contaminated water from plumbed water pumps. The local health territory of Sharkia governorate was conveyed immediately after presentation of each family to take its procedures for water supply in the residence areas of the patients. After admission complete history taking, clinical examination and laboratory investigations; complete blood count [CBC], liver and kidney functions, blood lead level [BLL], glutathione [GSH] and malondialdehyde [MDA] levels and activity of superoxide dismutase [SOD] and catalase enzymes were analyzed for all patients at the time of admission and after 1, 2, 6 months of follow up and for control subjects. Treatment lines included garlic, silymarin, vitamins and minerals together with symptomatic treatment were given for 1 month at hospital and for another 1 month at home. All patients were from rural areas in Sharkia governorate. At admission all patients complained of abdominal colic and severe constipation. About 80% and 66.7% of cased complained of easy fatigability and body aches respectively. Blue line and pallor were found in 50% and 93.3% of cases respectively. Some of these symptoms and signs disappeared gradually after 1 and 2 months of treatment together with improvement of CBC, liver function, BLLs and antioxidant activity. While after 6 months of follow up all symptoms disappeared completely and most of measured parameters returned nearly to control values except BLLs were still elevated compared to control values. The present study revealed that lead induced deleterious effects may be due to oxidant stress and lipid peroxidation, as evidenced by significant drop in GSH level and decreased in activity of SOD and catalase enzymes, with increased serum level of oxidation product MDA. Moreover, these effects were ameliorated by treatment with antioxidants [garlic and silymarin] together with supplementation and symptomatic therapy. Also, recovery of antioxidant enzymes activity and GSH level with drop of MDA level was noticed after treatment. It is recommended to change the plumbed pipes of the water pumps, and to conduct further studies on larger number of populations to evaluate the effectiveness of garlic, silymarin and other antioxidants in treatment of lead poisoning