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Dimexide (dimethyl sulfoxide; dMSO; c2h6os) is a small amphipathic organic molecule with a hydrophilic sulfoxide group and two hydrophobic methyl groups. dimethyl sulfoxide (dMSO) is an unusual chemical substance derived from lignin, synthesized more than 150 years ago. it is a highly polar, stable, hygroscopic organic liquid with exceptional solvent properties. miscible with water, lipoids and organic solvents, it can lead to the formation of an unusually diverse inorganic and organic chemicals. its industrial use is numerous and diverse: (1) as a solvent for resins, fungicides, dyes, pigments, etc .; (2) as a reagent for chemical synthesis; (3) as an extractant; and (4) as a reaction medium to accelerate the rate of a chemical reaction. dimethyl sulfoxide is a clear liquid, practically odorless. flash point in closed cup 192 ° f. vapors are heavier than air. some describe it as an “oyster” taste, others claim it tastes like garlic. skin contact may cause burning and smell of garlic when breathing. It is an excellent solvent that can transport solutions through the skin. The high vapor concentration of this compound can cause headache, dizziness and sedation. Its medical use was first promoted by Stanley Jacob, who in 1964 reported that DMSO easily penetrates the skin and transfers small molecules through biological membranes.

So, for today, Dimexide (dimethyl sulfoxide - DMSO) is a highly polar substance with exceptional solvent properties for both organic and inorganic chemicals, and is widely used as an industrial solvent. DMSO has been reported to have a wide spectrum of pharmacological activity, including membrane penetration, anti-inflammatory effects, local analgesia, weak bacteriostasis, diuresis, vasodilation, collagen dissolution, and free radical excretion. The main use of dimethyl sulfoxide as a carrier for drugs such as idoxuridine; promotes the penetration of the drug into the skin and, therefore, can enhance its effect. Clinical usefulness in surgery has been demonstrated in the treatment of acute trauma, postoperative pain in the area of ​​postoperative scars, some urological disorders, such as Peyronies disease; early Dupuytrens contracture, keloids, and subcutaneous fibrosis associated with cobalt irradiation. DMSO effectively transfers local anesthetics to the deeper layers of the skin and the eardrum, allowing an incision to be made without pain (The American Journal of Surgery). It is also used as a 50% aqueous bladder instillation solution to relieve symptoms of interstitial cystitis; 50 ml are instilled and left for 15 minutes. Treatment is repeated every 2 weeks. DMSO was administered orally, intravenously or topically for a wide range of indications, including skin and musculoskeletal disorders, but there is limited evidence of beneficial effects. Dimethyl sulfoxide is used as a cryoprotectant for various human tissues. A significant pharmacological action of DMSO is its ability to absorb oxygen-free radicals associated with tissue damage caused by xenobiotics when they are introduced before, during, or several hours after tissue damage.

Dimexide easily absorbed by all means. It is metabolized by oxidation to dimethyl sulfone and reduction to dimethyl sulfide. Dimexide and sulfite metabolite are excreted in urine and feces. Dimethyl sulfide is released through the lungs and skin and is responsible for the characteristic odor in patients.The maximum concentration in the blood is reached within 4-6 hours and remains at this level for 1.5-3 days. When used as a penetrating base for other drugs used topically, dimexide may enhance their toxic effect. Hepatic and renal function should also be evaluated at intervals of 6 months. Bladder instillation can be harmful to patients with malignant diseases of the urinary tract due to vasodilation. High concentrations of DMSO applied to the skin can cause burning discomfort, itching, erythema, vesiculation, and urticaria. Continued use may cause the problem to scale. Systemic effects, including gastrointestinal upset, drowsiness, headache, and hypersensitivity reactions, may occur after use by any means. The garlic-like smell when breathing and skin is due to the use of DMSO (drugster.org, published October 26, 2018).

DMSO was first obtained by the oxidation of dimethyl sulfide in 1866 by A. Zaitsev (a student of A. Butlerov). Then a series of experiments were started at the University of Oregon (to obtain evidence that DMSO was an active penetrating substance and an excellent carrier of other substances through the skin or tissue membranes). As a solvent, DMSO even surpasses water and is sometimes called a "super-solvent." Chemical characteristics - Dimexide is chemically classified as a dipolar aprotic hygroscopic solvent. Protonic solvents such as water, methanol and formamide are hydrogen donors. Although dipolar aprotic solvents, although they have hydrogen atoms, are unable to donate labile hydrogen atoms and form strong hydrogen bonds with some other substances.

Although toxicity was reported in clinical trials of the medical use of DMSO in the 1960s, the United States Food Control Authority (FDA) later classified DMSO as the safest solvent. DMSO has become widely used in many biomedical fields, and biological effects have been overlooked. Meanwhile, biomedical science has evolved towards sensitive high-performance methods and new research areas, including epigenomics and miRNAs. Given its widespread use, especially for cryopreservation and in vitro analyzes, we evaluated the biological effect of DMSO using these technological innovations.

Adverse reactions to DMSO are common, but usually minor and are associated with the concentration of DMSO in the drug solution. Therefore, the most common side effects, such as a skin rash and itching after application to the skin, intravascular hemolysis after intravenous infusion and gastrointestinal discomfort after oral administration, can be largely avoided by using more dilute solutions (Swanson B.N.).

Although DMSO is commonly used in relatively low concentrations, it still has medically beneficial properties such as induction of an anti-inflammatory process, nerve block (analgesia), diuretics, vasodilation and muscle relaxation. In addition, in cell biology, DMSO is also used as an inducer of cell differentiation, an absorber of free radicals and a radioprotective agent, but most often for cryopreservation. Research cell cultures are often stored in liquid nitrogen using a slow cooling methodology.

Dimethyl sulfoxide (DMSO), a cell culture reagent, is ideal for cryopreservation. In cryobiology, DMSO was used as a cryoprotectant and is still an important component of cryoprotectant vitrification mixtures used to preserve organs, tissues and cell suspensions.This is especially important for freezing and long-term storage of embryonic and hematopoietic stem cells, which are often frozen in a mixture of 10% DMSO and 90% fetal calf serum (prevents the formation of ice crystals and thus reduces cell death). As part of an autologous bone marrow transplant, DMSO is re-administered with the patient’s own hematopoietic stem cell. Dimexide is a polar aprotic organic solvent that is widely used in chemical and biological research. DMSO can uniquely provide the solubility of some very polar small molecules, such as simple biomolecules with several proton functional groups. It can also be used as an oxidizing reagent in certain transformations. The yield of polymerase chain reaction (PCR) processes is enhanced by DMSO as a co-solvent, which helps to inhibit the formation of secondary structures from DNA fragments.

Every application Dimexidum appears to provide rapid, temporary pain relief in patients with arthritis and connective tissue damage. However, the anti-inflammatory effect or the acceleration of healing is currently unjustified. There is no evidence that DMSO can alter the progression of degenerative joint disease, and for this reason DMSO can only be considered for palliative care (relief of disease symptoms), and not to exclude standard anti-inflammatory agents. Dimexide currently widely used in studies of inflammatory conditions such as rheumatoid arthritis, clinical trials are underway to study it, although it is difficult to draw any conclusions from them, since the garlic smell generated by the DMSO metabolite, DMS, negatively affects the reliability of the double-blind research.

To date, studies of the effectiveness of DMSO in animal models of rheumatoid arthritis have yielded conflicting results. Since it is known that DMSO violates the permeability of cells and causes their death at high concentrations, a study was conducted in which the relationship of anti-inflammatory properties with its effect on cell viability was studied. The results show that DMSO to a final concentration of 1% induces slight cytotoxicity for monocytes, but there is a significant decrease in monocytes by 2%, weak hemolysis by 5% and a sharp decrease in PBMC (from the English peripheral blood mononuclear cells) by 10%. Thus, DMSO has only a narrow therapeutic window and, possibly, a decrease in cytokines / chemokines at 2% DMSO is associated with lower monocyte viability. However, the effects of DMSO at concentrations of 0.5% and lower are probably independent of cytotoxicity. DMSO is an anti-inflammatory that demonstrates efficacy in human whole blood. This is due to a decrease in the production of inflammatory mediators. As a result of the study, it was concluded that the use of DMSO as an anti-inflammatory agent in conditions such as rheumatoid arthritis may have some advantages (Ingrid Elysia et al., 2016).

Data on analgesic effects Dimexidum alone is ambiguous. However, when DMSO is used as a carrier for other analgesics, it increases the effectiveness of these agents (in one study, lidocaine, in the other, diclofenac) and reduces the severity of the symptoms of the disease. Pain relief with immediate use is reported almost immediately and lasts up to 6 hours. This made DMSO ideal for the relief of acute pain in athletes whose condition requires immediate relief. To reduce the severity of chronic pain, patients may need to apply DMSO for almost 6 weeks before at least some therapeutic effect is noticeable.

DMSO enhances the diffusion of other chemicals through the skin, and for this reason, a mixture of idoxuridine and DMSO is used for topical treatment of herpes zoster in the UK. Dimethyl sulfoxide (DMSO) is currently used as an alternative treatment for various inflammatory conditions, as well as for cancer. Dimexide first used to treat acute soft tissue diseases such as bursitis and tendonitis. However, despite extensive enthusiastic evidence of efficacy, two controlled studies yielded conflicting results (Trice J.M., Pinals R.S., 1985). Nonetheless currently Dimexide indispensable for biotechnological applications. In these cases, one should take into account the effects that DMSO may have and maintain the concentration as low as possible, since even at low concentrations DMSO is not inert (Verheijen M., Schrooders Y. et al., 2019). It should be borne in mind that, in addition to facilitating the absorption of other drugs, DMSO can also enhance their effect. Therefore, drug interactions should always be evaluated prior to use, especially taking into account the fact that in some cases the level of drugs can reach the toxic limit and increase the risk to patients lives. Reactions such as nausea, vomiting, diarrhea, rash, redness of the skin, and in rare cases bronchospasm are known (Zenhausern et al., 2000; Crivellenti et al., 2013).

However, even now Dimexide continues to be the subject of controversy, controversy and messages of various kinds in the media. For the most part, clinical trials with DMSO do not meet the most standard requirements for conducting controlled trials for rheumatic diseases. The main problem was the difficulty in hiding the presence of DMSO due to its characteristic odor and in the development of a suitable placebo. A lot of interesting information about DMSO has accumulated in recent years, including evidence of its relative safety, but its therapeutic role and its legitimacy in medical practice remains in limbo, awaiting further substantiation of efficacy in well-designed clinical trials.

Tags: Dimethyl sulfoxide