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Getting a Fast-Acting Cyanide Antidote to First Responders

First responders gather around a victim to provide treatment

A new collaboration between the University of Minnesota Twin Cities and Windgap Medical aims to give first responders the edge in saving victims of cyanide poisoning.

Researchers from the Center for Drug Design (CDD), College of Pharmacy, and Windgap, a Massachusetts-based pharmaceutical company, are working together to develop an autoinjector that can be used on-scene to deliver a fast-acting antidote to cyanide victims. The project is funded by a five-year, $3.2 million grant from the National Institutes of Health’s CounterACT program, which aims to prepare countermeasures against chemical threats that have the potential to be used as weapons.

While the US Department of Homeland Security identifies cyanide among the highest priority chemical threats, Steven Patterson, PhD, a professor in the CDD, said current antidotes aren’t well-suited for use in situations where many people are exposed to the chemical at once.

“We have long recognized that a device to deliver a cyanide antidote as rapidly and easily as epinephrine would be extremely useful,” Patterson said. “It is clear that Windgap has the technology to develop such a device.”

While workers in gold mines or laboratories, for example, may experience long-term health problems from repeated exposure to lower levels of cyanide, a fast-acting antidote is most important for disasters that suddenly expose victims to high concentrations of the chemical, such as through a chemical attack, building fires (where smoke inhalation brings cyanide into the body), or an industrial accident.

Every second counts in these cases, and fast treatment can mean the difference between life and death. The toxin acts quickly, killing cells in the body by preventing them from using oxygen, which can then cause convulsions, loss of consciousness, and death, according to the Centers for Disease Control and Prevention. Those who survive the immediate effects of cyanide poisoning may still suffer from a long-term neurological disorder similar to Parkinson’s disease.

A Faster Treatment to Help More People

Cyanide antidotes on the market today require at least 15 minutes of an IV drip, limiting how many people first responders can treat before it’s too late.

The CDD and Windgap researchers’ efforts are focused on a faster-acting antidote called sulfanegen, which was recently developed and refined by Patterson as well as College of Pharmacy colleagues Robert Vince, PhD, director of the Center for Drug Design, and Herbert Nagasawa, PhD, adjunct professor. The antidote was patented with assistance from UMN Technology Commercialization.

Compared to existing antidotes, sulfanegen takes advantage of a different process in the body—one that normally serves to break down a common amino acid found in many foods. Sulfanegen provides the intermediate compound needed for this natural pathway to quickly convert cyanide into a far less toxic substance. The process takes effect in less than three minutes.

Adam Standley, vice president of R&D at Windgap, said he was researching alternative treatments for cyanide poisoning and wondering why a better solution didn't exist when he encountered the CDD researchers’ work. He reached out to Patterson and they met for coffee to discuss a potential collaboration. When they agreed the idea had promise, they approached NIH for funding.

“Dr. Patterson had developed a remarkable drug that could be administered by intramuscular injection to reverse the effects of cyanide poisoning,” Standley said. “But from what I understood, it could not be commercialized in standard autoinjector formats due to its short liquid shelf life. I suspected our dual-chamber autoinjector could stabilize the drug and get it to patients.”

Windgap develops treatments for allergic reactions, opioid abuse, diabetes, and chemical toxicity. What these treatments have in common is the use of a two-chambered delivery platform—a patented process that keeps the wet and dry drug components separate to lengthen the treatment’s shelf life, then mixes them when the injection is administered.

A dual-chamber autoinjector formulation of sulfanegen would deliver a single, preloaded dose of the antidote when pressed against the body, allowing first responders to save more lives before victims succumb to their exposure.

“This collaboration is a case study in the innovation that is catalyzed by academic-industry teaming, supported by CounterACT,” Standley said. “Here we have a promising drug and an innovative delivery technology coming together to form an elegant solution, addressing a largely unmet need. We look forward to developing and commercializing this product for both defense and civilian use with Dr. Patterson and the team at the University of Minnesota.”

Kevin Coss

Kevin Coss

Kevin is a writer with the Office of the Vice President for Research.

coss@umn.edu

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