关于“氰化钠能否治疗疾病”的讨论

孙学军老师是目前国内专门从事“氢气抗氧应激，抗自由基”研究的著名学者，前不久在他的博文中提到过一个问题：“氰化钠能治疗疾病？”。这里略写一小段笔者的观点，作一探讨。

许多生物分子是否有毒，单单浓度这一因素甚至就可起决定作用（引起生物反应平衡的移动及其连锁反应）。例如血液里葡萄糖，浓度为6 mM时是维持健康所必需的生物营养成分，12 mM就是糖尿病人的水平！当我们都已经认可，砒霜抗血癌确有一个有效的浓度范围，氰化钠为何不行？氰化钠其实没有砒霜那么“杀人不眨眼”，它的毒性只在于它的强还原性（氰离子(CN^–)在体内能迅速将氧化型细胞色素氧化酶的三价铁还原成二价铁）。因此，在氧应激损伤剧烈的情况下，适当浓度的(CN^–)的还原性应该是具有保护作用的。设计一定的实验模式与反应条件，做出阳性实验结果应该不难（若在生化抗辐射抗氧化模式中也许会轻而易举）。但是若笼统地就以此为真理（所谓双盲对照统计研究结果…）简单地向老百姓做科普说：“氰化钠能治疗疾病”，肯定会出人命。

附 孙学军老师的博文：

氰化钠能治疗疾病？

早就注意过这个文献，对这个研究本身并没有兴趣，只是对这个研究的对象有兴趣，氰化钠是非常毒的物质，大概很少有人想到这个东西曾被用于治疗疾病的研究。但不知道为什么现在没有这个方面的研究了。

Radiation Protection by Cyanide of both Rats and Mice

Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires.

MANY investigators have found^1–4 that the rat, unlike the mouse, is afforded little or no protection to irradiation damage by the prior administration of cyanide salts. In all their experiments, a limited dose-range of cyanide was tested. The frequently cited results of Dowdy et al. ¹, for example, were obtained using a single dose (3 mg/kg) of sodium cyanide. A recent theory⁵ states that compounds such as cyanide and azide owe their radiobiological action to the property of stabilization of cuprous (Cu I) ion involved in oxidative processes. The proposal suggests that the dose required to achieve protection would be sharply defined and, if not limited by chemical toxicity of cyanide, it should be possible to demonstrate protection in the rat using the proper dose. Accordingly, survival was compared in rats and mice given a wide range of doses of sodium cyanide prior to X-irradiation.

1. Dowdy, A. H. , Bennett, L. R. , and Chastain, S. M. , Radiology, 55, 879 (1950). | PubMed | ISI | ChemPort |
2. Patt, H. M. , Physiol. Rev., 33, 35 (1953). | PubMed | ISI | ChemPort |
3. Yakovlev, V. G. , and Ivanov, I. I. , Meditsinskaii Radiologia, 3, 14 (1958). | ChemPort |
4. Bacq, Z. M. , and Alexander, P. , Fundamentals of Radiobiology (Pergamon Press, New York, 1961).
5. Schubert, J. , Rad. Res., 14, 499 (1961).
6. Sollman, T. , A Manual of Pharmacology (W. B. Saunders Co., Philadelphia, 1957).
7. Hogeboom, G. H. , and Schneider, W. C. , J. Biol. Chem., 194, 513 (1952). | PubMed | ISI | ChemPort |
8. Felsenfeld, G. , Arch. Biochem. and Biophys., 87, 247 (1960). | Article | ISI | ChemPort |

Needham, A. E. , Nature, 189, 308 (1961). | Article | PubMed | ISI | ChemPort |