• Korean Journal of Veterinary Research
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• v.55 no.3
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• pp.199-204
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• 2015

4,4'-diaminodiphenyl sulfone (dapsone) is a sulfone drug that has antibacterial effects on a variety of bacteria, especially Mycobacterium leprae; thus, it has been used to treat leprosy. Previous studies demonstrated that dapsone inhibits integrin-mediated adherence of neutrophils and production of prostaglandin $E_2$ by polymorphonuclear leukocytes. Hence, dapsone may act in immune cells and regulate cell-mediated inflammation processes. However, its anti-inflammatory effects remain unclear. The present study demonstrated that dapsone modulates the production of inflammation-related cytokines in immune cells. We employed the spleen cells of mice, which are major immune cells, and lipopolysaccharide (LPS) as a causative agent of inflammation for experiments. Dapsone induced a proportional change in splenocyte subsets and the apoptosis of spleen cells. Interestingly, dapsone decreased the production of tumor necrosis factor-alpha and interleukin (IL)-10, but not IL-6, in LPS-treated spleen cells. In other assays, we measured the dapsone-induced production of nitric oxide (NO) and the expression of activation markers of spleen cells. Dapsone decreased NO production in LPS-treated spleen cells. Taken together, our results demonstrate that dapsone has anti-inflammatory effects in immune cells and provide new insight into the potential uses of this agent.

• Journal of Veterinary Science
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• v.19 no.6
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• pp.744-749
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• 2018

Dapsone, an antibiotic, has been used to cure leprosy. It has been reported that dapsone has anti-inflammatory activity in hosts; however, the anti-inflammatory mechanism of dapsone has not been fully elucidated. The present study investigated the anti-inflammatory effects of dapsone on bone marrow cells (BMs), especially upon exposure to lipopolysaccharide (LPS). We treated BMs with LPS and dapsone, and the treated cells underwent cellular activity assay, flow cytometry analysis, cytokine production assessment, and reactive oxygen species assay. LPS distinctly activated BMs with several characteristics including high cellular activity, granulocyte changes, and tumor necrosis factor alpha ($TNF-{\alpha}$) production increases. Interestingly, dapsone modulated the inflammatory cells, including granulocytes in LPS-treated BMs, by inducing cell death. While the percentage of Gr-1 positive cells was 57% in control cells, LPS increased that to 75%, and LPS plus dapsone decreased it to 64%. Furthermore, dapsone decreased the mitochondrial membrane potential of LPS-treated BMs. At a low concentration ($25{\mu}g/mL$), dapsone significantly decreased the production of $TNF-{\alpha}$ in LPS-treated BMs by 54%. This study confirmed that dapsone has anti-inflammatory effects on LPS-mediated inflammation via modulation of the number and function of inflammatory cells, providing new and useful information for clinicians and researchers.

• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.493-496
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• 2007

Diamino-diphenyl-sulfone (Dapsone) is widely used in the treatment of leprosy and a variety of blistering skin diseases. It sometimes has adverse side effects with common usual doses, such as skin, nervous system, gastrointestinal tract, liver, kidney and hematologic toxicity. One of these side effects is a rare but serious hypersensitivity reaction called dapsone syndrome, which occurs several weeks after the initial administration of the drug and results in unpredictable, sometimes fatal outcomes. This report deals with a 13-year-old girl's case with typical features of dapsone syndrome that included fever, exfoliative dermatitis, jaundice, hemolytic anemia and pleural effusion after being treated with dapsone for four weeks.

• Journal of Food Hygiene and Safety
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• v.11 no.2
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• pp.143-147
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• 1996

This study was carried out to determine and confirm of Dapsone in vegetables and fruits which were illegally used for freshness. We have developed a simple, arpid and precise method that Dapsone can be analyzed in the cabbages, grapes and strawberry by HPLC with photodiode array detector. Experimental subjects were included 15 cases of cabbages, 10 cases of grapes and 10 cases of strawberries purchased in Kangwon, Chungchong province and the Seoul area. The results were obtained that Dapsone in the experimental subject was separated completely within 10 min. Detection limit of Dapsone was 0.5 ng. Aberage recoveries from cabbages, grapes and strawberries were 93.3$\pm$0.37%, 91.4$\pm$0.65% respectively. 4 cases of cabbages were detected Dapsone and the amount was below the 0.3 ppm. There was not detected Dapsone in any grape and strawberry samples.

• Clinical and Experimental Pediatrics
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• v.63 no.5
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• pp.158-163
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• 2020

IgA vasculitis, formerly known as Henoch-Schönlein purpura, is a systemic IgA-mediated vasculitis of the small vessels commonly seen in children. The natural history of IgA vasculitis is generally self-limiting; however, one-third of patients experience symptom recurrence and a refractory course. This systematic review examined the use of dapsone in refractory IgA vasculitis cases. A literature search of PubMed databases retrieved 13 articles published until June 14, 2018. The most common clinical feature was a palpable rash (100% of patients), followed by joint pain (69.2%). Treatment response within 1-2 days was observed in 6 of 26 patients (23.1%) versus within 3-7 days in 17 patients (65.4%). Relapse after treatment discontinuation was reported in 17 patients (65.4%) but not in 3 patients (11.5 %). Four of the 26 patients (15.4%) reported adverse effects of dapsone including arthralgia (7.7%), rash (7.7%), and dapsone hypersensitivity syndrome (3.8%). Our findings suggest that dapsone may affect refractory IgA vasculitis. Multicenter randomized placebo-controlled trials are necessary to determine the standard dosage of dapsone at initial or tapering of treatment in IgA vasculitis patients and evaluate whether dapsone has a significant benefit versus steroids or other medications.

• Clinical and Experimental Pediatrics
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• v.56 no.6
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• pp.260-264
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• 2013

Dapsone (4,4'-diaminodiphenylsulfone, DDS), a potent anti-inflammatory agent, is widely used in the treatment of leprosy and several chronic inflammatory skin diseases. Dapsone therapy rarely results in development of dapsone hypersensitivity syndrome, which is characterized by fever, hepatitis, generalized exfoliative dermatitis, and lymphadenopathy. Here, we describe the case of an 11-year-old Korean boy who initially presented with high fever, a morbilliform skin rash, generalized lymphadenopathy, hepatosplenomegaly, and leukopenia after 6 weeks of dapsone intake. Subsequently, he exhibited cholecystitis, gingivitis, colitis, sepsis, aseptic meningitis, disseminated intravascular coagulation, syndrome of inappropriate antidiuretic hormone secretion, pneumonia, pleural effusions, peritonitis, bronchiectatic changes, exfoliative dermatitis, and acute renal failure. After 2 months of supportive therapy, and prednisolone and antibiotic administration, most of the systemic symptoms resolved, with the exception of exfoliative dermatitis and erythema, which ameliorated over the following 4 months. Agranulocytosis, atypical lymphocytosis, aseptic meningitis, and bronchiectatic changes along with prolonged systemic symptoms with exfoliative dermatitis were the most peculiar features of the present case.

• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.1
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• pp.37-41
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• 2008

Methemoglobinemia can be caused by dapsone toxicity. We report a case dapsone induced methemoglobinemia unresponsive to methylene blue successfully treated by exchange transfusion. A 52-year-old male ingested a handful of dapsone. He presented with severe peripheral cyanosis in lips and fingertips and his methemoglobin level was found to be 21.9%. After admission, methylene blue (1%) at 1 mg/kg was injected each time peripheral cyanosis and rising serum methemoglobin occurred. Despite methylene blue therapy, the patient‘s methemoglobin level continued to fluctuate. Five days after the injections of methylene blue, many Heinz bodies were visualized in the peripheral blood, suggestive of hemolytic anemia occurrence. By hospital day 6, serum methemoglobine levels were elevated and not measurable (> 50%) and the patient was constantly in a semi-comatose mental state. An exchange transfusion carried out by utilizing 6 units of packed red blood cells and 4 units of fresh frozen plasma was performed. The patient's methemoglobin levels were subsequently kept up below 20% and his peripheral cyanosis receded. Physicians should recognize the important role of exchange transfusion in refractory dapsoneinduced methemoglobinemia.

• Journal of Veterinary Clinics
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• v.37 no.6
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• pp.339-341
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• 2020

Subcorneal pustular dermatosis (SPD) is a rare pustular skin disorder of dogs. Dapsone is treatment of choice, but ineffective in some cases. Therapeutic alternatives are limited and less effective. In humans, successful results with oral retinoid have been reported. To describe successful treatment of a dog that developed SPD with acitretin as an alternative drug of dapsone. A 7-year-old male neutered miniature schnauzer was presented with generalized pustules and crusts. SPD was diagnosed based on physical, cytological, and histopathological examination with direct immunofluorescence test. In this report, we describe a case of canine SPD treated initially by dapsone with poor response that improved with acitretin. Acitretin could be considered as an alternative drug in canine SPD.

• Biomolecules & Therapeutics
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• v.10 no.3
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• pp.193-199
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• 2002

The arylamine N-acetyltransferases (NATs) are a family of enzymes that N-acetylate mylhydrazines and arylamines through transfer of an acetyl group from acetyl coenzyme A. This activity was found to vary among individuals as a Mendalian trait and the basis of the genetic differences in human NAT activity is one of the best of the genetic studied examples of pharmacogenetic variation. The classical N-acetylation polymorphism is regulated at the NAT2 locus, which segregates individuals into rapid, intermediate, and slow acetylator phenotypes. In this study, the relationship between NAT2 activity phenotype using HPLC:UV assay for the determination of dapsone and monoacetyldapsone in plasma and NAT2 genotype by PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) was investigated in the F2 hybrid (Fischer 344 vs Wistar-Kyoto) rats. Three Common mutant alleles at the NAT2 gene locus have been identified in the F2 generation progeny of Fischer 344 rats as raid acetylator and Wistar-Kyoto rats as slow acetylator segregated into three modes (low, intermediates, and high) with simple Mendelian inheritance. The metabolic activity of NAT2 of the intermediate and rapid acetylators is significant1y greater than slow acetylator, but the metabolic activity of rapid acetylator is not significantly different from Intermediate type. Therefore, we could observe that complete trimodal NAT2 genotypic alleles and incomplete trimodal NAT2 metabolic phenotypic distribution in tile F2 hybrid rats. These observations suggest that the relationships between NAT2 genotype and metabolic phenotype exists and F2 hybrid (Fischer 344: Wistar-Kyoto) animal models about NAT2 polymorphism might be applied in the toxicity and pharmacogenetic studies of arylamine drugs and carcinogens.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.2
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• pp.170-174
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• 2006

Methylene blue is a basic thiazine dye frequently used for histologic staining. In clinical toxicology settings, it is also used to treat clinically significant methemoglobinemia. It has dose-dependent oxidation or reduction properties, acting as a reducing agent at lower doses and as an oxidizing agent at higher doses. Hemolytic anemia and hyperbilirubinemia are known toxic effects of methylene blue treatment that have been reported clinically. A 42-year-old woman developed significant methemoglobinemia after acute dapsone overdose; she was treated appropriately with intravenous methylene blue in the therapeutic range. The patient's methemoglobin levels returned to normal. However, 2-4 days later she was noted to have rebound methemoglobinemia, hemolytic anemia, and hyperbilirubinemia. A repeat of Coomb's test and other anemia workups were negative. For management of methylene blue-induced hemolytic anemia, she was administered steroid therapy, N-acetylcysteine, and a blood transfusion. She ultimately recovered, and there were no long-term sequelae from the methylene blue poisoning.