Lidocaine metabolites immunoactive? (Was: Re: Local anesthetic a carcinogen (Was: Re: Amalgam study))

Brian Sandle bsandle at southern.co.nz
Fri Oct 29 20:54:34 EST 1999

On Wed, 27 Oct 1999, c. miller wrote:
> Date: Wed, 27 Oct 1999 09:41:45 -0600
> From: c. miller <rellim at mailhost.tcs.tulane.edu>
> To: toxicol at net.bio.net, bsandle at kalessin.southern.co.nz
> Subject: Lidocaine, immunotoxicity, and chronic diseases? 
> Brian Sandle posed some interesting questions about lidocaine metabolism,
> dimethylaniline, immunoreactivity, and chronic disease(s) below.
> I was wondering about the titers of aniline-albumin, aniline-hemoglobin (or
> other protein) antibodies following lidocaine anesthesia. Are they
> detectable? Is there an anti-idiotypic response as well?
> Aniline is a reasonably good hapten. Perhaps following lidocaine treatment
> (and its metabolism) as the primary immune challenge, it seems possible
> that aniline (or related compounds) exposure could be common enough of an
> environmental factor to perpetuate some level of chronic immune response
> (at least in some people).
Searching the databases for various combinations of
cognitive affective prenatal perinatal birth anesthetic epidural 
lidocaine bupivacaine
shows some adverse effects in infancy of prenatal or perinatal 
anesthetic exposure.
Here are a few refs from Medline and one abstract from PsycLit   
          Central administration of cocaine produces age-dependent
          effects on behavior in the fetal rat.
          Simonik-D-K; Robinson-S-R; Smotherman-W-P
   Source Journal
          Behavioral Neuroscience 108(6): 1179-1187
   Publication Year
          Prenatal lidocaine and the auditory evoked responses in term
          infants [published erratum appears in Am J Dis Child 1988
          Diaz-M; Graff-M; Hiatt-IM; Friedman-S; Ostfeld-B; Hegyi-T
          Am-J-Dis-Child.1988 Feb; 142(2): 160-1.
          Lack of effects of prenatal exposure to lidocaine on
          development of behavior in rats.
          Teiling-AK; Mohammed-AK; Minor-BG; Jarbe-TU; Hiltunen-AJ;
          Anesth-Analg.1987 Jun; 66(6): 533-41.
          [...]However, in
          the schedule of differential reinforcement of low rates of
          responding (DRL 20), the lidocaine-exposed males received more
          reinforcements than the controls and made fewer responses.[...]
          Behavioral effects of mid-pregnancy administration of lidocaine
          and mepivacaine in the rat.
          Smith-RF; Wharton-GG; Kurtz-SL; Mattran-KM; Hollenbeck-AR
          Neurobehav-Toxicol-Teratol.1986 Jan-Feb; 8(1): 61-8.
          [...]These data demonstrate that
          midgestational exposure to lidocaine or mepivacaine at a dose
          near the limits of permissible human exposure produces
          significant behavioral changes in the offspring. This
          preliminary study suggests that development of some portion of
          the central nervous system is altered by such exposure. Further
          work is required to determine the parameters and the extent of
          the effect. 
          Behavioral effects of prenatal exposure to lidocaine in the
          rat: Effects of dosage and of gestational age at
          Smith,-Robert-F.; Kurkjian,-Maura-F.; Mattran,-Kathleen-M.;
          Neurotoxicology-and-Teratology.1989 Jul-Aug; Vol 11(4):
          Pregnant rats dosed via injections into the gum with 3, 6, or 9
          mg/kg lidocaine or administered vehicle or uninjected on
          Gestational Day 4 (GD4), GD11, or GD18 produced offspring (8-21
          litters/group) that were tested for behavioral development and
          adult behavior. At GD4, only footshock sensitivity showed a
          significant effect of dosing. For administration on GD11,
          lidocaine was associated with slight but significant
          alterations in sex ratios and a trend toward effects on
          development of spontaneous alternation. Lidocaine dosing on
          GD18 was associated with a number of significant alterations of
          behavior, including visual discrimination, shuttlebox
          avoidance, tailflick, and water maze errors; there were also
          both vehicle and lidocaine effects on water maze latencies.
          Lidocaine may be a behavioral teratogen. ((c) 1999
          APA/PsycINFO, all rights reserved)

In sci.med.dentistry Brian Sandle <bsandle at southern.co.nz> wrote:
: In sci.med.dentistry Brian Sandle <bsandle at southern.co.nz> wrote:
: : Now does Lidocaine cross into to embryonic or fetal blood?

: : Do lidocaine metabolites pass over?

: : Does the embryo or fetus have the same risk of allergenicity or aniline 
: : toxicity as the mother?

: : What is more dangerous, amalgam or aniline?

: Now quite a few people have their amalgam fillings removed and replaced 
: with composite. Not all of them get any better. Also a number of people 
: report feeling unwell after a dental visit.

: I wonder if the aniline metabolites from the anaesthetic has been a problem 
: for a lot. Besides composite trouble, that is.

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