The haemolytic effects of diaphenylsulfone (DDS) in normal subjects and in those with glucose-6-phosphate-dehydrogenase deficiency

Abstract

The need to investigate further the phenomenon of sulfone-induced haemolysis is becoming greater as the use of sulfones may increase, particularly for malaria therapy in areas where Plasmodium falciparum is found to be resistant to chloroquine. The authors report on studies of the haemolytic effects of diaphenylsulfone (DDS) administered orally, in doses ranging from 25 mg to 300 mg daily for 21 days, to normal healthy men and to healthy Negro men with deficiency of glucose-6-phosphate dehydrogenase (G-6-PD). The latter proved more susceptible to diaphenylsulfone-induced haemolysis than did normal men. There was a direct relationship between the dose of diaphenylsulfone and the extent of haemolysis in both groups of men studied. Comparison of the haemolytic effects of diaphenylsulfone with those of the antimalarial drug primaquine revealed that, on a dose for weight basis, diaphenylsulfone is more haemolytic than primaquine in normal persons and less so in G-6-PD-deficient persons. A marked decrease in the content of reduced glutathione (GSH) in red cells, comparable to the changes in levels of erythrocytic GSH known to occur during primaquine-induced haemolysis, occurred just before and early during the acute haemolytic episode that resulted from administration of diaphenylsulfone to G-6-PD-deficient subjects; in contrast, levels of erythrocytic GSH increased early during the course of diaphenylsulfone-induced haemolysis in normal men.