The Syrian Terror

by Jad Hilal

Imagine living day to day in an environment where you could be killed at any moment by something completely undetectable. Imagine “the bodies of the dead lined up on hospital floors, those of the living convulsing and writhing in pain,” as described by Mark Mazetti and Mark Landler from a personal account in the New York Times. Imagine the thoughts of Zeina Karam and Kimberly Dozier of the Associated Press who protest the “photographs of many of the dead wrapped in white sheets,” and the “dozens of videos showing victims in spasms and gasping for breath.” This is not a description of the work of bullets, missiles or even suicide bombers. Instead, a different monster walks the streets of Syria, the new great fear of the Middle East – the neurotoxin sarin gas.

For Syrians, sarin has been a difficult and horrifying reality for the past two years of their 22-year civil war, and the toxin is only preceded by an equally evil past. The use of this illegal weapon of mass destruction has drawn international attention and has sparked an issue of enormous controversy over whether the United States has the responsibility to act as a guardian of ethics, or as President Obama would say, a preserver of the “blurred red line.” For now, one of the great responsibilities we can take as Americans is the step of information: know the enemy. In truth, sarin has only served as a mere symbol of death and destruction, but perhaps there is more to it. Knowledge really is power, for knowledge of sarin could lead to more peaceful conversation concerning solutions to the violence.

To fully understand sarin, we must consider an important property it possesses as a chemical that is often overlooked. As Ian Sample of The Guardian has pointed out, sarin is not actually a gas at room temperature, but a liquid (possessing a boiling point of 158 ̊C). However, to create maximum damage, sarin is vaporized and released in gaseous form, making it fine enough to enter the respiratory system. Why does this matter? A toxic chemical that takes a liquid form in a common environment means that it can linger in exposed areas for a much longer period of time than chemicals that are present in a gaseous form – months longer. Therefore, sarin’s impact lasts far past an attack. Even though the Syrian government is allegedly chemical-free, the Syrian streets still contain the traces of sarin.

Understanding sarin’s activity on a biochemical basis is the best way to determine how to fight it’s effects. Sarin is known as a nerve agent or neurotoxin, taking its toll on the nervous system. Typically, the cause of death due to sarin is from the inability to relax contracted muscles, in particular the diaphragm, which can ultimately lead to suffocation.

For any muscle activity to occur, the brain transmits electrical signals through neurons, almost like a telephone wire, until the message is finally relayed from a neuron to the targeted muscle tissue. For the electrical signal to be transferred from either neuron to neuron or from neuron to muscle, a chemical neurotransmitter must be used. A neurotransmitter serves as a messenger, carrying the message from the electrical impulse to the next cell and triggering it to act. Neurotransmitters have corresponding inhibitors that cause the message to cease and eventually the action to stop. Typically, the neurotransmitter acetylcholine would work to contract muscle tissue and its corresponding inhibitor, acetylcholinesterase, would break down the acetylcholine to stop the contraction. Instead, sarin disables acetylcholinesterase, binding to it and preventing it from binding to acetylcholine. Ultimately, this results in a continuous, deadly contraction of muscles – so deadly that it takes no more than a single milligram of sarin to kill the average human being.

Fortunately, there is an antidote. The Center for Disease Control and Prevention has identified pralidoxime, an agent that displaces sarin from acetylcholinesterase by binding to both the enzyme and the poison. When pralidoxime binds to the sarin/acetylcholinesterase complex, sarin changes conformation, loses affinity for acetylcholinesterase, and is released in complex with the antidote.

After chemical attacks in Syria, the short supply of pralidoxime quickly ran out. Thanks to agreements with Russia, the use of chemical warfare in Syria seems to have been curtailed and focus can shift to providing the antidote. Syrians no longer have to live in great terror of another attack, and the affected can begin to heal. Perhaps now, with less turmoil and destruction, pralidoxime and ultimately peace can be the new agent filtering itself throughout the streets of Syria.