The clinical application of cerium salts

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Chapter: Essentials of Inorganic Chemistry : The Clinical Use of Lanthanoids

The element cerium has the chemical symbol Ce and atomic number 58. It is a silvery and soft metal, which easily is oxidised in air. Cerium has three oxidation states, +II, +III and +IV, the last being the more stable one.


The clinical application of cerium salts

The element cerium has the chemical symbol Ce and atomic number 58. It is a silvery and soft metal, which easily is oxidised in air. Cerium has three oxidation states, +II, +III and +IV, the last being the more stable one. The electronic configuration of the resulting Ce4+ ion is [Xe]4f0. Ce+2 is the rarest oxidation state and the resulting electronic configuration is [Xe]4f2.


The clinical use of cerium dates back to the mid-nineteenth century, when cerium(III) oxalate was used as an antiemetic. The exact mode of action is unknown, but it is believed to be a local effect limited to the GI tract. This is based on the fact that lanthanoids are not easily absorbed after oral administration, as previously discussed, and that cerium oxalate has a low aqueous solubility. Nevertheless, the clinical use of cerium salts as antiemetic was eventually replaced by antihistamines (Figure 9.4) .

At the end of the nineteenth century, several Ce3+ salts were under investigation for their antibacterial activity in burn wounds. Especially, cerium nitrate [Ce(NO3)3] showed broad activity against a variety of pathogens and was subsequently used in combination with silver sulfadiazine. Initial studies were very suc-cessful and an estimated reduction of 50% of the mortality rate was suggested. It was believed that this result was due to the synergistic antimicrobial effect of both reagents .

Recent studies have shown that cerium nitrate has no significant effect on pathogens from burn wounds. Fur-thermore, research has shown that the suppression of the immune system in patients with serious burn wounds is a main factor for mortality. It has also been shown in animal models that cerium nitrate is a modulator of the burn-associated immune response. Nowadays, this is believed to be the main role of cerium(III) nitrate when used as part of a combination treatment of burn victims. Currently, the cerium salt is used in combination with silver sulfadiazine in individual cases for the treatment of life-threatening burn wounds. Reports suggest that wound healing improves, mortality rates drop and graft rejection rates are also significantly lower . 

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