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2,3-dimercaptosuccinic acid (DMSA), also known as succimer, is a small molecule chelating agent used primarily for the treatment of heavy metal poisoning, particularly lead. It contains two sulfhydryl groups that bind to lead ions in the blood, soft tissues, and kidneys, forming stable, water-soluble chelates that are subsequently excreted in the urine. In research conducted by China Medical University, DMSA was evaluated in combination with multi-nutrients (including calcium and ascorbic acid) to treat lead poisoning in children with blood lead levels between 100-440 µg/L. This combination approach aims to enhance lead removal while potentially reducing the adverse effects associated with chelation therapy. DMSA is an FDA-approved oral therapy for pediatric lead poisoning when blood lead levels exceed 45 mcg/dL.
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