4.3 STS (Sodium Ihiosulfate-Supplemented)
Sodium thiosulfate is also a water-soluble hydrogen sulfide donor with minimal side effects, and its chemical formula is Na2S203. STS is an antidote that has been approved by the FDA and is currently mainly used in clinical practice to treat calcification reactions and toxic reactions (such as cisplatin poisoning, CO poisoning, cyanide poisoning, etc. )[59-61]. As mentioned earlier in the metabolism of hydrogen sulfide, hydrogen sulfide can be oxidized to thiosulfate, and in turn, STS can also become a source of hydrogen sulfide. When the body is in a state of hypoxia, hydrogen sulfide can be regenerated in thiosulfate through 3-MST and rhodase[62]. In addition to releasing hydrogen sulfide, STS is also an effective antioxidant that has been proven to have strong protective effects in different organ injuries, such as acute liver injury[63], acute lung injury[64], brain injury caused by I/R[65], myocardial injury[66],, kidney injury[67], etc.
Studies have shown that STS may have anti-inflammatory effects and protect vascular endothelial cells. Hydrogen sulfide seems to be able to inhibit NF-κB signaling pathway exerts anti-inflammatory effects[68]. Because of these cytoprotection on I/R injury, STS therapy has great potential in organ transplantation. The organ preservation solution added with STS is expected to become a simple, cheap and safe new treatment strategy, which can reduce the transplant sequelae and improve the success rate[69].