Bebarta · FASEB journal : official publication of the Federation of American Societies for Experimental Biology 2025 · narrative review · n=?

Redirecting Intermediary Metabolism to Counteract Cyanide Poisoning.

Level 5 - mechanism / opinion, no new human data

Narrative review and theoretical mechanism paper with no new empirical or clinical data.

PubMed 40497726 · doi:10.1096/fj.202400230RR · record verified 2026-08-26

What was done

This review examined the cellular mechanisms of cyanide toxicity with a focus on intermediary metabolism. The authors synthesized historical research on endogenous cyanide-sequestering metabolites and evaluated modern advances in mass spectrometry-based metabolomics, subcellular drug targeting, and genome editing to formulate potential metabolic therapeutic approaches for cyanide poisoning.

What was found

The abstract reports no quantitative experimental data or statistical findings. It outlines the theoretical paradigm that although cyanide suppresses oxidative phosphorylation and forces a shift toward glycolysis, redirecting metabolic flux into other uninhibited intermediary pathways could counteract cyanide toxicity and alleviate broader cellular damage that current chelating agents do not reverse.

Why it matters

Current FDA-approved cyanide antidotes focus primarily on binding or chelating the toxic chemical directly. Metabolic redirection offers a potential alternative strategy to restore cellular homeostasis and address the downstream metabolic injuries associated with poisoning.

Limits

The paper is a conceptual narrative review with no primary human data or quantitative efficacy endpoints provided in the abstract. The proposed metabolic redirection strategies remain theoretical frameworks that require preclinical and clinical validation.

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