Why is cyanide acutely lethal at very low doses?
Cyanide is conventionally perceived as a binder of heme-Fe centers, disrupting oxygen transport by blood hemoglobin and mitochondrial cytochrome oxidase function. This explanation of toxicity would require millimolar (g/Kg dosage) concentration of cyanide, whereas it is lethal even at micromolar (mg/Kg dosage) ranges. It is long known that oxygen consumption by cells leads to the production of diffusible reactive oxygen species (DROS). Recently, DROS mediated catalytic/metabolic roles were proposed as a physiological source of heat and phosphorylation of ADP within mitochondria. In this purview, it is hypothesized herein that cyanide uses the catalytic DROS via futile cycles, stopping ATP-synthesis and thus killing cells. A quantitative mechanistic perspective delineating the old and new explanations is provided herein. Further, experimental modalities and predictable outcomes are detailed to test the new hypothesis.