It is now widely accepted that naphthalene itself does not cause cataracts but, instead, is biotransformed by cytochrome P450 into various metabolites, some of which are known to be directly cataractogenic.
34,36–38 The most prominent and cytotoxic of these metabolites is 1,2-naphthoquinone (1,2-NQ), which is produced by the intralenticular modification of its hepatic precursor, naphthalene-1,2-dihydrodiol (
Fig. 1).
2,28,34 1,2-NQ has pronounced electrophilic properties that enable it to bind covalently, via Michael addition, to cellular proteins and other macromolecules.
29,37,39 The highly reactive nature of 1,2-NQ, and its ability to arylate susceptible proteins, is attributed to its unsaturated, α,β-carbonyl system, which also facilitates efficient redox cycling and the production of reactive oxygen species.
40–42 Numerous studies have indeed confirmed that 1,2-NQ binds to and disrupts the function of glutathione S-transferase, crystallins, and other metabolically active proteins in the ocular lens.
39,43–45 Such reactions are typically accompanied by an increase in the uptake of oxygen and the formation of hydrogen peroxide and other free radicals.
39,42,44 Oxidative damage resulting from direct exposure to 1,2-NQ has been shown to initiate other pathologic sequelae in the ocular lens, including mobilization of intracellular calcium reserves, activation of proteolytic enzymes (e.g., calpain), and disruption of fiber cell morphology and organization.
46,47 All of these changes culminate in the formation of irreversible cataracts.