Serum sulphydryl levels in rheumatoid patients treated with alclofenac

In vivo effects of aurothioglucose and sodium thioglucose on rat tissue sulfhydryl levels and plasma sulfhydryl reactivity

The active component of aurothioglucose (ATG) in effecting changes in plasma sulfhydryl (SH) levels and plasma SH reactivity with 5,5'-dithiobis-(2-nitrobenzoic acid) (DTNB) was determined. These two measurements are applied clinically to rheumatoid arthritis patients undergoing chrysotherapy. Normal rats were injected intramuscularly daily for seven days with 30 mumol of either ATG or sodium thioglucose (STG)/kg body wt or with an equivalent volume of the carrier, 0.05% benzyl alcohol. ATG but not STG significantly increased total SH levels in plasma, liver, and kidney. The seven-day treatment with ATG significantly increased glutathione levels in kidney but not in liver or plasma. Thus, gold(I) rather than thioglucose was the active moiety that affected SH levels in ATG-injected rats. In vivo, gold(I) was also the active moiety that stimulated plasma SH reactions with DTNB at pH 7.4, since injection of ATG but not STG stimulated the SH reactivity in fresh plasma. In vitro, ATG increased the rate of plasma reaction with DTNB at pH 7.4, thus, gold(I) ions acted as a catalyst in the SH-disulfide exchange reaction. This study demonstrates that gold(I) but not its thiol ligand strongly interacts with protein SH groups in the rat tissues. Such an interaction may play an important role in the biological actions of gold.

Discriminatory indices of response of patients with rheumatoid arthritis treated with D-penicillamine

A long-term study is being undertaken to classify drugs used as specific agents in the treatment of rheumatoid arthritis in terms of their effects on biochemical and clinical characteristics of the disease. In particular is hoped to establish those indices which are most relevant to the response of RA to treatment. Fifteen patients were treated with D-penicillamine after an initial period of 2 weeks on aspirin alone, when the baseline investigations were made. The dose of penicillamine was increased gradually to a maximum of 500 mg a day over the period of 6 months, and changes in 8 clinical and 25 laboratory indices were measured on 8 separate occasions in the 6-month period. Marked clinical improvement took place, and this was mirrored by changes in a wide range of biochemical parametaers. ESR and C-reactive protein were shown to be the most suitable indices of disease improvement with penicillamine treatment.

A biochemical comparison of alclofenac and D-penicillamine in rheumatoid arthritis

In view of the claim that alclofenac has a specific antirheumatoid action a detailed biochemical study has been made over a 6-month period of 2 groups of patients with rheumatoid arthritis receiving either alclofenac or D-penicillamine for the first time. We found no biochemical evidence and little clinical evidence that alclofenac had a 'penicillamine-like' effect in rheumatoid arthritis.

A review of possible mechanisms of action of the antirheumatic drug, alclofenac

A number and variety of hypotheses have been proposed to explain the primary mechanism of action of the antirheumatic drugs. A critical review is made of the biochemical and pharmacological parameters which, on current evidence, parallel the clinical activity of the drugs. The numerous chemical mediators of the inflammatory response are discussed, as is the possible role of endoenous anti-inflammatory substances. Particular attention is paid to the plasma protein-binding effects of antirheumatic drugs and the competitive displacement theory of drug action is examined in the light of recent work on the behaviour of L-tryptophan binding in vitro and in vivo. It is suggested that antirheumatic drugs can be differentiated by their influence on the acute-phase protein response and their effects on tryptophan binding. Clinical findings are reviewed to support the proposal that drugs such as alcofenac, which both inhibit the acute-phase response and exert prolonged influence on the binding of tryptophan to plasma proteins, reduce inflammatory activity more profoundly than those drugs which produce symptomatic relief alone. They are capable, therefore, of altering the course of the disease.