Glutathione in erythrocytes: a parameter of change in disease activity and response to drugs in rheumatoid arthritis
Several thiols have been shown to have anti-rheumatic activity. Rheumatoid factor molecules are split in vitro by the thiol penicillamine. This was the rationale behind the use of penicillamine in the treatment of rheumatoid arthritis (RA)1. Later studies showed, however, that this mechanism did not operate in vivo, and it is still unknown how penicillamine works in RA. Other thiols and anti-oxidants, for example, the vitamin B6 derivatives 5-thiopyridoxine2 and its disulphide pyrithioxine3, and also thiola (thiopronine or 2-mercapto-propionyl glycine)4,5 are all found effective as slow-acting, ‘second-line’ anti-rheumatic drugs. The immunopotentiating drug levam-isole has also an anti-oxidant effect, probably through a sulphydryl metabolite6. Gold salts used in the treatment of RA are usually given as thio-compounds7. It has also been claimed that the action of chloroquine in RA is due to interference with mercaptides8. No convincing relation between a known biological effect of these drugs and clinical response to them in RA has yet been demonstrated.
KeywordsRheumatoid Arth Antirheumatic Drug Active Rheumatoid Arth Gold Salt Sulphydryl Group
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