Serendipity is what first lead physicians to use gold salts to treat arthritis. Initially, precious metal was tested like a treatment for tuberculosis; however, it had been observed that gold had salutary effects within patients with rheumatoid arthritis.
Gold was used extensively until the early 1980's when it was supplanted through methotrexate as the disease-modifying anti-rheumatic drug (DMARD) of preference. (DMARDS are drugs that actually slow down the progression of rheumatoid arthritis (RA) as opposed to non-steroidal anti-inflammatory drugs that help with symptoms.) More recently, biologic treatments also have entered the industry and are capable of putting RA into remission.
Gold treatment, while often effective, also was associated with a host of issues. The shots took months to take effect and side effects incorporated rashes, mouth sores, kidney damage, irritation of the lung, and from time to time, damage to the bone marrow causing life-threatening reductions in the number of red and white bloodstream cell counts and platelet counts.
Dr. David Pisetsky, chief of the division of rheumatology at Fight it out University School of Medicine, says " All of us rheumatologists have really by no means understood how gold works." Their hope is that once the mechanism of action is understood, it might be possible to produce new and better gold-like medicines to treat arthritis.
Pisetsky's interest in gold comes from their work with a particular particle, HMBG1, which causes inflammation, the linchpin to the development of rheumatoid arthritis. He states, "HMBG1 is a molecule which has two functions; it reacts one way when it's inside the nucleus of a cell, and 锟斤拷another way when it's launched from a cell."
Inside the nucleus, HMGB1 acts as a messenger and it is responsible for converting genetic information from Genetic make-up to RNA. But when HMGB1 is actually released from the cellular, for whatever reason, it energizes the immune system and encourages inflammation锟斤拷
Pisetsky feels that if HMGB1 were kept within the nucleus, it would help reduce the inflammation related to arthritis.
HMGB1 prodcution in the body is actually heterogenous- it is not produced in the same concentration in every tissue of the body. It comes with an unusually high amount of it present within joints where arthritis occurs.
The experiments proceeded to go like this... researchers at the University of Pittsburgh, the actual Karolinska Institute in Sweden, and Duke stimulated mouse and human defense mechanisms cells to make HMGB1, then treated the cells along with gold. They found that the gold obstructed release of HMGB1 from the nucleus. In theory, that should lessen the quantity of HMGB1 available to promote a good inflammatory response.
Pisetsky feels that gold works by interfering with the action of interferon beta and nitric oxide. These two substances help control the release of HMGB1.
(The research will appear in the January, 2008 issue of the Journal of Leukocyte Biology, however will be available ahead of print on the journal's web site. Co-authors of the study consist of lead investigators Weiwen Jiang, from Duke University, and Cecilia Zetterstrom, from the Karolinska Institute; Heidi Wahamaa, Therese Ostberg, Ann-Charlotte Aveberger, Hanna Schierback and Ufl Anderson from the Karolinska Institute; Helena Erlandersson Harris, older co-author, from the Medicine and Rheumatology Unit of the Karolinksa University Hospital and Michael Lotze, from the University of Pittsburgh.)
This description about how exactly gold may work is fascinating to an joint disease specialist who began practice in 1981. At that time we had hydroxychloroquine, gold, and d-penicillamine. None of these treatments was ideal as well as both gold as well as d-penicillamine were very toxic. Our treatment options have increased greatly and we are now able to get many patients with RA into remission. Nevertheless, we still have the ways to go. Research into the mechanisms of disease will help us find better therapies later on. It may be that some of the older therapies such as gold- if we can develop medicines that have the good effects锟斤拷 without the bad, may be very useful.
For more information on gold therapy go to arthritis-treatment-and-relief . com/gold-treatment.html
Article resource: articlemotron . com
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