Biomedical subjects
Publications and source records attributed to C J McNeil.
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Sixty-three patients with rheumatoid arthritis were randomly divided into 3 groups, and treated with either sodium aurothiomalate (Myocrisin), auranofin, or placebo. Gold levels in whole blood, plasma, and haemolysate were measured serially along with clinical and laboratory parameters of efficacy. Auranofin produced a higher ratio of haemolysate to plasma gold than Myocrisin, and it appears that the affinity of the red cell for gold is reduced during therapy with auranofin. Gold levels did not correlate with changes in the pain score, erythrocyte sedimentation rate, and C-reactive protein, nor with the development of toxicity. In the Myocrisin group the haemolysate gold level achieved was dependent on the number of cigarettes smoked. In the auranofin group there was no such correlation, but the haemolysate gold level was higher for smokers than non-smokers. The likely action of gold is discussed.
The thiol status of patients with rheumatoid arthritis is significantly different from that of controls. Plasma thiol levels are lower, albumin thiol reactivity is altered and intracellular thiol levels measured after hemoglobin precipitation are increased. These variations correlate with other indices of disease severity and are one measure of a disturbance in the degree of oxidation of the blood. Penicillamine, in common with other effective therapeutic agents, produces an increase in serum thiol concentration. It causes a greater effect on serum thiol reactivity than other drugs and in particular it increases 'fast reacting' thiol levels without significantly altering the 'slow reacting' thiol level.
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Serum copper and thiol levels an caeruloplasmin activity were determined and compared with measurements of articular index, erythrocyte sedimentation rate, and zinc and haemoglobin levels in patients with rheumatoid arthritis. Superoxide dismutase activity, thiol, zinc, and copper levels of haemolysate were measured and compared with each other and to the above parameters. In serum, caeruloplasmin activity increased and thiol levels decreased, whereas in the haemolysate superoxide dismutase activity decreased and thiol levels increased. It is suggested that the changes in copper levels and in the activities of process which may be copper-dependent between plasma and cytosol in patients with rheumatoid arthritis reflect a change in oxidative status of the blood which may have implications in the pathogenesis of the disease.
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