The first recorded use of gold salts to treat rheumatoid arthritis was in 1935 by J. Forestier. He conduct a 6 year study to determine if the compound would provide relief for RA patients. The treatments proved somewhat successful but required up to six months of weekly injections and had some negative side effects such as kidney damage, mouth sores, rashes and, in rare cases, aplastic anemia. Drugs containing gold salts are marketed under the names of Ridaura, Myocrisin, Aurolateor, Myochrysine and Solganal, But until recently it was unknown how gold salts impacted inflammatory diseases.
But recently researchers at Duke University may have unlocked this mystery. Dr. David Pisetsky has had a particular interest in a molecule that triggers inflammation, HMBG1. This molecule acts differently when it is in the nucleus of a cell that when it is released. This is known a dual-function molecule. Inside the nucleus of a cell it is key in the process that converts genetic information in the DNA to its RNA equivalent. But when HMBG1 is released from the cell it stimulates the immune system and exaggerates inflammation. HMGB1 appears to exist in unusually high amounts in the synovial tissue and fluid that surrounds and cushions the joints.
Dr. Pisetsky and colleagues from the University of Pittsburgh and the Karolinska Institute in Sweden conducted tests in which they stimulated mouse and human immune system cell to secrete HMBG1 and then treated them with gold salts. They discovered that the gold inhibited the release of HMBG1 from the nucleus. This was accomplished by gold’s interference with the activity of two helper molecules, interferon beta and nitric oxide, which allows the release of HMBG1 from the cell nucleus. The result was reduced amounts of HMBG1 and therefore less induced inflammation.
Gold salts are typically used currently as a last resort treatment for RA. The usual treatments include methotrexate and other engineered drugs. But based on these findings the development of newer and safer gold based treatments may be possible.
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