Chrysotherapy: a synoptic review

Abstract

Chrysotherapy - the treatment of rheumatoid arthritis (RA) patients with monovalent gold drugs possessing anti-inflammatory and other properties - has been used with some success for more than 70 years; however, the metabolites generated from gold drugs have not been identified positively and the mechanisms of action are not known with certainty. This account selectively reviews recent available literature on the history of gold in medicine, with emphasis on RA; the role of Au(+) and Au(+) metabolites (Au(CN)(2)(-), Au(+3), Au(o)) and other mechanisms in chrysotherapy; current treatment regimes for RA using gold drugs; chrysotherapy case histories based on 2166 RA patients; and adverse effects of chrysotherapy, mainly various forms of dermatitis. More research seems needed on the role of gold metabolites in the treatment of RA, the use of more sensitive and uniform indicators of treatment success, improved routes of drug administration for maximum efficacy, and the development of gold drugs with minimal side effects.

Role of nanostructured gold surfaces on monocyte activation and Staphylococcus epidermidis biofilm formation

“…53 Zymosan stimulation promoted significantly higher secreted levels of IL-10 in monocytes on nanostructured gold surfaces, suggesting that the nanofeatures had anti-inflammatory potential. Gold ions released from the surfaces could result in an anti-inflammatory reaction, 54 but measurements of gold in the media (data not shown) indicated low yet equal levels in smooth and nanostructured gold samples, whereas elevated levels of IL-10 were only seen for nanostructured gold samples, indicating that the effect is caused by the nanofeatures, rather than gold ions leaking from the surface. Other studies have found a lower gene expression of IL-1β and TNF-α on nanomodified TiO surfaces (rms 4.8) compared with smooth surfaces, using a murine macrophage cell line, 55 and less TNF-α protein as well as more rounded human monocytes on 20 nm pores compared with 200 nm pores, 11 indicating that small surface nanofeatures may have a down-regulatory effect on monocytes/macrophages.…”

Synthesis and antimicrobial activities of gold(I) sulfanylcarboxylates

“…Studies on gold complexes have mainly focused on antiarthritic properties [16][17][18][19][20][21], but growing interest is evident in antitumoral [22][23][24], antiparasitic [25] and antibacterial activities. In this last field, the compounds under investigation include a major collection of the type R 3 PAuL, in which the gold atom is coordinated to a phosphine ligand and L is an O- [26,27], N- [28,29], Cl- [30] or S- [29,[31][32][33][34][35] 2 ], Na 3 [Au(mna) 2 ] (H 2 mna 02-mercaptonicotinic acid) [13] and the cationic complexes [Au(L) 2 ](NO 3 ) 3 (L01-[2-(acridin-9-ylamino)ethyl]-1,3-dimethylthiourea) [34].…”

An investigation into the interactions of gold nanoparticles and anti-arthritic drugs with macrophages, and their reactivity towards thioredoxin reductase

“…This is due in part to the complexity of the autoimmune response that is at the center of RA, and the wide range of biological targets in vivo [7]. For example, auranofin inhibits activation of the transcription protein complex NF-κB [8], and reduces expression of the inflammatory enzyme COX-2 [8,9].…”

“…Initially the majority of the gold becomes bound to Cys-34 of serum albumin in processes that result in the loss of most, if not all, of the original ligands [4]. Several metabolites of the gold(I) complexes have been identified, including [Au(CN) 2 ] -, Au(III) complexes and Au(0) [7]. It has also been shown that cells sequester gold into lysosomal bodies termed aurosomes [13,14].…”