Clinical pharmacology of gold

Abstract

Since the dawn of civilization, elemental gold and gold compounds have been revered and utilized by Shamen and medical practitioners alike for many varied pathological problems. In the 20(th) century following the observations of Jacques Forestier, injectable gold compounds were successfully used for the treatment of rheumatoid arthritis. Of the many compounds developed, gold sodium thiomalate has been the most extensively studied by basic scientists and by clinicians. In the1980s, the oral gold compound auranofin showed promise as a therapeutic contender to injectable gold, but the clinical side effect profile and fear of long term effects of immune suppression by auranofin, resulted in gold sodium thiomalate continuing as the preferred gold compound for rheumatoid treatment. However, the increased use and demonstration of effectiveness of low dose Methotrexate (MTX) in rheumatoid treatment over the last 20 years has resulted in a significant decline in the use of injectable gold sodium thiomalate, this despite the claims and evidence that it remains a useful agent in the management of rheumatoid arthritis. Several authors still contend that the injectable gold compounds can still play a valuable role, and indeed may be the correct first choice in the management of rheumatoid arthritis.

Supra-molecular synthons based on gold…π(arene) interactions

“…Gold(I) compounds are well established to present efficacious activity for treatment of rheumatoid arthritis [51]. Besides this pharmacological role, gold(I), and indeed gold(III), compounds continue to be developed as potential therapeutic agents for a range of ailments such as tropical diseases, viruses and, especially, cancer [52][53][54].…”

In vitro antibacterial and time kill evaluation of mononuclear phosphanegold(I) dithiocarbamates

“…A prominent element in this context is gold [14][15][16][17][18][19][20]. While the clinical use of gold compounds for the treatment of rheumatoid arthritis and the development of both gold(I) and gold(III) compounds as anti-cancer 4 agents is well documented, their investigation as potential antimicrobial agents is emerging and has only recently been the subject of a comprehensive review [21].…”

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

“…The use of gold compounds to treat RA dates back to pioneering studies by Forestier in the 1920s and 1930s [1][2][3]. Subsequently, for over 50 years, chrysotherapy became a mainstay of treatment for RA, with sodium aurothiomalate (Myochrisine), gold thioglucose (Solganol), sodium bis(thiosulfato)gold, and auranofin (Ridaura) among the most used therapeutic agents [4,5]. Each of these compounds contains gold in the +1 oxidation state (Fig.…”

“…One mechanism by which the gold(I) drugs exert their anti-RA effects is inhibition of hydrolytic enzymes such as β-glucuronidase and elastase [5]. In addition, aurothiomalate and auranofin inhibit cathepsins K and S, which play a role in the progression of RA [16].…”