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a silvery soft waxy metallic element of the alkali metal group; occurs abundantly in natural compounds (especially in salt water); burns with a yellow flame and reacts violently in water; occurs in sea water and in the mineral halite (rock salt) (同)Na, atomic number 11

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ソジウム,ナトリウム(金属元素;化学記号はNa)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/11/29 19:56:10」(JST)

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Sodium aurothiomalate (INN, known in the United States as gold sodium thiomalate) is a gold compound that is used for its immunosuppressive anti-rheumatic effects.^[2]^[3] Along with an orally-administered gold salt, auranofin, it is one of only two gold compounds currently employed in modern medicine.^[4]

Medical uses

It is primarily given as a once or twice weekly by intramuscular injection for moderate-severe rheumatoid arthritis although it has also proven itself effective in treating tuberculosis.^[5]

Adverse effects

Its most common side effects are digestive (mostly dyspepsia, mouth swelling, nausea, vomiting and taste disturbance), vasomotor (mostly flushing, fainting, dizziness, sweating, weakness, palpitations, shortness of breath and blurred vision) or dermatologic (usually itchiness, rash, local irritation near to the injection site and hair loss) in nature, although conjunctivitis, blood dyscrasias, kidney damage, joint pain, muscle aches/pains and liver dysfunction are also common.^[6] Less commonly, it can cause GI bleeds, dry mucous membranes and gingivitis.^[6] Rarely it can cause: aplastic anaemia, ulcerative enterocolitis, difficulty swallowing, angiooedema, pneumonitis, pulmonary fibrosis, hepatotoxicity, cholestatic jaundice, peripheral neuropathy, Guillain–Barré syndrome, encephalopathy, encephalitis and photosensitivity.^[6]

Pharmacology

Its precise mechanism of action is unknown but is known that it inhibits the synthesis of prostaglandins.^[4] It also modulates phagocytic cells and inhibits class II major histocompatibility complex-peptide interactions.^[4] It is also known that it inhibits the following enzymes:^[4]^[7]

Acid phosphatase
Beta-glucuronidase
Elastase
Cathepsin G
Thrombin

History of use

Reports of favorable use of the compound were published in France in 1929 by Jacques Forestier. ^[8] The use of gold salts was then a controversial treatment and was not immediately accepted by the international community. Success was found in the treatment of Raoul Dufy's joint pain by the use of gold salts in 1940; "(The treatment) brought in a few weeks such a spectacular sense of healing, that Dufy ... boasted of again having the ability to catch a tram on the move." ^[9]

In popular culture

The compound was used as a poison by a patient's wife in an episode of House ("Clueless", season 2 episode 15).

References

^ ^a ^b ^c "aurothiomalate, sodium, Myochrysine (gold sodium thiomalate) dosing, indications, interactions, adverse effects, and more". Medscape Reference. WebMD. Retrieved 13 March 2014.
^ Jessop, J. D.; O'Sullivan, M. M.; Lewis, P. A.; Williams, L. A.; Camilleri, J. P.; Plant, M. J.; Coles, E. C. (1998). "A long-term five-year randomized controlled trial of hydroxychloroquine, sodium aurothiomalate, auranofin and penicillamine in the treatment of patients with rheumatoid arthritis". British journal of rheumatology. 37 (9): 992–1002. doi:10.1093/rheumatology/37.9.992. PMID 9783766.
^ Iqbal, M. S.; Saeed, M.; Taqi, S. G. (2008). "Erythrocyte Membrane Gold Levels After Treatment with Auranofin and Sodium Aurothiomalate". Biological Trace Element Research. 126 (1–3): 56–64. doi:10.1007/s12011-008-8184-x. PMID 18649049.
^ ^a ^b ^c ^d Kean, WF; Kean, IRL (4 June 2008). "Clinical pharmacology of gold". Inflammopharmacology. 16 (3): 112–125. doi:10.1007/s10787-007-0021-x. PMID 18523733.
^ Benedek, TG (January 2004). "The history of gold therapy for tuberculosis.". Journal of the History of Medicine and Allied Sciences. 59 (1): 50–89. doi:10.1093/jhmas/jrg042. PMID 15011812.
^ ^a ^b ^c Rossi, S, ed. (2013). Australian Medicines Handbook (2013 ed.). Adelaide: The Australian Medicines Handbook Unit Trust. ISBN 978-0-9805790-9-3.
^ Berners-Price, SJ; Filipovska, A (September 2011). "Gold compounds as therapeutic agents for human diseases.". Metallomics. 3 (9): 863–73. doi:10.1039/c1mt00062d. PMID 21755088.
^ FREYBERG, R.H.; et al. (July 1941). "METABOLISM, TOXICITY AND MANNER OF ACTION OF GOLD COMPOUNDS USED IN THE TREATMENT OF ARTHRITIS. I. HUMAN PLASMA AND SYNOVIAL FLUID CONCENTRATION AND URINARY EXCRETION OF GOLD DURING AND FOLLOWING TREATMENT WITH GOLD SODIUM THIOMALATE, GOLD SODIUM THIOSULFATE, AND COLLOIDAL GOLD SULFIDE". J Clin Invest. 20 (4): 401–412. doi:10.1172/jci101235. PMC 435072. line feed character in |title= at position 60 (help)
^ Lamboley, Claude (December 6, 2010). "Deux rhumatisants au soleil du Midi : Renoir et Dufy" [Two rheumatic in the Midi sun: Renoir and Dufy] (PDF). Académie des Sciences et Lettres de Montpellier (in French). Montpellier. Retrieved July 7, 2015.

UpToDate Contents

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1. バーター症候群およびギテルマン症候群 bartter and gitelman syndromes
2. 急性腎障害（急性腎不全）におけるナトリウム（FENa）、尿素（FEUrea）、およびその他分子の排泄率 fractional excretion of sodium urea and other molecules in acute kidney injury acute renal failure
3. 腎集合管ナトリウムチャンネルの遺伝的障害：リドル症候群および偽性低アルドステロン症1型 genetic disorders of the collecting tubule sodium channel liddles syndrome and pseudohypoaldosteronism type 1
4. Diagnostic evaluation of adults with hyponatremia
5. 成人における体液量減少の病因、臨床症状、および診断 etiology clinical manifestations and diagnosis of volume depletion in adults

English Journal

The role of thioredoxin reductase and glutathione reductase in plumbagin-induced, reactive oxygen species-mediated apoptosis in cancer cell lines.

Hwang GH1, Ryu JM2, Jeon YJ1, Choi J1, Han HJ2, Lee YM1, Lee S1, Bae JS1, Jung JW1, Chang W3, Kim LK4, Jee JG5, Lee MY6.
European journal of pharmacology.Eur J Pharmacol.2015 Oct 15;765:384-93. doi: 10.1016/j.ejphar.2015.08.058. Epub 2015 Sep 2.
Plumbagin is a secondary metabolite that was first identified in the Plumbago genus of plants. It is a naphthoquinone compound with anti-atherosclerosis, anticancer, anti-inflammatory, antimicrobial, contraceptive, cardiotonic, immunosuppressive, and neuroprotective activities. However, the mechanis
PMID 26341012

Reactions of model proteins with aurothiomalate, a clinically established gold(I) drug: The comparison with auranofin.

Darabi F1, Marzo T2, Massai L2, Scaletti F2, Michelucci E3, Messori L4.
Journal of inorganic biochemistry.J Inorg Biochem.2015 Aug;149:102-7. doi: 10.1016/j.jinorgbio.2015.03.013. Epub 2015 Apr 1.
Aurothiomalate (AuTm) is an old, clinically established, antiarthritic gold drug that is currently being reconsidered as a candidate drug for cancer treatment and for other therapeutic indications within a more general drug repositioning program. As the biological effects of gold drugs seem to be me
PMID 25865000

A small molecule inhibitor of atypical protein kinase C signaling inhibits pancreatic cancer cell transformed growth and invasion.

Butler AM1, Scotti Buzhardt ML2, Erdogan E3, Li S1, Inman KS1, Fields AP1, Murray NR1.
Oncotarget.Oncotarget.2015 Jun 20;6(17):15297-310.
Pancreatic cancer is highly resistant to current chemotherapies. Identification of the critical signaling pathways that mediate pancreatic cancer transformed growth is necessary for the development of more effective therapeutic treatments. Recently, we demonstrated that protein kinase C iota (PKCι)
PMID 25915428

Japanese Journal

関節リウマチの経過中に発症した急性リンパ性白血病の一例

日本臨床免疫学会会誌 = Japanese journal of clinical immunology 30(6), 461-466, 2007-12-31
NAID 10021242128

関節リウマチに多彩な腎組織像を呈した１例

日本腎臓学会誌 48(2), 67-73, 2006
NAID 130004170749

抗リウマチ薬のエスケープ現象の検討

藥學雜誌 125(3), 293-297, 2005-03-01
NAID 110003667407

Related Pictures

Schematic representation of the structure of thioredoxin reductase. | Download 【シオゾール注10mg】効果と副作用（高田製薬株式会社） - QLife Sodium aurothiomalate ≥99.9% (metals basis) | VWR (PDF) Progressive Hemorrhage and Myotoxicity Induced by Echis carinatus Venom in Gold sodium thiomalate | CAS 12244-57-4 | SCBT - Santa Cruz Biotechnology Myocrisin Injection (Sodium Aurothiomalate) - United Pharmacies Best Drug extra of All Time | Rankly

★リンクテーブル★

リンク元	「金チオリンゴ酸」
関連記事	「aurothiomalate」

「金チオリンゴ酸」

Sodium aurothiomalate
Clinical data
Trade names	Myocrisin
AHFS/Drugs.com	Multum Consumer Information
License data	US FDA: Gold_sodium_thiomalate;
Pregnancy; category	AU: B2; US: C (Risk not ruled out); ;
Routes of; administration	Intramuscular
ATC code	M01CB01 (WHO)
Legal status
Legal status	AU: S4 (Prescription only); CA: ℞-only; UK: POM (Prescription only); US: ℞-only;
Pharmacokinetic data
Protein binding	High
Biological half-life	6-25 days
Excretion	Urine (60-90%), faeces (10-40%)
Identifiers
	Systematic (IUPAC) name: Sodium 2-(auriosulfanyl)-3-carboxypropanoate
CAS Number	12244-57-4
PubChem (CID)	16760302
ChemSpider	7827788
UNII	E4768ZY6GM
ChEBI	CHEBI:35863
Chemical and physical data
Formula	C4H4AuNaO4S
Molar mass	367.939350590
3D model (Jmol)	Interactive image
	SMILES [Au+].[Na+].[O-]C(=O)C([S-])CC(=O)O ;
	InChI InChI=1S/C4H6O4S.Au.Na/c5-3(6)1-2(9)4(7)8;;/h2,9H,1H2,(H,5,6)(H,7,8);;/q;2*+1/p-2 ; Key:LTEMOXGFFHXNNS-UHFFFAOYSA-L ;
(verify)

　　[★]

英: aurothiomalate
同: 金チオリンゴ酸ナトリウム sodium aurothiomalate, gold sodium thiomalate
商: シオゾール

副作用

重大な副作用：骨髄抑制(再生不良貧血)

「aurothiomalate」

　　[★] 金チオリンゴ酸ナトリウム

[MSR-1] "aurothiomalate, sodium, Myochrysine (gold sodium thiomalate) dosing, indications, interactions, adverse effects, and more". Medscape Reference. WebMD. Retrieved 13 March 2014.

[2] Jessop, J. D.; O'Sullivan, M. M.; Lewis, P. A.; Williams, L. A.; Camilleri, J. P.; Plant, M. J.; Coles, E. C. (1998). "A long-term five-year randomized controlled trial of hydroxychloroquine, sodium aurothiomalate, auranofin and penicillamine in the treatment of patients with rheumatoid arthritis". British journal of rheumatology. 37 (9): 992–1002. doi:10.1093/rheumatology/37.9.992. PMID 9783766.

[3] Iqbal, M. S.; Saeed, M.; Taqi, S. G. (2008). "Erythrocyte Membrane Gold Levels After Treatment with Auranofin and Sodium Aurothiomalate". Biological Trace Element Research. 126 (1–3): 56–64. doi:10.1007/s12011-008-8184-x. PMID 18649049.

[mech08-4] Kean, WF; Kean, IRL (4 June 2008). "Clinical pharmacology of gold". Inflammopharmacology. 16 (3): 112–125. doi:10.1007/s10787-007-0021-x. PMID 18523733.

[5] Benedek, TG (January 2004). "The history of gold therapy for tuberculosis.". Journal of the History of Medicine and Allied Sciences. 59 (1): 50–89. doi:10.1093/jhmas/jrg042. PMID 15011812.

[AMH-6] Rossi, S, ed. (2013). Australian Medicines Handbook (2013 ed.). Adelaide: The Australian Medicines Handbook Unit Trust. ISBN 978-0-9805790-9-3.

[rsc-7] Berners-Price, SJ; Filipovska, A (September 2011). "Gold compounds as therapeutic agents for human diseases.". Metallomics. 3 (9): 863–73. doi:10.1039/c1mt00062d. PMID 21755088.

[freyberg-8] FREYBERG, R.H.; et al. (July 1941). "METABOLISM, TOXICITY AND MANNER OF ACTION OF GOLD COMPOUNDS USED IN THE TREATMENT OF ARTHRITIS. I. HUMAN PLASMA AND SYNOVIAL FLUID CONCENTRATION AND URINARY EXCRETION OF GOLD DURING AND FOLLOWING TREATMENT WITH GOLD SODIUM THIOMALATE, GOLD SODIUM THIOSULFATE, AND COLLOIDAL GOLD SULFIDE". J Clin Invest. 20 (4): 401–412. doi:10.1172/jci101235. PMC 435072. line feed character in |title= at position 60 (help)

[9] Lamboley, Claude (December 6, 2010). "Deux rhumatisants au soleil du Midi : Renoir et Dufy" [Two rheumatic in the Midi sun: Renoir and Dufy] (PDF). Académie des Sciences et Lettres de Montpellier (in French). Montpellier. Retrieved July 7, 2015.

v t e Specific antirheumatic products / DMARDs (M01C)

Quinolines	Oxycinchophen

Gold preparations	Sodium aurothiomalate Sodium aurothiosulfate Auranofin Aurothioglucose Aurotioprol

Other	Penicillamine #/Bucillamine Chloroquine #/Hydroxychloroquine Leflunomide Sulfasalazine # antifolate (Methotrexate #) thiopurine (Azathioprine) #

^#WHO-EM ^‡Withdrawn from market Clinical trials: ^†Phase III ^§Never to phase III

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sodium aurothiomalate