myochrysine

同: gold sodium thiomalate

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/10/31 20:08:53」(JST)

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Sodium aurothiomalate

Auranofin

Gold salts are ionic chemical compounds of gold. The term, which is a misnomer, has evolved into a synonym for the gold compounds used in medicine. The application of gold compounds to medicine is called "chrysotherapy" and "aurotherapy."^[1] The first reports of research in this area appeared in 1935,^[2] primarily to reduce inflammation and to slow disease progression in patients with rheumatoid arthritis. The use of gold compounds decreased since the 1990s because of numerous side effects and monitoring requirements, limited efficacy, and very slow onset of action. Most chemical compounds of gold, including some of the drugs discussed below, are not, in fact, salts but are examples of metal thiolate complexes.

Medical uses

Investigation of medical applications of gold salts began at the end of the 19th century, when gold cyanide demonstrated effectiveness against Mycobacterium tuberculosis.^[3]

Indications

The use of injected gold salts is indicated for rheumatoid arthritis. However, the use of gold is now rare due to numerous side effects, the need for continual patient monitoring, limited efficacy and slow onset of action. The efficacy of orally administered gold is even more limited than injectable gold compounds.^[4]

Mechanism in arthritis

The mechanism by which gold drugs affect arthritis is unknown.^[4]

Administration

Gold salts for rheumatoid arthritis are administered by intramuscular injection but can also be administered orally (although the efficacy is low). Regular urine tests to check for protein (indicating kidney damage) and blood tests are needed.

Efficacy

A 1997 review (Suarez-Almazor ME et al.)^[5] reports that treatment with intramuscular gold (parenteral gold) reduces disease activity and joint inflammation. Gold salts taken by mouth are less effective than by injection. Three to six months are often required before gold treatment noticeably improves symptoms.

Side effects

Chrysiasis

One noticeable side-effect of gold-based therapy is the coloring of the skin in shades of mauve to a purplish dark grey when exposed to sunlight, if the salts are taken on a regular basis over a long period of time .^[6] Excessive intake of gold salts while undergoing chrysotherapy result – through complex redox processes – in the saturation by relatively stable gold compounds of skin tissue and organs (as well as teeth and ocular tissue in extreme cases), a condition known as chrysiasis, similar to a certain extent to argyria which is related to silver salts and colloidal silver. Chrysiasis can ultimately lead to acute renal failure (such as tubular necrosis, nephrosis, glomerulitis ),^[7] severe heart conditions and hematologic complications (leukopenia, anemia).^[8]^[9]^[10] While some effects can be healed with moderate success, the pigmentation of the skin is considered permanent.

Other side effects

Other side effects of gold salts include kidney damage, itching rash, and ulcerations of the mouth, tongue and pharynx. Approximately 35% of patients discontinue the use of gold salts because of these side effects. Kidney function must be monitored continuously while taking gold salts.^[4]

Types of gold salts

Auranofin (UK & U.S.)
Aurothioglucose (Gold thioglucose) (U.S.)
Disodium aurothiomalate
Sodium aurothiosulfate (Gold sodium thiosulfate)
Sodium aurothiomalate (Gold sodium thiomalate) (UK)

References

^ Shaw III, C. F. (1999). "Gold-Based Medicinal Agents". Chemical Reviews 99 (9): 2589–600. doi:10.1021/cr980431o. PMID 11749494.
^ Forestier J. (1935). "Rheumatoid arthritis and its treatment with gold salts - results of six years experience.". J Lab Clin Med 20: 827–40.
^ William O. Foye; Thomas L. Lemke; David A. Williams (1 September 2007). Foye's principles of medicinal chemistry. Lippincott Williams & Wilkins. pp. 989–. ISBN 978-0-7817-6879-5. Retrieved 14 November 2010.
^ ^a ^b ^c Bingham, C. Updated, 2012. Rheumatoid Arthritis Treatment. Johns Hopkins Medical. http://www.hopkinsarthritis.org/arthritis-info/rheumatoid-arthritis/ra-treatment/#gold
^ Clark P, Tugwell P, Bennett KJ, Bombardier C, Shea B, Wells GA, Suarez-Almazor ME. Injectable gold for rheumatoid arthritis. Cochrane Database of Systematic Reviews 1997, Issue 4. Art. No.: CD000520. doi:10.1002/14651858.CD000520.
^ "BMJ case reports: Chrysiasis" http://casereports.bmj.com/content/2009/bcr.07.2008.0417.full
^ Drug Reference for EMS Providers, Richard K.Beck, 2002, pp. 164–165: auranofin and Aurothioglucose side effects & overdose
^ Auranofin complete list of warnings,precautions and reactions http://www.drugs.com/pro/ridaura.html and various inflammations
^ Aurothioglucose Suspension adverse effects : http://www.healthdigest.org/topics/category/979-aurothioglucose-suspension-dosage-interactions-side-effects-how-to-use
^ Gold sodium thiomalate: adverse effects including allergy to gold, tolerance to gold decreasing with age, skin and renal complications. http://web.squ.edu.om/med-Lib/MED_CD/E_CDs/Focus%20on%20Nursing%20Pharmacology%202000/mg/gold_sodium_thiomalate_%28gold%29.htm

External links

"Gold salts for juvenile rheumatoid arthritis". BCHealthGuide.org
"Gold salts information". DiseasesDatabase.com
"HMS researchers find how gold fights arthritis: Sheds light on how medicinal metal function against rheumatoid arthritis and other autoimmune diseases." Harvard University Gazette (2006)
"Aurothioglucose is a gold salt used in treating inflammatory arthritis". MedicineNet.com
"About gold treatment: What is it? Gold treatment includes different forms of gold salts used to treat arthritis." Washington.edu University of Washington (December 30, 2004)

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 金治療の主な副作用 major side effects of gold therapy
2. リウマチ性疾患への金化合物の使用 use of gold compounds in rheumatic diseases
3. 金誘発性肺疾患 gold induced pulmonary disease
4. 関節リウマチにおける薬剤誘発性肺疾患 drug induced lung disease in rheumatoid arthritis
5. 再生不良性貧血：病因、臨床症状および診断 aplastic anemia pathogenesis clinical manifestations and diagnosis

English Journal

Protein kinase C iota as a therapeutic target in alveolar rhabdomyosarcoma.

Kikuchi K, Soundararajan A, Zarzabal LA, Weems CR, Nelon LD, Hampton ST, Michalek JE, Rubin BP, Fields AP, Keller C.SourcePediatric Cancer Biology Program, Papé Family Pediatric Research Institute, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239-3098, USA.
Oncogene.Oncogene.2013 Jan 17;32(3):286-95. doi: 10.1038/onc.2012.46. Epub 2012 Feb 20.
Alveolar rhabdomyosarcoma is an aggressive pediatric cancer exhibiting skeletal-muscle differentiation. New therapeutic targets are required to improve the dismal prognosis for invasive or metastatic alveolar rhabdomyosarcoma. Protein kinase C iota (PKCι) has been shown to have an important role in
PMID 22349825

Effects of aurothiomalate and gold(III) complexes on spontaneous motility of isolated human oviduct.

Janković SM, Djeković A, Bugarčić Z, Janković SV, Lukić G, Folić M, Canović D.SourceDepartment of Pharmacology and Toxicology, Medical Faculty, University of Kragujevac, Ul. Svetozara Markovica 69, 34000, Kragujevac, Serbia. slobodan.jankovic@medf.kg.ac.rs
Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine.Biometals.2012 Oct;25(5):919-25. doi: 10.1007/s10534-012-9558-2. Epub 2012 May 19.
Organic gold complexes have different biological activity, depending on their potential for interactions with key functional molecules.The aim of this study was to investigate potential of several newly synthesized organic gold complexes to influence spontaneous motility of the Fallopian tubes.The e
PMID 22610585

Effect of NF-κB inhibitor aurothiomalate on local inflammation in experimental Th1- and Th2-type immune response.

Ligacheva AA, Ivanova AN, Belsky YP, Belska NV, Trofimova ES, Danilets MG, Dygai AM.SourceInstitute of Pharmacology, Siberian Division of the Russian Academy of Medical Sciences, Tomsk, Russia. vittelli@mail.ru
Bulletin of experimental biology and medicine.Bull Exp Biol Med.2012 Aug;153(4):472-4.
We compared the effect of NF-κB inhibitor aurothiomalate and voltaren on local inflammation in different types of immune response. Both substances reduced edema caused by sheep erythrocytes (Th1-type immune response) and local immediate-type hypersensitivity response induced with ovalbumin (Th2-dep
PMID 22977847

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