Chrysotherapy Khoảng 100 triệu người bị ảnh hưởng với viêm khớp dạng thấp (RA), trong đó có 8 triệu người Mỹ. Bệnh đau đớn này có liên quan với bệnh tật và tử vong cao. Các nguyên nhân của RA là không rõ và không có phương thức chữa trị. Chrysotherapy, hoặc điều trị RA do thuốc thiol đơn giá vàng, đã được thực hành từ năm 1929, mặc dù cơ chế của hành động là không biết một cách chắc chắn. Nói chung, các loại thuốc vàng hiệu quả nhất - và độc hại - trong 2 năm điều trị. | CHAPTER 9 Chrysotherapy About 100 million individuals are afflicted with rheumatoid arthritis RA including 8 million Americans. This painful disease is associated with high morbidity and mortality. The causes of RA are unknown and there is no known cure. Chryso-therapy or the treatment of RA by monovalent gold thiol drugs has been practiced since 1929 although the mechanisms of action are not known with certainty. In general the gold drugs were most efficacious and toxic during the first 2 years of treatment. This chapter synthesizes information on 1 the history of gold drugs used in the treatment of RA 2 proposed modes of action of gold drugs and 3 chrysotherapy treatment regimes adverse effects and case histories as modified from Eisler 2003 . HISTORY Rheumatoid arthritis RA is an inflammatory condition that leads to progressive erosion of the articular cartilage lining the interfaces of bones in joints Shaw 1999a . Unchecked the bones will eventually fuse after cartilage loss is complete. Inflammation occurs first in the synovial membrane which surrounds the joints and then moves into the synovial cavity between the bones. Damage to the tissues is effected by lysosomal enzymes including collagenase and other proteases that are released because of the inflammatory condition. The resulting tissue destruction releases cell and tissue fragments which stimulates further inflammation and the migration of immune cells including macrophages into the inflamed area. Thus a cycle is established of degradation and further release of destructive enzymes Shaw 1999a . About 1 to 2 of the world s population about 60 to 120 million individuals are affected by RA Gromer et al. 1998 including an estimated 8 million Americans Roberts and Shaw 1998 . Rheumatoid arthritis is a disease associated with high morbidity and mortality from infection. Death from infection is nine times more common in patients with RA than the general population the majority of these deaths are due to .
