Effect of chrysotherapy on parameters of immune response.

Thirty-nine subjects with classical or definite rheumatoid arthritis received weekly intramuscular gold sodium thiomalate (GST) to sustain gold blood levels of more than 320 microgram/dl. Statistical analysis revealed significant declines from pre-treatment values for IgM, IgG, and IaA. Rheumatoid factor titer decreased in 29 of 39 subjects, 15 becoming seronegative. Circulating lymphocytes decreased by 27%. The maximal suppressive effect on IgM was not achieved until the 3rd and 4th years of GST administration. Auranofin (AF) 6 mg/day was administered to 15 patients for an average interval of 45 weeks. In vitro and in vivo suppression of lymphocyte mitogen response with AF was more rapid in onset and significantly greater than with GST. Suppression of dinitrochlorobenzene skin sensitization was observed in AF patients. The clinical response in GST treated subjects correlated with suppression of immunoglobulins, rheumatoid factor titer, and circulating lymphocytes. A significant decline in these variables was not achieved for a corresponding interval with AF treatment. It is suggested that chrysotherapy may be applied more widely to immunologically-mediated disorders and perhaps be used to affect selectively B versus T mediated dysfunction.