Wollheim F A, Jeppsson J O, Laurell C B
Scand J Rheumatol Suppl. 1979(28):21-7. doi: 10.3109/03009747909108230.
D-Penicillamine treatment in rheumatoid arthritis resulted in a fall in plasma alfa-1-antitrypsin-IgA complexes which was significantly more pronounced among responders than among non-responders. Plasma free cystine levels also fell during D-penicillamine treatment, the fall being dose dependent up to a daily dose of 500 mg. Higher doses did not result in further lowering, and no difference was detected between responders and non responders. The dominating sulphur containing aminoacid excreted in the urine was penicillamine-cysteine disulphide, the concentration of which did not correlate to either toxicity or clinical effectiveness, but showed much individual variation. The slow kinetics of change in the complex concentration taken together with in vitro experiments, suggest that the effect of D-penicillamine is more likely to be on the de novo formation of the complexes, rather than on their reduction.
青霉胺治疗类风湿性关节炎导致血浆α-1-抗胰蛋白酶-IgA复合物水平下降，在有反应者中这种下降比无反应者更为明显。在青霉胺治疗期间，血浆游离胱氨酸水平也下降，在每日剂量达500毫克之前，这种下降呈剂量依赖性。更高剂量并未导致进一步降低，且在有反应者和无反应者之间未检测到差异。尿中排泄的主要含硫氨基酸是青霉胺-半胱氨酸二硫化物，其浓度与毒性或临床疗效均无相关性，但个体差异很大。复合物浓度变化的缓慢动力学以及体外实验表明，青霉胺的作用更可能是影响复合物的从头形成，而非其还原。
