Mellbye O J, Munthe E
Ann Rheum Dis. 1977 Oct;36(5):453-8. doi: 10.1136/ard.36.5.453.
In most normal human sera the addition of penicillamine to a final concentration of 0-2 mmol/l and subsequent dialysis caused a slight reduction in serum haemolytic complement (CH50). At 200 mmol/l, CH50 activity was no longer demonstrable. Even high concentrations of penicillamine were needed to inhibit the ability of immunoglobulin to fix complement to preformed or forming immune complexes. This indicated that the reduction of CH50 observed in serum was due to an effect on the complement factors. In vivo, a dose of 240 mg penicillamine caused a slight transient reduction in CH50 in rabbit serum, while 1000 mg penicillamine had no effect on serum CH50 in patients with rheumatoid arthritis. In arthritis patients there was, however, some evidence for removal of complement deposits in synovial tissue during penicillamine treatment. Since it is theoretically possible that concentrations high enough to cause reduction of complement activity can be achieved locally in synovial tissue, the effect on complement may be one of the mechanisms by which penicillamine exerts its effect in rheumatoid arthritis.
在大多数正常人血清中，加入青霉胺使其终浓度达到0 - 2 mmol/L，随后进行透析，会导致血清溶血补体（CH50）略有降低。在200 mmol/L时，CH50活性不再能检测到。即使需要高浓度的青霉胺才能抑制免疫球蛋白将补体固定到预先形成或正在形成的免疫复合物上的能力。这表明在血清中观察到的CH50降低是由于对补体因子的影响。在体内，240 mg青霉胺剂量会使兔血清中的CH50出现轻微的短暂降低，而1000 mg青霉胺对类风湿关节炎患者的血清CH50没有影响。然而，在关节炎患者中，有一些证据表明在青霉胺治疗期间滑膜组织中的补体沉积物被清除。由于理论上有可能在滑膜组织局部达到足以导致补体活性降低的浓度，对补体的影响可能是青霉胺在类风湿关节炎中发挥作用的机制之一。
