Lack of beneficial effect of zinc sulphate in rheumatoid arthritis.
ABSTRACT Twenty-two patients with severe long-standing rheumatoid arthritis were treated with oral zinc sulphate in a prospective long-term open trial. Six patients had (only subjective) improvement during the first 6 months of treatment, but all deteriorated subsequently. The remaining 16 deteriorated or did not improve and these patients expressed a wish to stop taking the drug after a mean period of 5 months. In the whole group of 22 patients, neither the number of affected joints, the ARA grading, nor functional classification changed significantly, nor did ESR, haemoglobin, haematocrit, or platelet count. The unpleasant taste and nausea caused by zinc sulphate was the main side effect. Our study confirms that ZnSO4 has no long-lasting beneficial effect for patients severely affected with rheumatoid arthritis.
SourceAvailable from: Elliot D Rosenstein[Show abstract] [Hide abstract]
ABSTRACT: The oft-quoted Ebers papyrus, a therapeutic compendium from the eighteenth Dynasty of ancient Egypt (about 1500 bc), is one of the first known citations of the use of trace elements, particularly various metallic compounds, for relief of musculoskeletal disorders. Verdigris (basic copper acetate), blue vitriol (copper(II) sulfate), and pulverized metallic copper were recommended as topical therapies for rheumatic pains.30 The role of these trace elements in chronic inflammatory conditions such as rheumatoid arthritis (RA) is of great interest because many of them are co-factors in metabolic processes involving collagen and bone or immune system function.1, 7, 13 and 32 Studies of the nutritional status of patients with active RA frequently demonstrate deficiencies in these “micronutrients, ” in particular various metallic elements, including copper, zinc, selenium, and magnesium.1 and 13 The increase in levels of proinflammatory cytokines such as interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α) and IL-6 seen in the setting of active RA may affect the availability of these elements by inducing the production of metal-binding proteins, metallothioneins, in the liver or intestine.32 The increased metallothionein production may result in sequestration of these metal ions so that they are unavailable to peripheral tissues.7, 13 and 32 In peripheral tissues, including within inflammatory cells, many of these trace metallic elements are incorporated into antioxidant enzymes. Antioxidant metalloenzymes interfere with the production of free radicals by inactivating reactive oxygen molecules in tissues and immune cells. Although the physiologic role for these trace elements may be reasonably well substantiated, their therapeutic usefulness is less compelling.Rheumatic Disease Clinics of North America 11/1999; 25(4):929–935. DOI:10.1016/S0889-857X(05)70111-3 · 1.74 Impact Factor
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ABSTRACT: Metabolites play numerous roles in the healthy and diseased body, ranging from regulating physiological processes to providing building blocks for the body. Therefore, understanding the role of metabolites is important in elucidating the etiology and pathology of diseases and finding targets for new treatment options. Rheumatoid arthritis is a complex chronic disease for which new disease management strategies are needed. The aim of this review is to bring together and integrate information about the various roles that metabolites have in rheumatoid arthritis. An extensive PubMed search is conducted to collect the relevant manuscripts. The metabolites are discussed in relation to rheumatoid arthritis. Subsequently, the metabolites are organized according to levels of system organization. In the last section an integrated pathway analysis of the metabolites conducted with Ingenuity Pathway Analysis software is presented. Literature search resulted in information about vitamins, eicosanoids, fatty acids, lipids, hormones and peptides. The metabolites could be related to metabolic processes, oxidative stress processes and inflammatory processes. Cell death, lipid metabolism and small molecule biochemistry were found by the pathway analysis to be the top functions, characterized by the metabolites arachidonic acid, ascorbic acid, beta-carotene, cholecalciferol, hydrocortisone, keratan sulfate, melatonin, palmitic acid and stearic acid. These nine metabolites are highly connected to a number of canonical pathways related to immune functions, the production of nitric oxygen and reactive oxygen species in macrophages and pathways involved in arthritis. This review indicates groups of metabolites that could be interesting for metabolomics studies related to rheumatoid arthritis. Circadian rhythms of metabolite levels are found to be important for understanding and treating rheumatoid arthritis. In addition, some key processes and pathways are found by integrating the metabolite data. This might offer new ideas for studies into the mechanism of and possible treatment options for rheumatoid arthritis.
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ABSTRACT: Conventional treatments for rheumatoid arthritis (RA) present a number of problems, in terms of both safety and efficacy. A number of different alternative therapies have been studied, including dietary modifications, nutritional supplements, botanicals, and antibiotics. While the response to these treatments is variable and often unpredictable, some patients have shown dramatic improvement or even complete and long-lasting remission. Moreover, alternative therapies, with the exception of antibiotics, have a low incidence of adverse effects. Consideration of these treatment options has the potential to benefit many patients with RA.Alternative medicine review: a journal of clinical therapeutic 12/1999; 4(6):392-402. · 4.86 Impact Factor