In recent years there has been an increasing interest in toxic reactions to drugs, and a number of these have been reported following the treatment of Wilson's disease with penicillamine, particularly the D-L racemic mixture. Purified L-penicillamine has been shown to be a pyridoxine antimetabolite in rats (Kuchinskas and du Vigneaud, 1957; Kuchinskas, Hovarth, and du Vigneaud, 1957) and more r...

D-Penicillamine, a reducing and chelating agent used in the treating of rheumatoid arthritis, was tested for its effects of polymorphonuclear leukocyte chemotaxis, phagocytosis, and lysosomal enzymes. beta-Glucuronidase release from polymorphonuclear leukocytes after phagocytosis of latex particles was not affected by D-penicillamine at concentrations ranging from 25 to 400 mg/liter. No direct ...

One hundred and eighty nine patients with primary biliary cirrhosis were entered into a double blind, placebo controlled randomised trial starting in January 1978 to assess the therapeutic value of d-penicillamine 1200 mg daily. Eighteen of the 98 patients receiving d-penicillamine and 22 of the 91 placebo treated patients died during the study. Thirty six per cent of those on d-penicillamine a...

Indian childhood cirrhosis (ICC) is an almost uniformly fatal disease whose outcome may be modified with penicillamine if given at a sufficiently early stage. Twenty nine children with ICC seen in Pune, India, in 1980-7, who had survived at least five years from onset of penicillamine treatment, were reviewed aged 6.3 to 13 years. They were assessed clinically, biochemically, histologically, an...

In view of the claim that alclofenac has a specific antirheumatoid action a detailed biochemical study has been made over a 6-month period of 2 groups of patients with rheumatoid arthritis receiving either alclofenac or D-penicillamine for the first time. We found no biochemical evidence and little clinical evidence that alclofenac had a 'penicillamine-like' effect in rheumatoid arthritis.

α-Oxoaldehydes, which are produced in higher quantities in diabetes, uremia, oxidative stress, inflammation and aging, react with the amino, guanidine and thiol groups of proteins and cause the formation of advanced glycated end-products and protein cross-linking. To prevent these reactions, the efficiency of low molecular mass thiols with an α-amino-β-mercapto-ethane group (Cys, penicillamine ...

A 68-year-old black woman who was put on D-penicillamine therapy (250-500 mg per day, total dose 15 g) for rheumatoid arthritis developed ocular myasthenia gravis. Two weeks after she discontinued D-penicillamine her signs and symptoms cleared with no other treatment. Review of previous cases and possible immunological mechanisms are discussed.

Rheumatologists are closet historians, our modern history is relatively short, and the drugs with which we treat patients are of recent vintage but better understood with every passing year. Penicillamine now has a definite place in the management of rheumatoid arthritis and other disorders. Deutsch and Morton (1957) showed that cysteine and mercaptoethanol converted macroglobulin to molecular ...