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[A578]Anti Inflammatory Rheumatoid Arthritis

by Nathan Wei, Nat

Gold was used extensively until the early 1980's when it was supplanted by methotrexate as the disease-modifying anti-rheumatic drug (DMARD) of choice. (DMARDS are drugs that actually slow down the progression of rheumatoid arthritis (RA) as opposed to non-steroidal anti-inflammatory drugs that merely help with symptoms.) More recently, biologic treatments have also entered the arena and are capable of putting RA into remission.

Gold treatment, while often effective, also was associated with a host of problems. The shots took months to take effect and side effects included rashes, mouth sores, kidney damage, inflammation of the lung, and occasionally, damage to the bone marrow causing life-threatening reductions in the number of red and white blood cell counts and platelet counts.

Dr. David Pisetsky, chief of the division of rheumatology at Duke University School of Medicine, says " We rheumatologists have really never understood how gold works.” His hope is that once the mechanism of action is understood, then it might be possible to create new and better gold-like drugs to treat arthritis.

Pisetsky's interest in gold comes from his work with a particular molecule, HMBG1, which causes inflammation, the linchpin to the development of rheumatoid arthritis. He states, “HMBG1 is a molecule which has two functions; it behaves one way when it's inside the nucleus of a cell, and …another way when it's released from a cell.”

Inside the nucleus, HMGB1 acts as a messenger and is responsible for converting genetic information from DNA to RNA. But when HMGB1 is released from the cell, for whatever reason, it stimulates the immune system and promotes inflammation…

Pisetsky feels that if HMGB1 were kept within the nucleus, it would help reduce the inflammation associated with arthritis.

HMGB1 prodcution in the body is heterogenous- it is not produced in the same concentration in every tissue of the body. There is an unusually high amount of it present within joints where arthritis occurs.

The experiments went like this... researchers at the University of Pittsburgh, the Karolinska Institute in Sweden, and Duke stimulated mouse and human immune system cells to make HMGB1, then treated the cells with gold. They found that the gold blocked release of HMGB1 from the nucleus. Theoretically, that should lessen the amount of HMGB1 available to promote an inflammatory response.

Pisetsky feels that gold works by interfering with the action of interferon beta and nitric oxide. These two substances help control the release of HMGB1.

(The study will appear in the January, 2008 issue of the Journal of Leukocyte Biology, but will be available ahead of print on the journal's website. Co-authors of the study include lead investigators Weiwen Jiang, from Duke University, and Cecilia Zetterstrom, from the Karolinska Institute; Heidi Wahamaa, Therese Ostberg, Ann-Charlotte Aveberger, Hanna Schierback and Ufl Anderson from the Karolinska Institute; Helena Erlandersson Harris, senior co-author, from the Medicine and Rheumatology Unit of the Karolinksa University Hospital and Michael Lotze, from the University of Pittsburgh.)

This description about how gold may work is fascinating to an arthritis specialist who started practice in 1981. At that time we had hydroxychloroquine, gold, and d-penicillamine. None of these treatments was ideal and both gold and d-penicillamine were very toxic. Our treatment options have increased greatly and we are now able to get many patients with RA into remission. However, we still have a ways to go. Research into the mechanisms of disease will help us find better therapies in the future. It may be that some of the older therapies like gold- if we can develop drugs that have the good effects… without the bad, may be very useful.

For more information on gold treatment go to http://www.arthritis-treatment-and-relief.com/gold-treatment.html

Rheumatoid arthritis is a systemic disease that begins with severe pain in the small joints of hands and feet, spreading to the wrists, knees, shoulders, ankles, and elbows. Overlying skin appears red and shiny. This condition affects mostly women, often beginning between the ages of 20 and 40, although it can occur at any time. Symptoms include joint pain, swelling, and stiffness, accompanied by fatigue, low-grade fever, and poor appetite.

Rheumatoid arthritis is an autoimmune reaction resulting in a chronic, inflammatory condition affecting the joints and the tissues around them. The joints themselves become painful, swollen, unstable, and then greatly deformed. It varies in severity.

Treatment

Diet and Nutrition It is sensible to increase your intake of wholefoods, vegetables, and fiber. Reduce intake of meat, refined carbohydrates, and saturated fats. A qualified nutritional therapist will check for food allergies or intolerance, such as dairy, wheat, corn, and so on, and will, perhaps, suggest daily supplementation with vitamins C (2g), E (400iu), and B complex, along with calcium pantothenate, selenium (100mg), and zinc (30mg).

Hydrotherapy Cold compresses are useful when the joints are acutely inflamed, followed by alternating hot and cold compresses.

Massage Joints can be massaged with tiger balm, lavender, and camomile oils, and Ruta graveolens cream.

Consult a qualified practitioner/therapist for:

Acupuncture This will be aimed at energy balance, and pain relief.

Herbal Medicine Useful herbs include black cohosh, wild yam, willow bark, and licorice.

Homeopathy Specific remedies include Arnica 6c, Bryonia 30c, Rhus tox. 6c, and Ruta grav. 6c, but treatment should always be constitutional.

Osteopathy Treatment will be to address the maintenance of body mechanics.

Healing This therapy can be beneficial.

Gout

Gout is caused by the buildup of crystalized uric acid around the joints, causing severe pain, swelling, and redness around them. It affects mainly the big toe, knuckles, knees, and elbows. An attack may be accompanied by a high fever, and repeated attacks damage bones. Gout is usually an indication that the body is not processing and removing uric acid efficiently.

Treatment

Diet and Nutrition Avoid shellfish, sardines, kidneys, and beans, and increase your intake of water. Biochemic tissue salts include Nat. phos and Nat. sulf.

Massage Oils of peppermint, lavender, camomile and geranium may be massaged into the affected area. Ruta graveolens cream may also be used. Self-mobilize the toe by gently pulling it and moving it around.

Acupressure Massage of points relating to the feet will be useful.

Consult a qualified practitioner/therapist for:

Herbal Medicine Celery seeds, and wintergreen teas; bladderwrack may be taken internally, or seaweed can be eaten or added to the bath. Burdock and nettle neutralize and eliminate poisons from the body. A poultice of comfrey and marigold may be useful.

Chiropractic and Osteopathy Both provide foot mobilization maneuvers to help the condition.

Article Source : Pg. 18

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Both Nathan Wei & Richard Bean are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.

Nathan Wei has sinced written about articles on various topics from Arthritis Pain, Health and Arthritis Signs. Nathan Wei, MD FACP FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine. For more info:. Nathan Wei's top article generates over 550000 views. to your Favourites.

Richard Bean has sinced written about articles on various topics from Types of Cancer, Hair Removal and Medicine. Read out for . Check out. Richard Bean's top article generates over 49500 views. to your Favourites.