A STUDY OF THE INFLUENCE OF VARIOUS ANTIRHEUMATIC DRUG REGIMENS ON SERUM ACUTE-PHASE PROTEINS, PLASMA TRYPTOPHAN, AND ERYTHROCYTE SEDIMENTATION RATE IN RHEUMATOID ARTHRITIS

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Abstract
In patients with rheumatoid arthritis neither indomethacin nor aspirin influenced the levels of the erythrocyte sedimentation rate (e.s.r.) or serum acute-phase proteins (fibrinogen, hapto-globin, C-reactive protein and alpha1 acid-glycoprotein). Treatment with D-penicillamine, sodium aurothiomalate, or alclofenac produced a significant reduction both in acute-phase protein levels and in e.s.r. Each of the drugs displaced L-tryptophan from plasma proteins in vivo but withdrawal of indomethacin and aspirin was followed immediately by excessive binding of this amino acid to circulating proteins: this phenomenon was not observed when alclofenac, sodium aurothiomalate or D-penicillamine were withdrawn. It has been demonstrated that disease activity in rheumatoid arthritis is reflected in acute-phase protein concentrations and in the extent to which L-tryptophan is bound to plasma protein. It is suggested that drugs which profoundly affect these parameters provide not only symptomatic relief but also possible beneficial effects upon the disease process itself.

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