Plasma zinc and its relationship to clinical symptoms and drug treatment in rheumatoid arthritis.

Abstract

SUMMARY Total plasma zinc levels in patients with rheumatoid arthritis on different therapeutic treatments were determined in conjunction with total serum proteins, serum albumin and globulin, and articular index of joint tenderness, erythrocyte sedimentation rate, rheumatoid factor, serum copper, and serum iron. There were significantly lower zinc levels in patients with rheumatoid arthritis on nonsteroidal anti-inflammatory drugs than in patients on levamisole and penicillamine. Zinc levels correlated positively with serum albumin, and there was an inverse correlation between zinc levels and both ESR and globulin concentration in all rheumatoid patients. However, the correlation coefficient varied in the different treatment groups. The results of this study support the hypothesis that low plasma zinc level in rheumatoid arthritis is one of the nonspecific features of inflammation.Strangely, considerably less attention has been paid to divalent as opposed to monovalent cation metabolism in medicine. This may be attributable to the earlier appearance of simple methods of measurement for the alkali metals (Na+, K1) rather than to their relative biological importance. Elevation of serum copper and ceruloplasmin has long been associated with rheumatoid arthritis, and we have recently reported a relationship between serum copper, serum iron, articular index of joint tenderness, and erythrocyte sedimentation rate

Copper and zinc intake and serum levels in patients with juvenile rheumatoid arthritis

“…The disease duration did not show correlation with the serum copper levels, even when the disease duration was considered related to the age of the patient, as in this study (Table 6), or when the duration of arthritis over 1 y was considered (Honkanen et al, 1989), or the mean of 8.6 y (Balogh et al, 1980). The number of inflamed joints, besides correlating positively with serum copper level (Table 6), was the only disease characteristic that showed statistical significance on the variation of this level (Table 7).…”

“…Serum albumin, which is an important Zn-carrier, is decreased during inflammation, and presents positive correlation with the reduced zinc levels (Milanino et al, 1993;Maes et al, 1997). Therefore, zinc absorption and distribution seems to be disturbed in JRA (Honkanen et al, 1989), implying that its serum level is probably, one of the nonspecific features of inflammation (Balogh et al, 1980;Honkanen et al, 1991a).…”

Changes in zinc, copper and selenium status during adjuvant-induced arthritis in rats

“…This modification seems to be associated with an increase in hepatic zinc uptake [22,23], such as recently confirmed in the acute inflammatory carrageenan induced pleurisy of the rat [16]. Patients suffering from chronic rheumatic inflammatory diseases such as rheumatoid arthritis [25,26] and psoriatic arthritis [26] as well as animals with established adjuvant arthritis [13,14] were shown to have lower than normal plasma zinc levels. Oral zinc supplementation has demonstrated beneficial effects in some patients [27].…”

Sex Differences in Trace Metals and Disease Activity in Patients With Rheumatoid Arthritis.

“…Antiarthritic drugs in their active forms are complexed with copper 35 . The hypercupreuria was also suggested to be the outcome of dyslipedemia 43 or inflammation, as the cytokines have been reported to enhance the release of Cu thioneins during the oxidative burst of polymorphonuclear cells 44 . As many studies have reported higher levels of copper in active RA, therefore copper has been suggested to be used as an additional biochemical biomarker for RA 45 .…”

“…However lower values of zinc in other studies may be due to pharmacological treatments or other effects which also need to be considered. Serum zinc levels have been shown to decrease during acute-phase response of inflammation and with treatment with NSAIDS 44 . Probably alterations in inflammation may have some role in the levels of essential minerals.…”