The
gold drugs, gold sodium thiomalate (Myocrisin), aurothioglucose
(Solganal), and the orally administered auranofin (Ridaura), are utilized
in modern medicine for the treatment of inflammatory arthritis including
rheumatoid and juvenile arthritis; however, new gold agents have been
slow to enter the clinic. Repurposing of auranofin in different disease
indications such as cancer, parasitic, and microbial infections in
the clinic has provided impetus for the development of new gold complexes
for biomedical applications based on unique mechanistic insights differentiated
from auranofin. Various chemical methods for the preparation of physiologically
stable gold complexes and associated mechanisms have been explored
in biomedicine such as therapeutics or chemical probes. In this Review,
we discuss the chemistry of next generation gold drugs, which encompasses
oxidation states, geometry, ligands, coordination, and organometallic
compounds for infectious diseases, cancer, inflammation, and as tools
for chemical biology via gold–protein interactions. We will
focus on the development of gold agents in biomedicine within the
past decade. The Review provides readers with an accessible overview
of the utility, development, and mechanism of action of gold-based
small molecules to establish context and basis for the thriving resurgence
of gold in medicine.