[Ceruloplasmin and immunoglobulins under controlled D-penicillamine therapy in rheumatoid arthritis]

In a controlled therapeutic trial 17 patients with active rheumatoid arthritis (stage II and III) were divided in two randomized groups. One group of 9 patients was treated with 900 mg of D(-)penicillamine (Trolovol) plus 1500 mg of salicylate per day, the other group of 8 patients with 10 mg of prednisolone plus 1500 mg of salicylate daily. Before and after 1, 2, 3, 4 and 6 months of treatment IgA, IgG, IgM and caeruloplasmin were estimated with immunodiffusion technique. In both groups the IgA and IgG levels remained unchanged; unter D-penicillamine, on the contrary, a statistically significant and continuous fall of IgM and caeruloplasmin was observed; prednisolone treatment induced only a temporary fall of caeruloplasmin. In the DPA treated patients, a significant correlation of IgM with caeruloplasmin and of caeruloplasmin with ESR was found. In both groups there was no correlation between joint count and caeruloplasmin, joint count and IgM, caeruloplasmin and copper, copper and ESR; in the prednisolone group no correlation between caeruloplasmin, ESR and IgM was observed. The correlations suggest that the remarkable fall of IgM and caeruloplasmin under D(-)penicillamine treatment is caused at least partially by direct interference of DPA with these plasma proteins.