Related Experiment Video
Updated: Jun 6, 2026
Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
Published on: May 16, 2025
Slow turnover of manganese in active rheumatoid arthritis accelerated by prednisone
Abstract:
Total body and area counts of intravenously injected (54)Mn were measured periodically in 29 in-patients. A heterogeneous group of 19 control patients showed fair reproducibility in the immediate distribution, and considerable individual variance in the subsequent loss of the isotope. Eight studies of the effects of feeding excesses of manganous sulfate to five patients showed acceleration of the rate of loss of the radioisotope from the whole body and the liver. These findings seem compatible with the presence of control mechanisms in man, operating to vary the metal's excretion, while tending to preserve constancy of its concentration in tissues. Slow turnover rates of the metal were demonstrated in seven out of eight patients with active rheumatoid arthritis, in one with hydralazine disease, but not in one arthritic undergoing an impressive, spontaneous remission. Statistically significant differences were encountered in the measurements of (54)Mn turnover of the total body, the thyroid, and the liver. Administration of prednisone induced clinical improvement and significant acceleration of these turnovers. Slow turnovers are characteristic of nutritional manganese deficiency. Therefore, serum and blood manganese determinations were performed by neutron activation analysis on 14 control patients, and on six patients with active rheumatoid arthritis. A statistically significant elevation of the red cell manganese concentration was encountered in patients with rheumatoid arthritis. This argued against the presence of classical tracemetal deficiency and called for an alternative explanation of these findings.
Insights
Manganese (Mn) turnover is slower in patients with rheumatoid arthritis, suggesting altered metal metabolism. Prednisone treatment accelerated Mn turnover, indicating potential therapeutic effects on this process.
Area of Science:
- Biochemistry
- Medical Isotopes
- Trace Element Metabolism
Background:
- Manganese (Mn) is an essential trace element with poorly understood homeostatic mechanisms in humans.
- Previous studies suggest individual variations in Mn distribution and loss, with potential regulatory controls.
- Nutritional manganese deficiency is associated with slow turnover rates.
Purpose of the Study:
- To investigate manganese (54Mn) kinetics and metabolism in patients with rheumatoid arthritis (RA) and other conditions.
- To explore the impact of manganous sulfate administration and prednisone treatment on Mn turnover.
- To determine if RA is associated with manganese deficiency or an alternative metabolic alteration.
Main Methods:
- Intravenous injection of radioactive manganese (54Mn) and periodic whole-body and regional measurements.
- Analysis of 54Mn distribution and loss patterns in control patients and those with RA.
- Assessment of 54Mn turnover following oral manganous sulfate or prednisone administration.
- Neutron activation analysis for serum and blood manganese levels in control and RA patients.
Main Results:
- Heterogeneous Mn distribution and variable loss observed in control patients; excess manganous sulfate accelerated Mn loss.
- Significantly slower 54Mn turnover rates were found in patients with active RA and hydralazine disease.
- Prednisone administration improved clinical symptoms and significantly accelerated Mn turnover in RA patients.
- Elevated red blood cell manganese concentration was observed in RA patients, contradicting classical trace metal deficiency.
Conclusions:
- Human manganese metabolism involves regulatory mechanisms for excretion and tissue concentration maintenance.
- Active rheumatoid arthritis is characterized by slow manganese turnover, distinct from nutritional deficiency.
- Prednisone treatment positively impacts manganese turnover in RA patients, suggesting a role in disease management.
- Elevated red cell manganese in RA points to a specific metabolic dysregulation rather than a simple deficiency.
Related Concept Videos
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
01:21Rheumatic Heart Disease III: Medical Management