Interactions of zinc and molybdenum with copper in therapy of Wilson's disease

We review two newer treatments for Wilson's disease that each use an interaction of another metal with Cu to bring about therapeutic benefit. The two metals are Zn, in the form of the acetate salt, and Mo in the form of ammonium tetrathiomolybdate (TM). Zn, which blocks absorption of Cu in the intestine by inducing intestinal cell metallothionein, is used for maintenance therapy, treatment of the presymptomatic patient from the beginning, and treatment of the pregnant patient. TM, which complexes Cu in a tripartite complex with protein, is used for the initial treatment of neurologically presenting patients.