Tissue gold levels after chrysotherapy. Annals ofthe Rheumatic Diseases

Although the use of gold salts in the treatment of rheumatoid arthritis is well established, the mode of action is still not known. The finding that gold is taken up by synovial tissue macrophages and accumulates in the lysosomes (Persellin and Ziff, 1966) has led to speculation that perhaps it acts either by lysosome stabilization, as does hydro-cortisone (Weissmann and Thomas, 1963), or by the inhibition of the lysosomal enzymes, acid phospha-tase, /J-glucuronidase, and cathepsin, as is known to occur in vitro (Ennis, Granda, and Posner, 1968). These mechanisms would presuppose a site of action of gold within the synovial membrane and cavity. Yet information on the quantitative aspects of gold deposition in the body during chrysotherapy i