COPPER AND ZINC STATUS IN RHEUMATOID-ARTHRITIS - STUDIES OF PLASMA, ERYTHROCYTES, AND URINE, AND THEIR RELATIONSHIP TO DISEASE-ACTIVITY MARKERS AND PHARMACOLOGICAL TREATMENT

We studied the status of copper and zinc in rheumatoid arthritis (RA). The aims of the work were to ascertain whether or not RA is associate d with copper and/or zinc deficiency, to establish the relationship be tween these trace metals and the main biohumoral and clinical indices of the disease, and to examine the effect on copper and zinc of the dr ugs normally used by RA patients. Metal levels were measured by atomic absorption spectroscopy in the plasma, whole blood cells and 24 hr ur ine of 120 RA patients; 70 patients suffering from primary osteoarthri tis were used as the control group. In the plasma of RA patients coppe r and ceruloplasmin levels were found to be significantly increased wh ereas zinc levels were significantly decreased No major variations wer e observed in the blood cell and 24 hr urine copper and zinc levels. P lasma copper was significantly correlated with some of the biohumoral markers of RA, but did not correlate with any of the clinical indices of the disease. Plasma zinc was significantly correlated with numerous of the biohumoral as well as clinical markers of RA. With the excepti on of an increased urinary excretion of copper in D-penicillamine trea ted RA patients, drug therapy did not influence the copper status in R A. Conversely, plasma zinc was found to be lower in RA patients taking NSAIDs and/or steroids. These results suggest the following conclusio ns: i) RA patients do not seem to be deficient in either copper or zin c; ii) plasma copper appears to be a poor index of RA severity; iii) p lasma zinc could have some practical value in defining the overall sev erity of the disease.