Physicians first used injections of gold salts in the early 1900s to ease arthritis, but treatment took months to take effect and side effects included rashes, mouth sores, and kidney damage. Now treatments like methotrexate and biologically engineered drugs are preferred over gold. Scientists at Duke University Medical Center have discovered how the healing properties of gold work, which may make the building of new and safer-acting, gold-based treatments possible.

Dr. David Pisetsky of Duke studied a particular molecule, HMBG1, which provokes inflammation — the key process underlying the development of rheumatoid arthritis. HMBG1 is a dual-function molecule, meaning it behaves one way when inside the nucleus of a cell, and another way when released from the cell.

Pisetsky, working with colleagues at the University of Pittsburgh and the Karolinska Institute in Sweden, stimulated mouse and human immune system cells to secrete HMGB1, and then treated them with gold salts. They found that the gold inhibits the release of HMGB1 by interfering with the activity of two helper molecules that ease HMGB1's release from the cell, interferon beta and nitric oxide. That, in turn, should lessen the amount available to provoke the immune system and therefore weaken the inflammatory response.

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