On the effects of antirheumatic drugs on protein sulphydryl reactivity in human serum

Hall and Gillan (1979), using single point estimations, suggest that stimulation of sulphydryl-disulphide exchange reactions in vivo may distinguish 'specific antirheumatic' drugs from non-steroidal antiinflammatory agents (NSAIA's) in the treatment of rheumatoid arthritis (RA). We feel that the significance of this 'rate reaction' is questionable since the increase they observed in untreated rheumatoid patients compared with normal subjects increased further away from normality with specific antirheumatic drug therapy. Moreover patients satisfied with NSAIA's alone usually have a lower level of disease activity than those requiring specific antirheumatic drugs. Thus, the differences in reaction rate observed between the various groups in Fig. 1 of Hall & Cillan's paper may simply be a reflection of differences in disease severity. As the authors point out, Gerber et al (1967) have shown that high dose aspirin affects sulphydryl reactivity which perhaps suggests that sulphydryl exchange reactions do not differentiate between specific antirheumatic and NSAIA's. To evaluate this further we have made use of a similar, though not directly comparable, reaction in making serial assessments on