Mortality in Longterm Survivors from Myocardial Infarction after D-Penicillamine Therapy

Abstract

At the present stage of research the drug therapy of human atherosclerosis aims at the reduction of the so called risk factors, especially arterial hypertension and hyperlipidemia, as well as at the blood coagulation respectively platelet aggregation (Anonym, 1975; Anonym, 1975; Ball and Turner, 1975; Buchwald, Moore and Varco, 1974; Boston collaborative drug surveillance group, 1974; Epstein, 1971; Elwood, Cochrane et al., 1974; Fejfar, 1975; Hammond and Garfinkel, 1975; Hollander, 1973; McCormick, 1973). Until now we have no knowledge that a drug study with human probands has been performed for the prevention of atherosclerotic heart disease which was based on the conception of suppressing the mesenchymal reaction, — if you will not regard the aspirin studies as such —, although there are good arguments from both theory and animal experiments for the conception of the mesenchymal reaction in the arterial wall as the initial factor for the development of human atherosclerosis (Gresham, 1976; Hauss, 1963; Hauss, 1976; Hauss, 1976; Hauss, Junge-Hülsing and Gerlach, 1968; Haust, More and Movat, 1960; Wissler, 1968; Wissler and Geer, 1972). The results of a series of animal experiments with penicillamine have proved the mesenchyme suppressive quality of the drug. Hauss and coworkers have shown that the growth of granuloma after implantation of cotton pellets was significantly inhibited by the drug, and the incorporation rate of 35-sulfate into the proteoglycanes of the connective tissue of the granuloma was significantly reduced. They showed also that the reaction of mesenchyme metabolism on formaline edema could be suppressed (Müller, Wagner, Wirth, Junge-Hülsing and Hauss, 1971; Müller, Wagner, Hrubesch, Büchner, Wirth, Junge-Hülsing and Hauss, 1971). An influence of penicillamine on the synthesis of collagen was demonstrated by other authors (Deshmukh and Nimmi, 1969; Harris and Sjoerdsma, 1966). Hollander (1973) has presented convincing evidence that penicillamine is capable of reducing the synthesis of collagen and elastin in the aorta of animals fed with atherogenic diet as well marked as colchicine does (Table I).