Gold in modern rational medicine
Robert Koch (1843-1910) is one of the greatest biologists of his time. He received the Nobel prize of medicine in 1905 for his research on tuberculosis (he discovered the causative agent of this disease). He is also known for the creation of “Koch’s postulate” which is still used to link a pathogen to a disease. He is considered as one of the fathers of modern medicine along with Louis Pasteur and Joseph Lister. During his work on M. Tuberculosis, in 1980, Robert Koch discovered that gold cyanide, K[Au(CN)2], was bacteriostatic towards this agent of tuberculosis. Back then, no treatment existed for tuberculosis and therefore, within a span of 10 to 15 years, the whole world used gold as the golden standard to treat tuberculosis. The (wrong) suggestion that the same agent could be responsible of rheumatoid arthritis led to the use of gold therapy also for this disease. Jacques Forestier, a French physician, was the first person to report it in 1928. He treated his patient with 50 mg of gold thiopropanol sodium sulphonate (Allochrysine) as weekly intramuscular injections (3).
Gold therapy soon proved to be actually ineffective against tuberculosis. After 30-years of debate about the effectiveness of gold therapy in rheumatoid arthritis treatment and a clinical study sponsored by the Empire Rheumatism Council, it was finally reported in 1961, that gold therapy is effective against this disease (4).
At present, besides allochrysine which is still administered intra-muscularly, another drug receives the FDA approval for the treatment of rheumatoid arthritis, Auranofin. Auranofin has been approved in 1985. It is an oral drug to be taken twice a day. Research about the use of gold in medicine is on-going. As an example, it has been shown very recently that Auranofin is able to inhibit Sars-CoV-2 replication and to attenuate inflammation in human cells (5).