Collagen synthesis penicillamine

In the past, penicillamine, because of its effects on collagen synthesis, has been suspected of interfering with normal wound healing. Experience of 217 operations in 150 patients did not show such effects, and consequently, there does not seem to be a need for stopping penicillamine before surgery (278). On the other hand, a few reports have suggested that penicillamine can, at least in some patients, have deleterious effects on wound healing (177,279). 

Ulcerative lesions of the vagina can occur in patients taking penicillamine, as a manifestation of pemphigus or cicatricial pemphigoid, or following impaired collagen synthesis (SED-8, 533) (315). 

The efficacy of penicillamine and cysteine in the treatment of rheumatoid arthritis was considered modest only further enhancement in potency and improvement of side-effects are needed. Sulfhydryl compounds possess an inhibitory effect on collagen synthesis but their immunochemical properties remain to be elucidated. 

Penicillamine is an analog of cysteine. Only the d-isomer is used. In patients with progressive rheumatoid arthritis which is refractory to treatment with gold compounds it may retard progression of articular cartilage and bone destruction. For these effects to become apparent a latency period of 3 4 month often is needed. Its mechanism is unknown but it supposedly interferes with the synthesis of DNA, collagen and mucopolysaccharides. 

The synthesis of collagen in vitro and in vivo in rats is inhibited by D-penicillamine, probably due to its ability to chelate Fe , a cofactor for proline hydroxylase (EC 1.14.11.2). ... 

---