Bio-inorganic effects of D-penicillamine in children and in the elderly.

The principle mechanisms of action of dimethylcysteine (D-penicillamine) are thiazolidine formation, sulphhydryl -disulphide exchange, chelation and superoxide dismutase-like activity; as a consequence, it can enter into many varied biological interactions. Thiazolidine formation with maturing collagen makes D-penicillamine potentially teratogenic; sulphhydryl -disulphide exchange allows the formation of a mixed disulphide with L-cysteine from the L-cystine dimer; chelation permits it to bind metals such as copper; and superoxide scavenging makes it theoretically capable of influencing the inflammatory response of specific cell systems. Not surprising, D-penicillamine is of value in the treatment of cystinuria, Wilson's disease, juvenile rheumatism, rheumatoid arthritis and various other conditions.