Aug 15, 2019
Colchicine is a lily plant that has been used to treat gout with its seeds and bulb extracts thousands of years ago. Its active ingredient, "colchicine", can effectively inhibit cell mitosis and reduce inflammatory reactions. The "medicine" of colchicine for the treatment of acute gouty arthritis. Most of the time, if used properly, colchicine can have immediate and dramatic effects on relieving joint pain caused by gout. The 2012 American College of Rheumatology (ACR) guidelines state that colchicine is recommended to control inflammation within 36 hours of an acute gout attack. In the pre-gout period, colchicine can prevent gout attacks.
The mechanism of action of colchicine to exert anti-inflammatory properties is complicated. It is generally recognized that colchicine can bind to free tubulin. When these tubulins are assembled into microtubules, the bound colchicine blocks further polymerization of the microtubules, thereby exhibiting dose-dependent inhibition of cell migration, cytokine release, and intracellular transport. Colchicine can alter the expression of L-selectin in neutrophils and the distribution of E-selectin in endothelial cells, and reduce the release of chemokine leukotriene B4, thereby inhibiting neutrophil adhesion, migration, and recruitment, and also changes the deformability of white blood cells
In addition, colchicine can inhibit the activation of NLRP3 inflammatory bodies induced by uric acid and calcium pyrophosphate crystals, thereby inhibiting caspase-1 activation and IL-1β and IL-18 release. NLRP3 inflammatory corpuscles are mainly expressed in myeloid cells, which also explains the clinical use of colchicine for the treatment of neutrophils and mononuclear/macrophage-associated diseases (innate immunity) rather than adaptive immune-related diseases.
On the one hand, colchicine can be used to eliminate inflammation and quickly relieve pain when acute gout attacks occur. On the other hand, it can also be combined with uric acid-lowering drugs to prevent acute gout attacks, which is the first-line drug for gout medication. Colchicine has been used for the treatment of gout long ago. In practical applications, the effect of colchicine is recognized by the majority of patients.
Colchicine can effectively reduce the activity and phagocytosis of leukocytes, reduce the formation of lactic acid, thereby reducing the deposition of urate crystals, reducing inflammation and playing a role in rapid analgesia. It needs to be clear that colchicine is an acute anti-inflammatory drug, not a uric acid-lowering drug.
Colchicine is only for the prevention of pain relief and acute gout. It is not recommended to take it for a long time every day. The sooner the application, the better the effect. It is recommended that gout patients start taking colchicine when there is a premonition. If the symptoms have been more than 48 hours, colchicine is no longer recommended because colchicine can not prevent the already started inflammation. reaction
The side effects of colchicine mainly include the following:
1.Digestive tract reaction: Expressed as nausea, loss of appetite, vomiting, abdominal discomfort and diarrhea.
2. Bone marrow toxicity: Mainly to inhibit the hematopoietic function of the bone marrow, leading to leukopenia, and aplastic anemia.
3.Liver damaging: Can cause abnormal liver function, severe cases can occur jaundice.
4.Kidney damage: Can occur proteinuria, generally does not cause renal failure
5.Others: Including hair loss, skin irritation, and depression.