Reducing Chronic Inflammation in Atherosclerosis with an Old Drug

Inflammation plays a crucial role in atherosclerosis progression. Recently, the COLCOT study has shown the benefits of colchicine in cardiovascular events. 

Colchicina para reducir la inflamación crónica de la aterosclerosis

This good old drug has an inflammatory effect which attenuates the NLRP3 cascade. This explains its effect on uric acid crystals in gout, which might be the same on atherosclerosis cholesterol crystals. 

This study called LoDoCo2 and published in Circulation, studied the potential anti-inflammatory effect of colchicine in patients with chronic coronary artery disease comparing lab exams 30 days before and after receiving the drug. 

It included 174 patients that had suffered acute coronary syndrome within the prior 6 months. 

A blood sample was obtained from all patients to quantify 184 proteins associated with inflammation at baseline, and another one after 30 days of receiving colchicine 0.5 mg/day plus all the standard medical treatment. 


Read also: AHA 2019 | COLCOT: Colchicine and the Return of the Anti-Inflammatory Theory.


At 30 days, there was a significant reduction of 37 proteins associated to inflammation (p<0.05). Attenuation of the NLRP3 inflammatory cascade was supported by a reduction of interleukin 18, IL-1 receptor antagonist, and IL-6. 

Other pro-inflammatory proteins not directly associated with the NLRP3 pathway also saw a reduction, especially those related to neutrophil degranulation. 

Conclusion

This study showed a significant reduction of multiple proteins related with inflammation after 30 days of treatment with low doses of colchicine in patients with chronic CAD. The anti-inflammatory effect of this drug exceeds the NLRP3 cascade effect, which suggests an important role in neutrophil inhibition. 

Original Title: Colchicine Attenuates Inflammation Beyond the Inflammasome in Chronic Coronary Artery Disease: A LoDoCo2 Proteomic Substudy.

Reference: Tjerk S.J. Opstal et al. Circulation. 2020 Nov 17;142(20):1996-1998. doi: 10.1161/CIRCULATIONAHA.120.050560.


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