Research progress of colchicine in cardiovascular diseases

doi:10.3760/cma.j.issn.1007-1245.2022.12.032

Abstract

Abstract:

Colchicine is a unique and complex anti-inflammatory agent, which has been used to prevent the acute inflammatory attack of gout for decades. Its potential in a series of cardiovascular diseases has been proved by clinical trials in recent years. Coronary heart disease is a chronic vascular inflammatory disease, the main pathological feature of which is that the accumulation of subintimal lipoprotein leads to abnormal immune response, further results in the formation of lipid rich inflammatory plaque. Inflammatory response is closely related to the occurrence and development of coronary heart disease, of which the infiltration and activity of neutrophils are considered to be an important mechanism of the progression. Colchicine can affect the mitotic process of cells by binding with tubulin dimer, inhibit the leukocyte motility, exocytosis, and phagocytosis triggered by tubulin, interrupt the activation and phagocytosis of NLRP3 inflammasome, prevent the production of leukotrienes and cytokines, and reduce the chemotaxis of inflammatory cells caused by microtubule, especially the chemotaxis, adhesion, and recruitment of neutrophils. The effect of colchicine on platelets is mainly manifested in the inhibition of platelet activation and the interaction between platelets and leukocytes. Anti-inflammatory and anti-platelet aggregation are important mechanisms of colchicine in the treatment of cardiovascular diseases, and anti-inflammatory may be the core mechanism of colchicine. Low-dose, long-duration colchicine intervention regimen may have substantial benefits for patients with cardiovascular diseases. This paper reviews the application of colchicine as an additional therapy in cardiovascular diseases such as pericarditis, coronary heart disease, acute coronary syndrome, in-stent restenosis, atrial fibrillation, and heart failure.

Key words: Colchicine, Pericarditis, Coronary heart disease, Acute coronary syndrome, In-stent restenosis, Atrial fibrillation, Heart failure

摘要： 秋水仙碱是一种独特、复杂的抗炎剂，几十年来一直用于预防痛风的急性炎症发作。近年来，临床试验已证明其在一系列心血管疾病中的潜力。冠心病是一种慢性血管炎症性疾病，其主要病理特征是内膜下脂蛋白累积引发异常免疫反应，进而导致富含脂质的炎症斑块形成。炎性反应与冠心病的发生发展密切相关，其中中性粒细胞的浸润及活动被认为是冠心病进展的重要机制。秋水仙碱可通过与微管蛋白二聚体结合而影响细胞的有丝分裂过程，抑制微管蛋白引发的白细胞运动、胞吐和吞噬作用，中断核苷酸结合寡聚化结构域样受体蛋白3炎症小体激活与吞噬，中断白三烯与细胞因子生成，减少微管相关炎症细胞趋化，尤其是中性粒细胞趋化、黏附和募集。秋水仙碱对血小板的作用主要表现在抑制血小板活化及血小板与白细胞相互作用2个方面。抗炎、抗血小板聚集是秋水仙碱治疗心血管疾病的重要机制，其中抗炎可能是秋水仙碱发挥治疗效果的核心机制。低剂量、长疗程的秋水仙碱干预方案可能对心血管疾病患者具有实质性好处。本文主要对秋水仙碱作为附加疗法在心包炎、冠心病、急性冠脉综合征、支架内再狭窄、心房颤动、心力衰竭等心血管疾病中的应用作一综述。

关键词: 秋水仙碱, 心包炎, 冠心病, 急性冠脉综合征, 支架内再狭窄, 心房颤动, 心力衰竭

Dong Wenjing, Sun Jingwu, Zhang Ning, Liu Zhen, Shi Xinye, Liu Jingyang. Research progress of colchicine in cardiovascular diseases [J]. International Medicine and Health Guidance News, 2022, 28(12): 1767-1771.

董文敬, 孙经武, 张宁, 刘振, 石新烨, 刘婧玚. 秋水仙碱在心血管疾病中应用的研究进展[J]. 国际医药卫生导报, 2022, 28(12): 1767-1771.

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