The role of physical exercise in diseases treated with colchicine - an ancient drug with novel clinical applications
DOI:
https://doi.org/10.12775/QS.2024.15.51771Keywords
colchicine, gout, physical exercise, athletes, rheumatologic diseases, Cardiovascular disease, COVID-19, acute coronary syndromeAbstract
Colchicine, a lipid-soluble alkaloid derived from Colchicum autumnale, has a long history of use dating back to ancient Egypt. Traditionally used to alleviate pain and swelling, colchicine is now administered for various diseases, including gout and Familial Mediterranean Fever (FMF). Recent studies have expanded its applications to atherosclerotic cardiovascular diseases, such as acute coronary syndromes and COVID-19. This review aims to summarize the diverse clinical applications of colchicine, with a particular focus on its role in athletes and the synergistic effects of physical exercise in these conditions.
Colchicine exhibits broad anti-inflammatory effects primarily by disrupting microtubule functions, which impairs neutrophil migration and reduces cytokine production. Despite its narrow therapeutic window and potential for drug interactions, colchicine is considered safe and effective for managing conditions like gout, FMF, and acute coronary syndromes. Physical exercise complements colchicine treatment by enhancing symptom control and disease management. However, the role of colchicine in COVID-19 treatment remains inconclusive, necessitating further research.
References
Angelidis C, Kotsialou Z, Kossyvakis C, et al. Colchicine Pharmacokinetics and Mechanism of Action. Current Pharmaceutical Design. 2018;24(6):659-663. doi:10.2174/1381612824666180123110042
Leung YY, Yao Hui LL, Kraus VB. Colchicine—Update on mechanisms of action and therapeutic uses. Seminars in Arthritis and Rheumatism. 2015;45(3):341-350. doi:10.1016/j.semarthrit.2015.06.013
Ben-Chetrit E, Bergmann S, Sood R. Mechanism of the anti-inflammatory effect of colchicine in rheumatic diseases: a possible new outlook through microarray analysis. Rheumatology. 2005;45(3):274-282. doi:10.1093/rheumatology/kei140
Dalbeth N, Lauterio TJ, Wolfe HR. Mechanism of Action of Colchicine in the Treatment of Gout. Clinical Therapeutics. 2014;36(10):1465-1479. doi:10.1016/j.clinthera.2014.07.017
Finkelstein Y, Aks SE, Hutson JR, et al. Colchicine poisoning: the dark side of an ancient drug. Clinical Toxicology. 2010;48(5):407-414. doi:10.3109/15563650.2010.495348
Hansten PD, Tan MS, Horn JR, et al. Colchicine Drug Interaction Errors and Misunderstandings: Recommendations for Improved Evidence-Based Management. Drug Safety. 2022;46(3):223-242. doi:10.1007/s40264-022-01265-1
Robinson PC, Terkeltaub R, Pillinger MH, et al. Consensus Statement Regarding the Efficacy and Safety of Long-Term Low-Dose Colchicine in Gout and Cardiovascular Disease. The American Journal of Medicine. 2022;135(1):32-38. doi:10.1016/j.amjmed.2021.07.025
Harris R, Marx G, Gillett M, Kark A, Arunanthy S. Colchicine-induced bone marrow suppression: treatment with granulocyte colony-stimulating factor. The Journal of Emergency Medicine. 2000;18(4):435-440. doi:10.1016/s0736-4679(00)00160-8
Imazio M, Nidorf M. Colchicine and the heart. European Heart Journal. 2021;42(28):2745-2760. doi:10.1093/eurheartj/ehab221
Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes: Developed by the task force on the management of acute coronary syndromes of the European Society of Cardiology (ESC). European Heart Journal. 2023;44(38):3720-3826. doi:10.1093/eurheartj/ehad191
Nidorf SM, Fiolet ATL, Mosterd A, et al. Colchicine in Patients with Chronic Coronary Disease. New England Journal of Medicine. 2020;383(19):1838-1847. doi:10.1056/nejmoa2021372
Imazio M. Colchicine for Recurrent Pericarditis (CORP). Annals of Internal Medicine. 2011;155(7):409. doi:10.7326/0003-4819-155-7-201110040-00359
FitzGerald JD, Dalbeth N, Mikuls T, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Care & Research. 2020;72(6):744-760. doi:10.1002/acr.24180
Treatment of gout flare. Practical Medicine for doctors. Accessed May 5, 2024. https://www.mp.pl/reumatologia/wytyczne/284440,leczenie-napadu-dny-moczanowej
Richette P, Doherty M, Pascual E, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Annals of the Rheumatic Diseases. 2016;76(1):29-42. doi:10.1136/annrheumdis-2016-209707
Slobodnick A, Shah B, Krasnokutsky S, Pillinger MH. Update on colchicine, 2017. Rheumatology. 2017;57(suppl_1):i4-i11. doi:10.1093/rheumatology/kex453
Dinarello CA, Wolff SM, Goldfinger SE, Dale DC, Alling DW. Colchicine Therapy for Familial Mediterranean Fever. New England Journal of Medicine. 1974;291(18):934-937. doi:10.1056/nejm197410312911804
Bhatt H, Cascella M. Familial Mediterranean Fever. StatPearls. Published online July 31, 2023.
Sevoyan MK, Sarkisian TF, Beglaryan AA, Shahsuvaryan GR, Armenian HK. Prevention of Amyloidosis in Familial Mediterranean Fever with Colchicine: A Case-Control Study in Armenia. Medical Principles and Practice. 2009;18(6):441-446. doi:10.1159/000235892
Livneh A, Zemer D, Siegal B, Laor A, Sohar E, Pras M. Colchicine Prevents Kidney Transplant Amyloidosis in Familial Mediterranean Fever. Nephron. 1992;60(4):418-422. doi:10.1159/000186801
Lidar M, Kedem R, Langevitz P, Pras M, Livneh A. Intravenous colchicine for treatment of patients with familial Mediterranean fever unresponsive to oral colchicine. The Journal of rheumatology. 2003;30(12):2620-2623.
Surma S, Basiak M, Romańczyk M, Filipiak KJ, Okopień B. Colchicine — From rheumatology to the new kid on the block: Coronary syndromes and COVID-19. Cardiology Journal. 2023;30(2):297-311. doi:10.5603/cj.a2021.0123
Grossman C, Farberov I, Feld O, Livneh A, Ben-Zvi I. Efficacy and safety of long-term treatment with intravenous colchicine for familial Mediterranean fever (FMF) refractory to oral colchicine. Rheumatology International. 2019;39(3):517-523. doi:10.1007/s00296-018-04237-w
Deligiannis A, Dervisopoulou E, Kouidi E. Usefulness of colchicine for Covid-19 myopericarditis in athletes. A case report and review of the literature. Case Reports and Reviews. 2021;2(1). doi:10.33425/2693-1516.1015
Schellhorn P, Klingel K, Burgstahler C. Return to sports after COVID-19 infection. European Heart Journal. 2020;41(46):4382-4384. doi:10.1093/eurheartj/ehaa448
Brito D, Meester S, Yanamala N, et al. High Prevalence of Pericardial Involvement in College Student Athletes Recovering From COVID-19. JACC: Cardiovascular Imaging. 2021;14(3):541-555. doi:10.1016/j.jcmg.2020.10.023
Starekova J, Bluemke DA, Bradham WS, et al. Evaluation for Myocarditis in Competitive Student Athletes Recovering From Coronavirus Disease 2019 With Cardiac Magnetic Resonance Imaging. JAMA Cardiology. 2021;6(8):945. doi:10.1001/jamacardio.2020.7444
Phelan D, Kim JH, Chung EH. A Game Plan for the Resumption of Sport and Exercise After Coronavirus Disease 2019 (COVID-19) Infection. JAMA Cardiology. 2020;5(10):1085. doi:10.1001/jamacardio.2020.2136
Aoi W, Naito Y. Immune Function, Nutrition, and Exercise. In: Nutrition and Enhanced Sports Performance. Elsevier; 2019:83-95. Accessed May 12, 2024. http://dx.doi.org/10.1016/b978-0-12-813922-6.00007-2
Agha-Alinejad H, Ahmadi Hekmatikar AH, Ruhee RT, et al. A Guide to Different Intensities of Exercise, Vaccination, and Sports Nutrition in the Course of Preparing Elite Athletes for the Management of Upper Respiratory Infections during the COVID-19 Pandemic: A Narrative Review. International Journal of Environmental Research and Public Health. 2022;19(3):1888. doi:10.3390/ijerph19031888
Steensberg A, Fischer CP, Keller C, Møller K, Pedersen BK. IL-6 enhances plasma IL-1ra, IL-10, and cortisol in humans. American Journal of Physiology-Endocrinology and Metabolism. 2003;285(2):E433-E437. doi:10.1152/ajpendo.00074.2003
Rose GL, Skinner TL, Mielke GI, Schaumberg MA. The effect of exercise intensity on chronic inflammation: A systematic review and meta-analysis. Journal of Science and Medicine in Sport. 2021;24(4):345-351. doi:10.1016/j.jsams.2020.10.004
Shinde S, Shah S. Impact of physical activity on gouty arthritis: A systematic review. D Y Patil Journal of Health Sciences. 2021;9(4):140. doi:10.4103/dypj.dypj_65_21
Schlesinger N, Detry MA, Holland BK, et al. Local ice therapy during bouts of acute gouty arthritis. The Journal of rheumatology. 2002;29(2):331-334.
Gwinnutt JM, Wieczorek M, Cavalli G, et al. Effects of physical exercise and body weight on disease-specific outcomes of people with rheumatic and musculoskeletal diseases (RMDs): systematic reviews and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs. RMD Open. 2022;8(1):e002168. doi:10.1136/rmdopen-2021-002168
Anna M. Accessed May 2, 2024. https://plantura.garden/uk/flowers-perennials/autumn-crocus/autumn-crocus-overview
Efficacy and Safety of Colchicine in Patients With Chronic Stable Coronary Disease. American College of Cardiology. Accessed May 9, 2024. https://www.acc.org/Latest-in-Cardiology/Articles/2020/10/30/15/06/Efficacy-and-Safety-of-Colchicine-in-Patients-With-Chronic-Stable-Coronary-Disease
Papageorgiou N, Briasoulis A, Lazaros G, Imazio M, Tousoulis D. Colchicine for prevention and treatment of cardiac diseases: A meta‐analysis. Cardiovascular Therapeutics. 2016;35(1):10-18. doi:10.1111/1755-5922.12226
Rachma B, Putra PYP, Putri DAE, Zulaifah Z, Prameswari AS. Colchicine as adjuvant therapy in COVID-19 patients: a meta-analysis. International Journal of Public Health Science (IJPHS). 2022;11(4):1458. doi:10.11591/ijphs.v11i4.21837
Vitiello A, Ferrara F. Colchicine and SARS-CoV-2: Management of the hyperinflammatory state. Respiratory Medicine. 2021;178:106322. doi:10.1016/j.rmed.2021.106322
Hariyanto TI, Halim DA, Jodhinata C, Yanto TA, Kurniawan A. Colchicine treatment can improve outcomes of coronavirus disease 2019 (COVID‐19): A systematic review and meta‐analysis. Clinical and Experimental Pharmacology and Physiology. 2021;48(6):823-830. doi:10.1111/1440-1681.13488
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Copyright (c) 2024 Julia Rejdych, Katarzyna Podyma, Sara Rosołowska-Żak, Maria Sambura, Wiktoria Sas, Gracja Ryznar, Piotr Pierzchała, Michalina Minkowska, Krystyna Chimiak, Gabriela Bylica
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