Which of the following best describes the mechanism of action of Colchicine in Acute Gout?
Colchicine produces its anti-inflammatory effects by binding to the intracellular protein tubulin, thereby preventing its polymerization into microtubules and leading to the inhibition of leukocyte migration. Colchicine-treated neutrophils develop a &;drunken walk&;. Colchicine is neither a uricosuric nor an analgesic agent, although it relieves pain in acute attacks of gout. Colchicine does not alter the metabolism or excretion of urates. Colchicine: It is an alkaloid from Colchicicum autumnalev which was used in gout since 1763. Beacause it has a narrow therapeutic window and a high rate of side effects, paicularly at higher doses it is considered as second-line therapy. Colchicine is neither analgesic nor anti-inflammatory, but it specifically suppresses gouty inflammation. Colchicine produces its anti-inflammatory effects by binding to the intracellular protein tubulin, thereby preventing its polymerization into microtubules and leading to the inhibition of leukocyte migration and phagocytosis. Colchicine-treated neutrophils develop a &;drunken walk&; It also inhibits the formation of leukotrienes B4 and IL-1b. It relieves the pain and inflammation of gouty ahritis in 12-24 hours without altering the metabolism or excretion of urates and without other analgesic effects. It is indicated for acute gout and is also used between attacks ("Inter-critical Period") for prolonged prophylaxis (at low doses) It often causes diarrhea and occasionally causes nausea, vomiting and abdominal pain. Hepatic necrosis, acute renal failure, disseminated intravascular coagulation, and seizures have also been observed. Ref: Katzung 14th edition Pgno: 660
Inhibition of chemotactic Factors
Tubulin binding and inhibition of leukocyte migration
Enhanced metabolism of Urate crystals
Enhanced excretion of Uric acid
Other topics and Adverse effects