Title:The Role of Colchicine in the Prevention of Cerebrovascular Ischemia
Volume: 24
Issue: 6
Author(s): Georgios Tsivgoulis*, Aristeidis H. Katsanos, Georgios Giannopoulos, Vasiliki Panagopoulou, Dalius Jatuzis, Robin Lemmens, Spyridon Deftereos and Peter J. Kelly
Affiliation:
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN,United States
Keywords:
Colchicine, inflammation, stroke, cerebral ischemia, transient ischemic attack, macrophages, prevention.
Abstract: Introduction: Despite the proven efficacy of anti-thrombotic, lipid-lowering, anti-hypertensive therapies
and lifestyle modification changes for secondary ischemic stroke prevention, the risk of recurrent stroke,
coronary events and vascular death remains substantial even for patients treated with high rates of established
secondary preventive medications.
Methods: In the present review, we summarize available literature data on the association between systemic inflammation
and symptomatic atherosclerosis including recurrent cerebral ischemia. We also highlight the potential
role of colchicine in the suppression of atherosclerosis-induced inflammation, plaque stabilization and thromboembolism
prevention.
Results: Accumulating evidence suggests that inflammation is of key importance in the pathophysiology of atherosclerotic
plaque de-stabilization and thromboembolism, with inflammatory cells being involved in all stages of
atherosclerosis development. Therefore, anti-inflammatory therapies targeting the atherosclerotic plaque inflammation
may be important contributors in plaque stabilization and in the prevention of thromboembolic events.
Colchicine is known to have multiple anti-inflammatory properties including inhibition of microtubule polymerization,
leading to reduced secretion in monocyte-macrophages. Currently the randomized controlled CONVINCE
trial is enrolling stroke patients to evaluate the effect of a daily low-dose of colchicine in reducing the rate of
recurrent stroke and major vascular events.
Conclusion: Inflammatory pathways seem to be key mediators in the development of atherosclerotic process,
atheromatous plaque destabilization and thromboembolism. Colchicine as a novel therapeutic agent could be a
safe and effective inhibitor of the inflammation cascade in patients with extra- or intracranial atherosclerosis or
arteriolosclerosis, resulting in reduced vascular events.
