Colchicine and Non-steroidal Anti-inflammatory Drug Applications in the Treatment of COVID-19

Öz

The new coronavirus disease 2019 (COVID-19) pandemic continues to exist as an unavoidable crisis that affects the whole world. The old drugs with anti-inflammatory activity have come to the fore again in the search for treatment to reduce the morbidity and mortality of the disease. Colchicine is an alternative drug with immunomodulatory and potential anti-viral properties. Control of hyper inflammation triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the most important stage for the development of acute respiratory disease syndrome (ARDS). Because of inhibiting different inflammation pathways, colchicine treatment may be effective in preventing the development of ARDS associated with mortality in COVID-19. Again, the lack of immunosuppression effect, ease of use, and being economical are its superior features compared to other drugs. In this review, along with colchicine treatment, non-steroidal anti-inflammatory drug (NSAID) applications used in COVID-19 mostly due to its acute anti-inflammatory effects will be discussed in the light of current information.

Anahtar Kelimeler

• Colchicine
• COVID-19
• ARDS
• Ibuprofen

COVID-19 Tedavisinde Kolşisin ve Non-steroid Anti-inflamatuar İlaç Uygulamaları

Öz

Yeni koronavirus hastalığı 2019 (COVID-19) pandemisi tüm dünyayı etkileyen ve henüz önüne geçilemeyen bir kriz olarak varlığını devam ettirmektedir. Hastalığın morbidite ve mortalitesini azaltacak tedavi arayışları içinde anti-inflamatuar etkinliğe sahip eski ilaçlar tekrar gündeme gelmiştir. Kolşisin immünomodülatör ve potansiyel anti-viral özellikleri ile alternatif bir ilaçtır. Şiddetli akut solunum yolu sendromu koronavirus 2’nin (SARS-CoV-2) tetiklediği hiperinflamasyonun kontrol altına alınması akut solunumsal hastalık sendromu (Akut respiratuar distress sendromu, ARDS) gelişimi için en önemli aşamadır. Farklı inflamasyon yolaklarını inhibe etmesi nedeni ile kolşisin tedavisi COVID-19’da mortalite ile ilişkili ARDS gelişiminin önlemesinde etkili olabilir. Yine immunsupresyon etkisinin olmaması, kullanım kolaylığı ve ekonomik olması diğer ilaçlara göre üstün özellikleridir. Bu derlemede kolşisin tedavisi ile birlikte , akut anti-inflamatuar etkileri nedeni ile COVID-19’da kullanılan non-steroid anti-inflamatuar ilaç (NSAİİ) uygulamalarıda, güncel bilgiler eşliğinde tartışılacaktır.

Anahtar Kelimeler

• Kolşisin
• COVID-19
• ARDS
• İbuprofen
• Sitokin

Kaynakça

1. 1. Scarsi M, Piantoni S, Colombo E, Airó P, Richini D, Miclini M, et al. Association between treatment with colchicine and improved survival in a single-centre cohort of adult hospitalised patients with COVID-19 pneumonia and acute respiratory distress syndrome. Ann Rheum Dis. 2020;79(10):1286–9.
2. 2. Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020;382(18):1708–20.
3. 3. Batah SS, Fabro AT. Pulmonary pathology of ARDS in COVID-19: A pathological review for clinicians Vol. 176, Respiratory Medicine. 2021
4. 4. Reyes AZ, Hu KA, Teperman J, Wampler Muskardin TL, Tardif JC, Shah B, et al. Anti-inflammatory therapy for COVID-19 infection: The case for colchicine.Annals of the Rheumatic Diseases. 2020.
5. 5. https://jpma.org.pk/PdfDownload/7112........................................................................................................................................................................................................................................................................
6. 6. Spoto S, Valeriani E, Locorriere L, Anguissola GB, Pantano AL, Terracciani F, et al. Influenza B virus infection complicated by life-threatening pericarditis: A unique case-report and literature review. Vol. 19, BMC Infectious Diseases. 2019. p. 40–40.
7. 7. ISHIZUKA T, HISADA T, MONDEN T, TSUNEKAWA K, IIZUKA K, TSUKAGOSHI H, et al. A case of non-specific interstitial pneumonia effectively treated with a combination of prednisolone and colchicine, in which granulation tissue was extensive. Respirology .2005;10(4):541–4.
8. 8. Pereira EG, Guimarães TF, Bottino CB, D’Acri AM, Lima RB, Martins CJ. Sarcoidosis and chronic hepatitis C: Treatment with prednisone and colchicine. An Bras Dermatol. 2016;91(2):231–4.

9. 9. Akhmerov A, Marbán E. COVID-19 and the Heart. Vol. 126, Circulation Research. Lippincott Williams and Wilkins; 2020. p. 1443–55.
10. 10. Mogensen TH. Pathogen recognition and inflammatory signaling in innate immune defenses. Vol. 22, Clinical Microbiology Reviews. Clin Microbiol Rev; 2009. p. 240–73.
11. 11. Thompson MR, Kaminski JJ, Kurt-Jones EA, Fitzgerald KA. Pattern recognition receptors and the innate immune response to viral infection Vol. 3, Viruses. Viruses; 2011 p. 920–40.
12. 12. Strowig T, Henao-Mejia J, Elinav E, Flavell R. Inflammasomes in health and disease. Vol. 481, Nature. 2012. p. 278–86.
13. 13. Lamkanfi M, Festjens N, Declercq W, Berghe T Vanden, Vandenabeele P. Caspases in cell survival, proliferation and differentiation. Vol. 14, Cell Death and Differentiation. Cell Death Differ; 2007. p. 44–55.
14. 14. Castaño-Rodriguez C, Honrubia JM, Gutiérrez-Álvarez J, DeDiego ML, Nieto-Torres JL, Jimenez-Guardeño JM, et al. Role of severe acute respiratory syndrome coronavirus viroporins E, 3a, and 8a in replication and pathogenesis. MBio 2018 ;9(3).
15. 15. Satış H, Özger HS, Aysert Yıldız P, Hızel K, Gulbahar Ö, Erbaş G, et al. Prognostic value of interleukin-18 and its association with other inflammatory markers and disease severity in COVID-19. Cytokine . 2021;137.
16. 16. Van De Veerdonk FL, Netea MG. Blocking IL-1 to prevent respiratory failure in COVID-19. Vol. 24, Critical Care. BioMed Central; 2020.
17. 17. Castaño-Rodriguez C, Honrubia JM, Gutiérrez-Álvarez J, DeDiego ML, Nieto-Torres JL, Jimenez-Guardeño JM, et al. Role of severe acute respiratory syndrome coronavirus viroporins E, 3a, and 8a in replication and pathogenesis. MBio. 2018 ;9(3).
18. 18. Slobodnick A, Shah B, Krasnokutsky S, Pillinger MH. Update on colchicine, 2017. Vol. 57, Rheumatology (Oxford, England). Rheumatology (Oxford); 2018. p. i4–11. 19. Schlesinger N, Firestein BL, Brunetti L. Colchicine in COVID-19: an Old Drug, New Use. Vol. 6, Current Pharmacology Reports. Springer; 2020. p. 137–45.
19. 20. Leung YY, Yao Hui LL, Kraus VB. Colchicine-Update on mechanisms of action and therapeutic uses. Vol. 45, Seminars in Arthritis and Rheumatism. W.B. Saunders; 2015. p. 341–50.
20. 21. Ben-Chetrit E, Levy M. Does the lack of the P-glycoprotein efflux pump in neutrophils explain the efficacy of colchicine in familial Mediterranean fever and other inflammatory diseases? Med Hypotheses. 1998;51(5):377–80.
21. 22. Cronstein BN, Molad Y, Reibman J, Balakhane E, Levin RI, Weissmann G. Colchicine alters the quantitative and qualitative display of selectins on endothelial cells and neutrophils. J Clin Invest. 1995 Aug 1;96(2):994–1002.
22. 23. Chia EW, Grainger R, Harper JL. Colchicine suppresses neutrophil superoxide production in a murine model of gouty arthritis: A rationale for use of low-dose colchicine. Br J Pharmacol. 2008;153(6):1288–95.
23. 24. Ding AH, Porteu F, Sanchez E, Nathan CF. Downregulation of tumor necrosis factor receptors on macrophages and endothelial cells by microtubule depolymerizing agents. J Exp Med. 1990;171(3):715–27.
24. 25. Dupuis J, Sirois MG, Rhéaume E, Nguyen QT, Clavet-Lanthier M-É, Brand G, et al. Colchicine reduces lung injury in experimental acute respiratory distress syndrome. Veldhuizen RA, editor. PLoS One. 2020;15(12):e0242318.
25. 26. Leung YY, Yao Hui LL, Kraus VB. Colchicine-Update on mechanisms of action and therapeutic uses. Vol. 45, Seminars in Arthritis and Rheumatism. W.B. Saunders; 2015. p. 341–50.
26. 27. Ribeiro SA, Lopes C, Amaral R, Amaral A. The therapeutic potential of colchicine in the complications of COVID19. Could the immunometabolic properties of an old and cheap drug help? Metab Open. 2020;7:100045.
27. 28. Jackman RW, Rhoads MG, Cornwell E, Kandarian SC. Microtubule-mediated NF-κB activation in the TNF-α signaling pathway. Exp Cell Res. 2009;315(19):3242–9.
28. 29. Richter M, Boldescu V, Graf D, Streicher F, Dimoglo A, Bartenschlager R, et al. Synthesis, Biological Evaluation, and Molecular Docking of Combretastatin and Colchicine Derivatives and their hCE1-Activated Prodrugs as Antiviral Agents. ChemMedChem. 2019;14(4):469–83.
29. 30. Weiss SR, Navas-Martin S. Coronavirus Pathogenesis and the Emerging Pathogen Severe Acute Respiratory Syndrome Coronavirus. Microbiol Mol Biol Rev. 2005;69(4):635–64.
30. 31. Deftereos SG, Giannopoulos G, Vrachatis DA, Siasos GD, Giotaki SG, Gargalianos P, et al. Effect of Colchicine vs Standard Care on Cardiac and Inflammatory Biomarkers and Clinical Outcomes in Patients Hospitalized With Coronavirus Disease 2019: The GRECCO-19 Randomized Clinical Trial. JAMA Netw open. 2020;3(6):e2013136.
31. 32. Tardif J-C, Bouabdallaoui N, L’allier PL, Gaudet D, Shah B, Pillinger MH, et al. Efficacy of Colchicine in Non-Hospitalized Patients with COVID-19. medRxiv. 2021 ;2021.01.26.21250494. https://doi.org/10.1101/2021.01.26.21250494
32. 33. Bourguiba R, Delplanque M, Vinit C, Savey L, Grateau G, Hentgen V, et al. Clinical course of COVID-19 in a cohort of 342 familial Mediterranean fever patients with a long-term treatment by colchicine in a French endemic area. Annals of the Rheumatic Diseases. BMJ Publishing Group; 2020. https://pubmed.ncbi.nlm.nih.gov/33139307/
33. 34. Clinical Trials register - Search for Colchicine, covid. https://www.clinicaltrialsregister.eu/ctr-search/search?query=Colchicine%2C+covid
34. 35. Therapy G. COLCHICINE TABLETS.........................................................................................................................................................................................................................................................................
35. 36. Finkelstein Y, Aks SE, Hutson JR, Juurlink DN, Nguyen P, Dubnov-Raz G, et al. Colchicine poisoning: the dark side of an ancient drug. Clin Toxicol f. 2010;48(5):407–14.
36. 37. Voiriot G, Philippot Q, Elabbadi A, Elbim C, Chalumeau M, Fartoukh M. Risks Related to the Use of Non-Steroidal Anti-Inflammatory Drugs in Community-Acquired Pneumonia in Adult and Pediatric Patients. J Clin Med. 2019;8(6):786.
37. 38. https://www.bbc.com/turkce/haberler-dunya-51905372
38. 39. Russell B, Moss C, Rigg A, Van Hemelrijck M. COVID-19 and treatment with NSAIDs and corticosteroids: Should we be limiting their use in the clinical setting? Ecancermedicalscience. 2020;14.
39. 40. Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Vol. 8, The Lancet Respiratory Medicine. Lancet Publishing Group; 2020. p. e21.
40. 41. The use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with COVID-19. https://www.who.int/news-room/commentaries/detail/the-use-of-non-steroidal-anti-inflammatory-drugs-(nsaids)-in-patients-with-covid-19
41. 42. https://www.nice.org.uk/terms-and-........................................................................................................................................................................................................................................................................
42. 43. https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID Guidance.................................................................................................................................................