Colchicine reduces the activation of NLRP3 inflammasome in COVID-19 patients

• Published in: Inflammation research Vol. 72; no. 5; pp. 895 - 899
• Main Authors: Amaral, N. B., Rodrigues, T. S., Giannini, M. C., Lopes, M. I., Bonjorno, L. P., Menezes, P. I. S. O., Dib, S. M., Gigante, S. L. G., Benatti, M. N., Rezek, U. C., Emrich-Filho, L. L., Sousa, B. A., Almeida, S. C. L., Luppino-Assad, R., Veras, F. P., Schneider, A. H., Leiria, L. O. S., Cunha, L. D., Alves-Filho, J. C., Cunha, T. M., Arruda, E., Miranda, C. H., Pazin-Filho, A., Auxiliadora-Martins, M., Borges, M. C., Fonseca, B. A. L., Bollela, V. R., Del-Ben, C. M., Cunha, F. Q., Santana, R. C., Vilar, F. C., Zamboni, D. S., Louzada-Junior, P., Oliveira, R. D. R.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.05.2023; Springer Nature B.V
• Subjects: Allergology; Biomedical and Life Sciences; Biomedicine; Brief Report; Caspase-1; Clinical trials; Colchicine; Colchicine - therapeutic use; Coronaviruses; COVID-19; Cytokine storm; Dermatology; Humans; IL-1β; Immunology; Inflammasomes; Inflammasomes - metabolism; Interleukin 18; Interleukin-1beta - metabolism; Neurology; NLR Family, Pyrin Domain-Containing 3 Protein - metabolism; NLR Proteins; Patients; Pharmacology/Toxicology; Placebos; RBR; RBR8jyhxh; Rheumatology; Serum levels; COVID-19; Inflammasome; Colchicine; Cytokines
• ISSN: 1023-3830; 1420-908X; 1420-908X
• DOI: 10.1007/s00011-023-01718-y

Objective To evaluate whether colchicine treatment was associated with the inhibition of NLRP3 inflammasome activation in patients with COVID-19. Methods We present a post hoc analysis from a double-blinded placebo-controlled randomized clinical trial (RCT) on the effect of colchicine for the treatment of COVID-19. Serum levels of NOD-like receptor protein 3 (NLRP3) inflammasome products—active caspase-1 (Casp1p20), IL-1β, and IL-18—were assessed at enrollment and after 48–72 h of treatment in patients receiving standard-of-care (SOC) plus placebo vs. those receiving SOC plus colchicine. The colchicine regimen was 0.5 mg tid for 5 days, followed by 0.5 mg bid for another 5 days. Results Thirty-six patients received SOC plus colchicine, and thirty-six received SOC plus placebo. Colchicine reduced the need for supplemental oxygen and the length of hospitalization. On Days 2–3, colchicine lowered the serum levels of Casp1p20 and IL-18, but not IL-1β. Conclusion Treatment with colchicine inhibited the activation of the NLRP3 inflammasome, an event triggering the ‘cytokine storm’ in COVID-19. Trial registration numbers RBR-8jyhxh