Colchicine treatment of liver fibrosis.
OBJECTIVE
Because of its antifibrotic and anti-inflammatory effects, colchicine has been proposed as a treatment for liver disease. The results from clinical trials have however been inconsistent. The aim of the present study was to evaluate the effect of colchicine in the treatment of patients with hepatic fibrosis of various etiologies.


METHODS
Thirty-eight patients were randomized to receive either colchicine 1 mg per day (n=21, group A) or no antifibrotic agent (n=17, group B). Treatment lasted for at least 12 months. Liver biopsy was performed prior to entry and after 12 months. Liver function tests, serum aminoterminal peptide of procollagen III (PIIINP) levels and CD4:CD8 ratio of peripheral blood T lymphocytes (PBTLs) were performed at baseline and bimonthly or every 4 months post-treatment.


RESULTS
Mean albumin serum levels increased 12 months post-treatment period only in group A (p<0.05). Mean serum PIIINP levels did not change significantly after 12 months of treatment in group A; in 7 patients a reduction in mean serum PIIINP levels was noticed during 24-month post-treatment follow-up period (p<0.05). At baseline, a correlation between focal or bridging necrosis and CD4:CD8 ratio of PBTLs was noticed in group A (p < 0.05). The mean serum CD4:CD8 ratio was increased after 12 months of colchicine treatment (p<0.05) associated with abrogation of this correlation; comparison between the two groups revealed increased CD4:CD8 ratio in group A at 12 months (p<0.05). The histological findings according to Knodell criteria in both groups remained unchanged after 12 months follow-up. The treatment was well tolerated in all patients.


CONCLUSIONS
Long-term colchicine treatment in patients with hepatic fibrosis appears to exert an anti-inflammatory, anti-fibrotic and immunomodulatory effect.
Nikolaidis
Nikolaos
N
Division of Gastroenterology, 2nd Prop. Department of Internal Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, Macedonia, Greece.
Kountouras
Jannis
J
Giouleme
Olga
O
Tzarou
Valasia
V
Chatzizisi
Olga
O
Patsiaoura
Kaliopi
K
Papageorgiou
Athanasios
A
Leontsini
Maria
M
Eugenidis
Nikolaos
N
Zamboulis
Chrysanthos
C
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D016516:CD4-CD8 Ratio; D002908:Chronic Disease; D003078:Colchicine / Q000627:therapeutic use*; D005260:Female; D006505:Hepatitis / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide; D003078:Colchicine