title: The effects of colchicine on the progression and regression of encapsulating peritoneal sclerosis.
abstract: BACKGROUND
  Encapsulating peritoneal sclerosis (EPS) is an infrequent but extremely serious complication of long-term peritoneal dialysis. Fibrosis of the submesothelial compact zone and neoangiogenesis underlie the pathophysiology of EPS. Colchicine is a well-known anti-inflammatory and antifibrotic agent that has been used for some fibrosing clinical states, such as liver fibrosis.
  
  
  OBJECTIVE
  To determine the antifibrotic and anti-inflammatory effects of colchicine in an EPS rat model in both progression (P) and regression (R).
  
  
  METHODS
  48 nonuremic albino Wistar rats were divided into 5 groups: control group, 2 mL isotonic saline intraperitoneally (IP) daily for 3 weeks; CG group, IP injection of 2 mL/200 g chlorhexidine gluconate (CG) (0.1%) and ethanol (15%) dissolved in saline, daily for 3 weeks; resting group, CG (0 - 3 weeks) + peritoneal resting (4 - 6 weeks); C-R group, CG (0 - 3 weeks) + 1 mg/L colchicine (4 - 6 weeks); C-P group, CG (0 - 3 weeks) + 1 mg/L colchicine in drinking water (0 - 3 weeks). At the end, a 1-hour peritoneal equilibration test was performed with 25 mL 3.86% peritoneal dialysis solution. Dialysate-to-plasma ratio of urea (D/P urea), dialysate WBC count, ultrafiltration volume, and morphological changes of parietal peritoneum were examined.
  
  
  RESULTS
  Exposure to CG for 3 weeks resulted in alterations in peritoneal transport (increased D/P urea, decreased ultrafiltration volume; p < 0.05) and morphology (increased inflammation, neovascularization, fibrosis, and peritoneal thickness; p < 0.05). Resting had some beneficial effects on peritoneal derangements; however, once the peritoneum had been stimulated, resting alone was not enough to reverse these pathological changes. Colchicine had more pronounced effects on membrane integrity via decreased inflammation, cell infiltration, and vascularity compared to the resting group.
  
  
  CONCLUSIONS
  We suggest that colchicine may have therapeutic value in the management of EPS.
authors.affiliation: Department of Nephrology, Ege University, Izmir, Turkey.
authors.forename: Devrim
authors.initials: D
authors.lastname: Bozkurt
authors.forename: Selahattin
authors.initials: S
authors.lastname: Bicak
authors.forename: Savas
authors.initials: S
authors.lastname: Sipahi
authors.forename: Huseyin
authors.initials: H
authors.lastname: Taskin
authors.forename: Ender
authors.initials: E
authors.lastname: Hur
authors.forename: Muhittin
authors.initials: M
authors.lastname: Ertilav
authors.forename: Sait
authors.initials: S
authors.lastname: Sen
authors.forename: Soner
authors.initials: S
authors.lastname: Duman
mesh_terms: D000818:Animals; D002710:Chlorhexidine / Q000031:analogs & derivatives; D003078:Colchicine / Q000494:pharmacology / Q000627:therapeutic use*; D015314:Dialysis Solutions / Q000494:pharmacology; D004195:Disease Models, Animal; D005260:Female; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010537:Peritoneum / Q000187:drug effects / Q000473:pathology*; D051381:Rats; D017208:Rats, Wistar; D012598:Sclerosis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D050257:Tubulin Modulators / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D015314:Dialysis Solutions; D050257:Tubulin Modulators; C010882:chlorhexidine gluconate; D002710:Chlorhexidine; D003078:Colchicine