Lanfranco de' Clari, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
de' Clari L. Vulnerable Plaque. Ann Intern Med. 1999;131:393. doi: 10.7326/0003-4819-131-5-199909070-00017
Download citation file:
Published: Ann Intern Med. 1999;131(5):393.
TO THE EDITOR:
In their excellent review, Kullo and colleagues did not mention colchicine, a potent agent that precisely and specifically inhibits the very protagonists of plaque formation—destabilization and rupture. Colchicine binds to β-tubulin and inhibits the proliferation of microtubules and microtubule-dependent processes during cell activation. This affects not only lymphocyte proliferation and the migration, diapedesis, and phagocytic activity of granulocytes and macrophages but also the synthesis, intracellular transport, and secretion of cytokines (2). Colchicine decreases tumor necrosis factor and interleukin-2 secretion, downregulates tumor necrosis factor receptors on macrophages, and deactivates these receptors' secretion of proteases and other mediators. All of this can destabilize the plaque, lead to its rupture, and activate thrombocyte aggregation and intraluminal coagulation. Moreover, colchicine decreases the adhesiveness of neutrophils to endothelial cells by changing the distribution of E-selectin molecules on their surface, which are activated by cytokines (3).
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only