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Recurrence has a high risk of chronic heart lesions or worsening lesions in patients with previous rheumatic heart disease. The severity of rheumatic heart disease and the prognosis depend on the extent of the carditis and the frequency of recurrent attacks.
C-reactive protein (CRP) and interleukin-6 (IL-6) is increased in patients with acute rheumatic fever and chronic rheumatic heart disease, indicate the persistence of ongoing inflammation in the chronic phase.
Inflammation is an important contributor to the pathogenesis of rheumatic heart disease (RHD), a disorder of heart valves caused by a combination of immune, genetic and environmental factors. Cytokines are important mediators of inflammatory and immune responses. The role of cytokine gene polymorphisms and their potential usefulness as biomarkers in RHD patients may be useful markers for the identification of individuals susceptible to RHD, these individuals could be provided aggressive prophylactic intervention to prevent the morbidity and mortality associated with RHD.
The aim of the study was to detect the effect of colchicine as anti-inflammatory drug on the serum levels of the inflammatory markers CRP and IL-6 in patients with chronic RHD.It was a prospective cross-sectional controlled study. Thirty five patients with chronic RHD were visiting Ain Shams university hospital’s outpatient clinic for receiving long acting penicillin as rheumatic fever prophylaxis, were included in the study. Control group was formed of ten healthy individuals not known to have RHD or any other disease leading to rising of inflammatory markers. Blood samples for serum levels of CRP & IL-6 were collected before and after receiving colchicine 0.5 mg as an anti-inflammatory treatment for one month, to measure the effect of the treatment on serum levels of CRP & IL6.
We figured out that the baseline of the serum inflammatory markers CRP and IL-6 before starting the colchicine treatment showed high significant difference between the patients and the control group the results confer that there is ongoing inflammation in the chronic state in patient with chronic rheumatic heart diseases.
After adding colchicine 0.5 mg twice per day on regular basis for one month as anti-inflammatory drug, patients showed significant reduction in the serum inflammatory markers CRP and IL-6,moreover we found that the three regimens used for long acting penicillin, the basic level of serum levels of inflammatory markers were significantly higher in 30 days regimen than in 15 and 21 days and the same effect after receiving colchicine, so we should use the shortest regimen.