A 52-year-old man presents with an acute gout flare of the left ankle. He has no contraindications to colchicine. Colchicine is initiated for symptom resolution. What is the primary mechanism by which colchicine exerts its therapeutic effect in acute gout?

• A Inhibition of xanthine oxidase to reduce uric acid production
• B Inhibition of prostaglandin synthesis by blocking cyclooxygenase-2
• C Competitive antagonism of the IL-1β receptor
• D Binding to tubulin and inhibition of microtubule polymerization, thereby suppressing neutrophil migration and inflammasome activation ✓

Explanation

Colchicine binds tubulin and inhibits microtubule polymerization, which impairs neutrophil chemotaxis, degranulation, and NLRP3 inflammasome activation. It does not lower uric acid. Allopurinol inhibits xanthine oxidase. Anakinra is the IL-1 receptor antagonist. NSAIDs inhibit cyclooxygenase.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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