A Comprehensive Review of Colchicine: An Ancient Drug with Many Therapeutic Potentials

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In this study, we aimed to review the literature and formulate a comprehensive understanding of colchicine and its therapeutic potential. Colchicine is one of the oldest therapies which are still used today. Colchicine is an alkaloid agent that has anti-inflammatory and pain-relieving effects. It has been used to treat inflammatory diseases such as gout, familial Mediterranean fever (FMF), and Behcet’s disease. The ability of colchicine to reduce inflammation is related to its interaction with tubulin, a cytoskeletal structure. Colchicine inhibits neutrophil adhesion, migration, and chemotaxis. Tyrosine phosphorylation, which is crucial for neutrophil activation, is specifically inhibited by colchicine. In addition, colchicine prevents neutrophil deformability, which affects neutrophil extravasation. Colchicine inhibits superoxide production and the release of interleukin 1β and IL-6. Colchicine reduces inflammasome production, which stimulates caspase-1 activation and release of interleukins. Colchicine has received attention during the COVID-19 pandemic for the treatment of severe COVID-19 cases and for reducing mortality. Colchicine is considered a safe drug with high availability and affordability. The metabolism of colchicine is affected by cytochrome P450 (CYP3A4) and P-glycoprotein inhibitors, and impaired renal and hepatic function. The most documented adverse effects of colchicine are gastrointestinal symptoms such as diarrhea, vomiting, and nausea.