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

Download PDF

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 treatments 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. Colchicine's ability to reduce inflammation is linked 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. Additionally, colchicine inhibits neutrophil deformability, which influences neutrophil extravasation. Colchicine inhibits the production of superoxide and the release of interleukin 1β and IL-6. Colchicine decreases the production of inflammasomes that stimulate caspase-1 activation and release of interleukins. Colchicine has gained attention during the COVID-19 pandemic to treat severe COVID-19 cases and to decrease mortality. Colchicine is considered a safe drug with high availability and affordability. Colchicine metabolism is affected by cytochrome P450 (CYP3A4) and P glycoprotein inhibitors, and renal and hepatic function impairment. The most documented adverse effects of colchicine are gastrointestinal symptoms e.g., diarrhea, vomiting, and nausea.