General
Description & Use
Treats gout attacks, gouty arthritis, and other medical problems.
Colchicine
(Colgout tabs, Colchicum Dispert and Generic Colchicine) is originally
extracted from plants of the genus Colchicum (Autumn crocus, Colchicum
autumnale, also known as the "Meadow saffron"). Originally
used to treat rheumatic complaints and especially gout, it was
also prescribed for its cathartic and emetic effects. Its present
medicinal use is mainly in the treatment of gout; as well, it
is being investigated for its potential use as an anti-cancer
drug. It can also be used as initial treatment for pericarditis
and preventing recurrences of the condition. In neurons, axoplasmic
transport is disrupted by colchicine.
Colchicine is Food and Drug Administration (FDA)-approved
for the treatment of gout and also for familial Mediterranean
fever, secondary amyloidosis(AA), and scleroderma. It is also
used as an anti-inflammatory agent for long-term treatment of
Behçet's disease. The Australian biotechnology company
Giaconda has developed a combination therapy to treat constipation-predominant
irritable bowel syndrome which combines colchicine with the anti-inflammatory
drug olsalazine.
A
British drug development company is developing a prodrug of colchicine,
ZD6126
(also known as ANG453) as a treatment for cancer. Colchicine has
a relatively low therapeutic index. Colchicine is "used widely"
off-label by naturopaths for a number of treatments, including
the treatment of back pain.
News
in 2008
Sometimes during surgery to remove a tumor, cells become detached
from the bulk of the tumor. In a small number of cases, these
tumor cells stick to cells at the site of the surgical wound and
go on to form a secondary tumor, having an enormous negative impact
on the survival and quality of life of the patient.
New
data, generated at the John D. Dingell VA Medical Center and Wayne
State University, Detroit, using a mouse model of surgery to remove
a colon cancer tumor, suggest that perioperative treatment with
colchicine might decrease the incidence of tumor formation at
the site of the surgical wound. When colon cancer tumor cells
are exposed to high pressure they exhibit an increased ability
to stick to other cells. In the study, to mimic the conditions
of surgery, the authors removed colon cancer cells from one mouse,
exposed them to high pressure in vitro, and then transplanted
them into a second mouse that they monitored for the development
of tumors at the site of the surgical wound.
The most important observation made was that if
the mice from which the colon cancer cells came from were treated
perioperatively with colchicine there was a dramatic decrease
in the number of tumors that formed at the site of the surgical
wound in the second mouse.
As in vitro exposure of tumor cells from breast
and head and neck cancers to high pressure also increases their
ability to stick to other cells it is possible that these data
might have implications in several clinical settings.
Colchicine inhibits microtubule polymerization
by binding to tubulin, one of the main constituents of microtubules.
Availability of tubulin is essential to mitosis, and therefore
colchicine effectively functions as a "mitotic poison"
or spindle poison. Since one of the defining characteristics of
cancer cells is a significantly increased rate of mitosis, this
means that cancer cells are significantly more vulnerable to colchicine
poisoning than are normal cells. However, the therapeutic value
of colchicine against cancer is (as is typical with chemotherapy
agents) limited by its toxicity against normal cells.
Apart from inhibiting mitosis, a process heavily
dependent on cytoskeletal changes, colchicine also inhibits neutrophil
motility and activity, leading to a net anti-inflammatory effect.
Colchicine also inhibits urate crystal deposition, which is enhanced
by a low pH in the tissues, probably by inhibiting oxidation of
glucose and subsequent lactic acid production in leukocytes. The
inhibition of uric acid crystals is a vital aspect on the mechanism
of gout treatment.
Side
effects
Side effects include gastro-intestinal upset and neutropenia.
High doses can also damage bone marrow and lead to anaemia. Note
that all of these side effects can result from hyper-inhibition
of mitosis.
