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.
