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Colchicine

  • Eldad Ben-ChetritEmail author
Chapter

Abstract

Colchicine is an alkaloid which was originally extracted from bulbs of a plant called Colchicum autumnale (meadow saffron). Its active pharmacological component was isolated in 1820 and in 1833 the active ingredient was purified and named colchicine. It consists of three hexameric rings termed A, B, and C. It was first recommended for the treatment of gout by Alexander of Tralles in the sixth century AD. Later it has been employed for suggested and approved indications including primary biliary cirrhosis (PBC), alcohol induced hepatitis, psoriasis, Behçet disease, Sweet syndrome, scleroderma, sarcoidosis and amyloidosis. Perhaps the most effective results have been obtained in the prophylaxis of familial Mediterranean fever (FMF). Colchicine is absorbed in the jejunum and ileum and is trapped in the body tissues. It is metabolized in the liver and the intestine by cytochrome P (CYP) 450 3A4 and P-glycoprotein (PGY) 1. Colchicine is excreted mainly by the biliary system, intestines and the kidneys. It has a narrow therapeutic range, but with normal liver and kidney functions is relatively safe and can be used during pregnancy, nursing and in infants. The main mechanism of action of colchicine is probably through interaction with microtubules affecting leukocyte chemotaxis, thereby suppressing inflammation. The blood level of colchicine may be affected by concomitant drug administration and therefore, caution should be exercised when such medications are added.

Keywords

Colchicine Familial Mediterranean fever (FMF) Gout Inflammasome 

Abbreviations

ABCB1

ATP-binding cassette subfamily B member 1

AGREE

Acute Gout Flare Receiving Colchicine Evaluation

ARDS

Adult respiratory distress syndrome

COPPS

COlchicine for the Prevention of the Post-pericardiotomy syndrome

CRP

C-reactive protein

DIC

Disseminated intravascular coagulation

ER

Extended release

EULAR

European League Against Rheumatism

FDA

Food and Drug Administration

FMF

Familial Mediterranean fever

GEF

Guanine nucleotide exchange factor

HCC

Hepatic cell carcinoma

HPLC-MS

High performance liquid chromatography with mass spectrometry

IL

Interleukin

ILGF1

Insulin-like growth factor 1

IV

Intravenous

MDR1

Multiple drug resistant 1

MSU

Monosodium urate

NLRP3

NOD receptor family pyrin 3

NOD

Nucleotide-binding oligomerization domain

PAAND

Pyrin associated autoinflammatory disease with neutrophilic dermatosis

PBC

Primary biliary cirrhosis

PGY1

P-glycoprotein 1

PKN

Protein kinases

PRR

Pattern recognition receptor

RhoA

Rat sarcoma homolog gene family, member A

SAA

Serum amyloid A

TGF

Transforming growth factor

TNF

Tumor necrosis factor

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.FMF Center, Hadassah Hebrew University Medical CenterJerusalemIsrael

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