Colchicine: an ancient drug with novel applications

Abstract

Colchicine is a treatment for gout that has been used for more than a millennium. It is the treatment of choice for familial Mediterranean fever and its associated complication, amyloidosis. The 2009 U.S. Food and Drug Administration approval of colchicine as a new drug had research consequences. Recent investigations with large cohorts of patients with gout who have been taking colchicine for years have demonstrated novel applications within oncology, immunology, cardiology and dermatology. Some emerging dermatological uses include the treatment of epidermolysis bullosa acquisita, leucocytoclastic vasculitis, aphthous stomatitis and others. In this work we relate the history and the new horizon of this ancient medicine.

Figure 1

The Ebers Papyrus is one of the most important medical documents from ancient Egypt. It was produced ca 1550 BCE, and is currently housed in the library of the University of Leipzid, Germany. Image is public domain from the National Library of Medicine NIH Archives. https://www.nlm.nih.gov/archive/20120918/hmd/breath/breath_exhibit/MindBodySpirit/IIBa18.html

Figure 2

The chemical structure of colchicine.

Figure 3

Fluorescence microscopy images of basal cell carcinoma cell line showing the microtubule cytoskeleton and the nucleus. The cells are UW-BCC1 cells (58), grown on glass coverslips and imaged. Microtubules (red) were imaged by immunostaining with monoclonal anti-alpha tubulin antibody and the DNA in the nucleus (blue) was revealed by Hoechst stain. Scale bar is 20 μm.

Figure 4

Summary of colchicine’s actions in clinical applications. Colchicine interacts with tubulin, altering the tubulin – microtubule balance. This change in the dynamics of the cellular microtubule arrays results leads to changes in cell motility / chemotaxis, as well as changes in secretion, as indicated in the figure.