Colchicine in cardiovascular disease: an ancient drug with modern tricks

Abstract

From the dark history of being a poison and purgative, colchicine has risen to become one of the few irrefutable positives in the history of pharmacology in the management of myriad inflammatory conditions. Colchicine exerts its action through binding to tubulin, which in turn affects several cellular processes and pathways modulating the inflammatory response. Despite narrow therapeutic-toxicity window and the most common complaint of gastrointestinal upset, its list of medicinal use is expanding in recent years as we continue to unravel the mystery of this ancient remedy. In this review, we summarise the history of colchicine use, discuss its pharmacokinetics and mechanism of actions, and examine the most up-to-date evidence of colchicine in the treatment of various cardiac conditions with a focus on cardiovascular disease.

Novel Carbon Dots Derived from Puerariae lobatae Radix and Their Anti-Gout Effects

“…It is noteworthy that PLR-CDs also exhibited anti-inflammatory activities by improving the ankle swelling and synovial inflammatory injury in rats with acute gouty arthritis. In addition, clinically used therapeutic drugs such as allopurinol and indomethacin have side effects [31,32], so does colchicine [33]. As a result, researchers have been looking for the development of safer and more powerful new drugs with both anti-hyperuricemic and anti-inflammatory effects.…”

The anti-viral facet of anti-rheumatic drugs: Lessons from COVID-19

“…Its ability to bind tubulin achieves multiple cellular actions, including inhibition of the assembly of the nucleotide-binding domain and leucine-rich repeat protein 3 (NLRP3) inflammasome [198]. In addition to its effect on neutrophils [199,200], colchicine impairs the release of IL-1β into neutrophil extracellular traps [201]. Many of the actions have been demonstrated in patients with coronary disease [202,203].…”

Colchicine for primary prevention of atrial fibrillation after open-heart surgery: Systematic review and meta-analysis

“…Although colchicine reduced early AF recurrence after pulmonary vein isolation [14], its narrow therapeutic range and frequent gastrointestinal intolerance are disadvantages. [15] Recent meta-analyses have drawn opposing conclusions regarding colchicine's efficacy in POAF reduction. [16][17][18][19] Discrepancies probably occurred because these analyses used different inclusion criteria, different procedures, and assessed outcomes at different times.…”