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Stamp LK, Horsley C, Te Karu L, Dalbeth N, Barclay M. Colchicine: the good, the bad, the ugly and how to minimize the risks. Rheumatology (Oxford) 2024; 63:936-944. [PMID: 38019947 PMCID: PMC10986813 DOI: 10.1093/rheumatology/kead625] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/25/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Colchicine has an important role in managing various conditions, including gout, familial Mediterranean fever, amyloidosis, Behçet's syndrome, recurrent pericarditis and calcium pyrophosphate deposition disease. The adverse effect profile of colchicine is well understood. However, due to its narrow therapeutic index, colchicine has been associated with overdose and fatalities. When ingested in toxic amounts, the mainstay of management is supportive care. Strategies to minimize the risk of colchicine poisoning can focus on three broad causes: unauthorized access, intentional overdose and inappropriate dosing. Culturally safe and appropriate education about storage and appropriate use of colchicine is essential to minimize the risk of overdose.
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Affiliation(s)
- Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Carl Horsley
- Critical Care Complex, Middlemore Hospital, Auckland, New Zealand
| | - Leanne Te Karu
- Faculty of Medicine, University of Auckland, Auckland, New Zealand
| | - Nicola Dalbeth
- Faculty of Medicine, University of Auckland, Auckland, New Zealand
| | - Murray Barclay
- Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand
- Department of Clinical Pharmacology, Te Whatu Ora, Waitaha Canterbury, New Zealand
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Huang R, Duan J, Huang W, Cheng Y, Zhu B, Li F. Inhibition of CYP1A1 Alleviates Colchicine-Induced Hepatotoxicity. Toxins (Basel) 2024; 16:35. [PMID: 38251251 PMCID: PMC10818746 DOI: 10.3390/toxins16010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Colchicine, a natural compound extracted from Colchicum autumnale, is a phytotoxin, but interestingly, it also has multiple pharmacological activities. Clinically, colchicine is widely used for the treatment of gouty arthritis, familial Mediterranean fever, cardiovascular dysfunction and new coronary pneumonia. However, overdose intake of colchicine could cause lethal liver damage, which is a limitation of its application. Therefore, exploring the potential mechanism of colchicine-induced hepatotoxicity is meaningful. Interestingly, it was found that CYP1A1 played an important role in the hepatotoxicity of colchicine, while it might also participate in its metabolism. Inhibition of CYP1A1 could alleviate oxidative stress and pyroptosis in the liver upon colchicine treatment. By regulating CYP1A1 through the CASPASE-1-GSDMD pathway, colchicine-induced liver injury was effectively relieved in a mouse model. In summary, we concluded that CYP1A1 may be a potential target, and the inhibition of CYP1A1 alleviates colchicine-induced liver injury through pyroptosis regulated by the CASPASE-1-GSDMD pathway.
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Affiliation(s)
- Ruoyue Huang
- Department of Gastroenterology & Hepatology, Laboratory of Metabolomics and Drug-Induced Liver Injury, State Key Laboratory of Biotherapy, and Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jingyi Duan
- Department of Gastroenterology & Hepatology, Laboratory of Metabolomics and Drug-Induced Liver Injury, State Key Laboratory of Biotherapy, and Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Wen Huang
- Laboratory of Ethnopharmacology, Tissue-Orientated Property of Chinese Medicine Key Laboratory of Sichuan Province, West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yan Cheng
- Department of Gastroenterology & Hepatology, Laboratory of Metabolomics and Drug-Induced Liver Injury, State Key Laboratory of Biotherapy, and Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
- Academician Workstation, Jiangxi University of Chinese Medicine, Nanchang 330004, China
| | - Beiwei Zhu
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China;
- National Engineering Research Center of Seafood, Dalian 116034, China
| | - Fei Li
- Department of Gastroenterology & Hepatology, Laboratory of Metabolomics and Drug-Induced Liver Injury, State Key Laboratory of Biotherapy, and Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
- State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu 610041, China
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