Those who love walking in the mountains will have experienced regret seeing that purple flower of the lily family that signals the imminent end of summer and which, not surprisingly, is called Colchicum autumnale peeking out in the pastures. It is a poisonous flower, as is the snowdrop Galanthus nivalis the narcissus that almost acts as a counterpoint, heralding spring, and from which galantamine is extracted, the active ingredient that slows down the cognitive deterioration of Alzheimer’s disease.
The beneficial poison of colchicine poison of the autumn colchicum is colchicine, an alkaloid already known since ancient Greece, but whose chemical structure was defined only in 1955 the only contact with the plant can cause damage to the skin and ingestion causes vomiting, diarrhea, and even death, which occurs 7 to 48 hours after acute intoxication there may be neurological or hematological complications days later. It happened that inexperienced hikers mistaken colchicum for wild saffron with lethal consequences.
But, as Toto said every reverse has its own coin colchicine has an antimitotic effect on the cell, which, although it cannot be exploited in oncology due to its high toxicity, works well against inflammation, because it inhibits motility of leukocytes and blocks their phagocytic activity. Furthermore, colchicine decreases the production of leukotrienes (a group of lipid molecules involved in inflammatory processes and immune mechanisms at the bronchial level) and, in particular, of leukotriene B4, a powerful chemoattractant and leukocyte activator.
The pharmacological action of colchicine has so far been used for the treatment of gout and familial Mediterranean fever, an inherited autoinflammatory disease; from 2017, the new indication for the treatment of acute pericarditis and Dressler’s post-infarct pericarditis is authorized. Now, it is thought to use colchicine as a weapon against Sars-CoV-2, making use, in the early stages of the disease, of its antiviral and anti-inflammatory action.
AIFA also launches an experiment Italian Medicines Agency (AIFA) has expressed a favorable opinion on a study on the therapeutic protocol that provides for the use of colchicine in patients with COVID-19, which will begin in the next few days and will be coordinated by the rheumatology group of Perugia, assisted for technical management by the Study Center of the Italian Society of Rheumatology (SIR) and by the Research Center by the Association of Hospital Pulmonologists (AIPO) the society of Infectious and Tropical Diseases (SIMIT) is also involved in the study.
The major criticalities of colchicine are related to the methods of administration and its toxic effects in the indications accepted so far, it must be administered at a dose of 1 mg (one granule) by mouth, repeatable only after 1 hour up to a maximum total of 2-3 mg per day and stopped at the first appearance of nausea, vomiting or diarrhea. The intravenous drug (of which there are also some reports of its use) is not on the market in Italy and has possible serious side effects even at doses of 2mg.
The side effects are, for the most part, gastrointestinal, but hematological ones, from bone marrow depression, such as anemia and platelet disorders, are possible. The toxic dose of colchicine is around 10 mg but is lower in the case of advanced age or predisposing conditions such as heart failure, uncontrolled hypertension, renal failure, peptic ulcer, bleeding diathesis, or anticoagulant therapy. Great caution should be paid to the simultaneous intake of some drugs, such as macrolide antibiotics, simvastatin, cyclosporine, verapamil, and diltiazem, which can reduce the elimination of colchicine, inhibiting the activity of cytochrome P450 and the transport system of P-glycoprotein, a hepatocyte transmembrane protein, responsible for the transcanalicular transport of many hydrophobic molecules. Colchicine is eliminated mainly via the biliary route and its metabolism is mediated by cytochrome CYP3A the family of cytochrome P450 is a superfamily of enzymes designed to detoxify the organism from exogenous (drugs and toxins of external origin) and endogenous molecules (products of waste of the organism). Individual enzymes are identified by the common abbreviation CYP.
Ivermectin, against scabies and tropical diseases according to the infectious disease specialists of the department of the Institute of Hospitalization and Scientific Treatment (IRCCS) for Infectious and Tropical Diseases of Negrar (VR), led by Zeno Bisoffi, it might be worthwhile to carry out a clinical study to test the efficacy on Sars-CoV-2 virus of an antiparasitic drug used to treat scabies and also severe tropical parasites such as strongyloidiasis and onchocerciasis which in Italy is registered for veterinary use and, in humans, only topically, in cream. It is ivermectin the discovery of which earned the 2015 Nobel Prize in