Colchicum autumnale (Meadow Saffron, Autumn Crocus)
This is a perennial bulbous plant in the Family Liliaceae with an underground brown scaly corm which bears solitary violet-coloured tubular crocus-like flowers from August to October. Its orange anthers give the plant its name of Meadow Saffron, but due to its poisonous nature these should not be used in cooking under any circumstances. This plant is widespread throughout Europe and its name is derived from Colchis, which is at the eastern end of the Black Sea.
Dioscorides first described the plant in detail in the first century AD, and recognised it as poisonous. It was recommended in the 6th century AD by Alexander of Tralles, who used it to alleviate joint pain. Baron Anton von Storck of Vienna demonstrated its effect on gout in 1763. Colchicum corm appeared in the London Pharmacopoeias of 1618, 1627, 1632 and 1639. It was then deleted but reappeared in the 1788 edition.
Pelletier and Caventou isolated the main active ingredient of the plant, the alkaloid colchicine, in 1820 ( and also isolated quinine from Peruvian bark the same year). Colchicine can be extracted from several other species of Colchicum, as well as the related Glory Lily (Gloriosa superba). Colchicum autumnale is grown commercially in India, which supplies most of the dried corms used in commercial preparation of Colchicine for the UK market.
Until recently, Colchicine has been the primary treatment for the pain of acute gout, and it still is for patients who cannot tolerate non-steroidal anti-inflammatory drugs. Its mode of action in this disease is by inhibiting the phagocytic activity of polymorphonuclear leucocytes, which ingest the urate crystals and thereby release their inflammatory lysosomal enzymes. Taken orally or intravenously, Colchicine quickly relieves the intense pain of acute gout.
The discomfort of gout was well described by Sydenham in 1683: “The part affected has such a quick and exquisite pain, that it is not able to bear the weight of the cloaths upon it, nor hard walking in the chamber and the night is not passed over in pain upon this account only but also by reason of the restless turning of the part hither and thither and the continual change of its place”. Sydenham suffered this disease himself, and when incapacitated by it, his young assistant, Hans Sloane, took over the running of his extensive medical practice in London, thereby establishing himself.
Colchicine has several actions in the body apart from its effect on white blood cells. It inhibits cell mediated immune responses by inhibiting immunoglobulin production, Interleukin 1 production, histamine release and HLA-DR expression. It also reduces procollagen synthesis by impairing its cellular secretions. It induces mitotic arrest and inhibits DNA synthesis. It has therefore been a useful laboratory tool used in the study of cell division.
Apart from its use in acute gout, Colchicine has been used in many other disorders and has been the mainstay of treatment of amyloidosis secondary to familial Mediterranean fever. It has also been used in the treatment of the orogenital and ocular aspects of Behcet’s syndrome, psoriasis and its variant known as palmoplantar pustulosis, as well as scleroderma. Anecdotally it is also useful in leucocytoclastic vasculitis, aphthous stomatitis and pyoderma gangrenosum.
The main adverse reaction to Colchicine is gastrointestinal toxicity, which occurs in up to 80% of patients receiving a maximal dose of 3 mg per day. Myopathy and neuropathy can also occur, as well as serious haematologic side-effects, including pancytopenia.
Meadow Saffron is a dangerous plant and should never be collected and used for self-medication. The plant is also toxic to animals, particularly when they are fed dry fodder.