Phytomedicine and the Nobel Prize: Benefits of integrating traditional remedies into modern medicine

Shweta Singh¹, Ranil Johann Boaz²,  
¹ Department of Medicine, Church of South India Hospital, Bangalore, Karnataka, India
² Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
Dr. Ranil Johann Boaz
Department of Urology, Christian Medical College, Vellore, Tamil Nadu
India

Full Text

Sir,

This is in response to “Role of Pharmacology for Integration of Modern Medicine and Ayurveda,” an editorial in the Indian Journal of Pharmacology, September 2015. We strongly endorse the clarion call for meaningful collaboration between traditional Indian medicine and modern practice. Despite ample evidence that investigation of naturally occurring extracts can yield significant breakthroughs in medical science, there continues to be resistance and skepticism in the mind of the practicing allopath. Where would oncology be without the discovery of vinca alkaloids? Where indeed would medicine be without quinine? The rosy periwinkle (Catharanthus roseus) is widely used for a multitude of maladies in both Indian and Chinese traditional medicine. Investigation of myelosuppressive effects led to the isolation of vincristine and vinblastine in 1958. These drugs are vital agents in the chemotherapy of leukemia and Hodgkin's lymphoma.[1] Cinchona tree bark extract was first used by native Quechua Indians of Peru for febrile illness. Jesuit missionaries and the Spanish conquistadors later brought this knowledge back to Europe in 1638. Quinine was isolated and continued to be in use until the advent of semi-synthetic antimalarial in the 1920s. With the development of chloroquine resistance, quinine is resurgent in modern therapy of this ancient disease.[2] The award of a share of the 2016 Nobel Prize in Physiology or medicine to the discoverer of artemisinin is a landmark in phytomedicine and a compelling reminder to medical professionals of the untapped potential of traditional medicine. Seamless amalgamation of traditional and modern medicine can have no better example than the seminal work of Prof. Youyou Tu, a graduate of allopathic pharmacy who also trained in Chinese herbal medicine; she was appointed the head of a key malaria research team incorporating both pharmacologic and phytochemical researchers in 1967. This was in response to the alarming failure of disease control and rise of resistant strains. Using a mouse model of malaria, her team systematically tested in excess of 2000 herbal preparations. An extract of qinghao (Artemisia annua) showed initial results in parasitic growth inhibition that were not consistently reproducible. An intensive search of Chinese literature revealed a simple formulation for qinghao used to cure malaria symptoms in Ge Hong's-Handbook of Prescriptions for Emergencies, an 1800-year-old manuscript. Aided by the text, Tu rightly surmised that high temperatures of the extraction technique had degraded the active ingredient. Refined methods led to the isolation of artemisinin in 1972.[3] While artemisinin and it derivatives continue to be highly effective against falciparum malaria, they have also been shown to be an effective antihelminthic against schistosomes and are under anticancer trials in hepatocellular carcinoma models. Apart from phytotherapy, ancient Chinese texts have recently contributed to the discovery of arsenic trioxide and its adoption as first-line treatment in acute promyelocytic leukemia.[4] Researchers worldwide are investigating curcumin, a derivative of turmeric (Curcuma longa) which is native to the South India. Several trials show promising results in myriad disorders.[5] Jasmine (Jasminum sambac) is used traditionally to suppress puerperal lactation. The flower extract was recently proven by the Indian researchers to reduce prolactin levels significantly in women experiencing menstrual disturbances and galactorrhea while on antipsychotics.[6] The Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy has recently received strong support from the government of India. The central government allocated Rs. 1069 crore ($174 million) for the 2014–2015 financial year to promote traditional medical systems and has commissioned the All India Institute of Ayurveda, to develop on the lines of All India Institute of Medical Sciences. While this augurs well for the future of traditional medicine, there will likely need to be a great deal of interactive collaboration with modern medicine if we are to harvest the bounty that our storied medical history affords us. While Ayurvedic formulations distil centuries of experience, the strength of modern science is to systematically examine the process by which these ingredients intervene. Modern pharmacologic research elucidates the mechanisms of action, isolates active principles, improves bioavailability, identifies interactions, defines dosage, optimizes delivery, and determines drug schedules. Chemical profiling is required to define standards; this allows for the verification of authenticity and assured quality control. Controlled clinical trials determine safety and efficacy, paving the way for acceptance into mainstream, modern medicine.[7] The Indian Journal of Pharmacology is, at the forefront of this effort, providing a platform to publish robust scientific evidence that impels the medical fraternity to integrate the wisdom of ages into current practice. In the last year alone, this journal has published works on C. longa, Justicia neesii, and Feronia limonia among others. It behooves us all to unite in cooperation across all schools of medicine in our endeavor to bring the best holistic care to our fellow Indians.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.

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