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From traditional Chinese medicine to the Nobel prize

In the late 1960s, Mao Zedong instructed The YOYO (Youyou Tu) to find a cure for malaria. And after 40 odd years of its opening every year are already helping to save the lives of over 100 thousand people in Africa alone, and she was awarded the highest award in medicine — the Nobel prize. The residences shared with their colleagues William Campbell (William Campbell C) and Omurai Satoshi (Satoshi Ōmura), who developed a new means of treating human diseases caused by parasitic worms.

Unusual in scientific work That Yuyu may seem that she started his research with the study of plants used in Chinese folk medicine. However, this is not the only case where modern medicine is developed on the basis of Chinese traditional medicine — and probably not the last.

The Yuyu colleagues studied the ancient Chinese medical treatises, trying to find mention of herbs and recipes that could be used to treat diseases with symptoms similar to malaria, such as fever, chills and headache. They methodically went through the known detailed texts and carefully checked descriptions of over two thousand medicines made from traditional Chinese herbs, they found among them 380 herbal extracts and tested them on lab mice infected by Plasmodium falciparum.

One of these herbs is widespread in China, annual wormwood(Artemesia annua) is in the treatise of dynasty Jin was proposed to use in the treatment of fever — the main symptom of malaria. During laboratory studies it has been discovered that this plant helps reduce the amount of malaria parasites in the blood.

Turning plants into medicine

Then The YOYO with colleagues began to test various solvents, which allows to allocate from annual wormwood various chemicals. They in turn checked these chemicals on mice infected with malaria parasites, until then, until he identified one active compound, is able in small doses to kill malaria parasites more effectively than other antimalarials. The substance, artemisinin, unlike other, capable of generating chemically active molecules inside the parasite, which kills him.

To highlight the plants in various types of active chemical substances, it is necessary to have a plan of action and patience. But the main thing is to get from plant a sufficient number of pure chemical substances similar to artemisinin, which is more effective than synthetic drugs. Often this is done using a solvent emitting from the plant material with certain active chemical substances, and then slowly evaporated the resulting solution to extract the these substances. By repeating this process with different solvents, it is possible to allocate different active chemicals.

But along with the use of scientific methods That Yuyu for the isolation of artemisinin again resorted to Chinese traditional medicine, the main principle of which is the treatment of plants in certain ways that allow you to affect their chemical properties. Following on from this, Tu discovered that the process of separation of artemisinin from the plant is best occurs at low temperatures.

Antimalarial activity

The discovery of artemisinin significantly altered the process of organizing the treatment of malaria worldwide. In 2013, in countries where the disease is endemic, treatment with this drug was administered to 393 million cases. If malaria parasites could develop resistance to the drug, this significantly complicated the process of malaria eradication and would lead to a significant growth of child mortality in Africa.

To avoid this, the doctors tried to limit the use of drugs based on artemisinin, in combination with other drugs, destroying the malaria parasite in a different way. Such combination therapy based on drugs containing artemisinin, recommended for the treatment of uncomplicated malaria (which leads to serious damage to internal organs) caused by the parasite Plasmodium falciparum. Full doses of drugs from the group of derivatives of artemisinin (e.g. artemether or artesunate) prescribed only in severe cases of malaria.

Despite the measures taken for the purpose of early diagnosis of malaria and ensure careful treatment, in the areas on the border between Thailand and Cambodia there have been cases of emergence of parasite resistance to drugs from the group of derivatives of artemisinin. Given the likelihood of emergence of resistance of Plasmodium to drugs from the group of derivatives of artemisinin, apparently, we should remember the traditional Chinese methods of combined treatment, which involve the combination of different herbal preparations.

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