With all the technological advances of the modern age, it is reasonable that one might be led to think all drugs are developed through highly sophisticated, novel experimental methods and human ingenuity. There’s no way that a drug that cost millions of dollars to create could have come from a humble plant, right? In fact, of all the drugs approved from 1981 to 2014, only 27% were purely synthetic while 50% came from mimics, derivatives, or unaltered forms of natural products!1 There may be an air of exoticness or crudeness associated with natural products, but they are clearly prevalent even among the cutting-edge science of today and continue to occupy a significant space in medicine.
Two fields within the wide scope of pharmacy concerning natural products include pharmacognosy and ethnopharmacology. Pharmacognosy is the study of the biochemical and biological properties of drugs of natural origin as well as the search for new drugs from natural sources.2 Closely related, ethnopharmacology deals with the observation and experimental investigation of the biological activities of plant and animal substances used in the traditional medicine of past and present cultures of different indigenous groups.3 While one is in the realm of natural science and the other sits at the intersection of natural and social sciences respectively, the two are not mutually exclusive and both possess an acute understanding and appreciation of nature as a master chemist of diverse, complex molecules that provides invaluable resources for drug development.
From drugs that can treat cancer to medicines that help relieve a simple headache, the range of drugs that have been created from the trees and microorganisms that make up the background of our lives is astounding. A compound first isolated from the purple-pink flowers of the foxglove plant has been used for hundreds of years to treat a condition first referred to as “dropsy.”5 Although the name for the condition of fluid retention in the heart and lungs has become more refined under the category of heart failure, the same active ingredient in those dried, powdered leaves has been used for hundreds of years and even now is sold and dosed as the familiar digoxin.4
Scientists continue to isolate and discover viable structures from natural products as they have done for centuries past, but now they have the technology and innovations of today to help guide them in not only creating new drugs but also understanding current drugs. The therapeutic windows for dosing, toxicity, and other factors are becoming better elucidated as we are able to narrow down optimal doses and even generate synthetic antibody-type antidotes to drugs such as digoxin. On the other hand, researchers at universities are exploring novel compounds from natural sources in treating disease states. For example, the universal yet poorly understood state of pain is currently being treated mostly with opioids, another class of drugs isolated from the opium plant. Researchers at the Boston Children Hospital have found a potential delivery system for TTX, a neurotoxin found in pufferfish.6 This treatment could potentially reduce dependence on opioids and dosing frequency and combat the opioid epidemic plaguing the world.
However, the transition from traditional to modern society is not always so innocuous. The Matses people of Brazil and Peru remain isolated in one of the most carbon-rich, densest parts of the Amazon rainforest. As they are integrated into the outside world, the elderly medicinal shamans have found their knowledge at risk of being lost forever and have thus created an encyclopedic trove of information regarding their interpretations of disease states and various natural treatments, drawn from their environment in the rainforest.7 It is critical to preserve these wealths of knowledge passed down through generations of indigenous groups as they are disappearing at an alarming rate. As pharmacists, we have to keep in mind the important role traditional medicine continues to play in the lives of many patients who come from different cultural backgrounds.
The advancement of modern medicine provides life-saving therapies for millions around the world, but we also cannot forget the vast influences traditional medicine exerts. What connects the two together is the limitless opportunities that natural products offered in the past, continue to offer in the present, and, undoubtedly, will offer in the ages to come.
Authors: Aimee Ho and Anna Li
1. Newman DJ, Cragg GM. Natural Products as Sources of New Drugs from 1981 to 2014.JournalofNaturalProducts.2016;79(3):629-661. doi:10.1021/acs.jnatprod.5b01055.
2. AbouttheASP.TheAmericanSocietyofPharmacognosy.https://www.pharmacognosy.us/ what-is-pharmacognosy/. Accessed February 20, 2020.
3. Journal of Ethnopharmacology. Aims & scope - Journal of Ethnopharmacology | ScienceDirect.com.https://www.sciencedirect.com/journal/journal-of-ethnopharmacology/about/aims-and-scope. Accessed February 20, 2020.
4. Digitalis.https://www.ch.ic.ac.uk/vchemlib/mim/bristol/digitalis/digitalis_text.htm. Accessed February 20, 2020.
5. McLachlan A, McLachlan A. Weekly Dose: Digoxin, the heart medicine that may have givenusVanGogh'sStarryNight.TheConversation. http://theconversation.com/weekly-dose-digoxin-the-heart-medicine-that-may-have-given-us-van-goghs-starry-night-57980. Published August 23, 2019. Accessed February 20, 2020.
6. Liu A. Could a pufferfish toxin be a safe alternative to opioids? FierceBiotech. https://www.fiercebiotech.com/research/could-a-pufferfish-toxin-be-a-safer-painkiller-than-opioid. Published June 12, 2019. Accessed February 23, 2020.
7. Amazon tribe creates 500-page traditional medicine encyclopedia. Mongabay Environmental News. https://news.mongabay.com/2015/06/amazon-tribe-creates-500-page-traditional-medicine-encyclopedia/. Published December 20, 2018. Accessed February 23, 2020.
In October 2019 the UCL School of Pharmacy PharmAlliance team were fortunate enough to meet with the School of Pharmacy Director, Professor Duncan Craig, for a truly insightful interview that covered a number of different topics.
1. What were some of the highlights of the Stakeholders’ Dinner 2019 for you?
I enjoyed the whole thing enormously. The presentations from the guests were fantastic, and I was extremely proud of our students for the articulate and intelligent way that they addressed the room.
I was also very impressed by their courage as well, because I’m not at all sure that when I was an undergraduate I would have dared to stand up and speak to an eminent group of guests. I have to say it was very nice hearing the comments from the stakeholder guests. They were incredibly impressed with the school and particularly with the students. I think having students on every table brought a bit of life and spontaneity to a formal occasion. Overall, it was a big success.
2. We heard you recently went to Abuja, Nigeria. What did you like best about the city?
I liked the people very much. It’s a big city and the number of people you meet will always be limited but I was made to feel very welcome.
The purpose of the visit was to talk to the Nigerian Sovereign Investment Agency (NSIA) about how UCL might be able to work with them to help boost the pharmaceutical sector in the country. Meeting various stakeholders within Nigeria who run various agencies provided me with an understanding of how the system works, and what the various barriers to getting safe and effective medicines into the country. It was a fascinating insight and I learnt a great deal.
3. What do you think students can gain from studying abroad and observing another country’s pharmacy system?
The wealth of benefit is very difficult to overstate. Going outside your comfort zone in a controlled and safe manner is the way that all of us grow. We encourage our staff to go on sabbaticals as well. I’ve moved around quite a lot and I’ve learnt an enormous amount from every move.
It’s really important to us that once our students leave the school, that they’ve got the skills but also the confidence to deal with whatever life throws in their direction — one of the ways you can do that is by studying abroad. You can see a different system and you can get different perspectives — you can then having something to compare this institution with other institutions and it’s quite nice to have that realisation early on in your studying career.
4. We know you are a huge advocate for PharmAlliance. Why do you think PharmAlliance is important?
PharmAlliance is important because it’s quality-driven. Although the three universities are in three different continents with three very different time zones, we have so much more in common than we do that differentiates us. All three universities are very high quality and we’re like-minded; we place as much emphasis on education as we do research — and the beauty of pharmacy is in both. We’ve learnt a huge amount from each other and we want our students to get the same benefit.
5. What more do you want to see from PharmAlliance in terms of activities?
We actually had the new Dean of Monash here earlier this week. I think probably the way that we’re going is to place more emphasis on student activities. Just think how much more we could enrich the student experience in all three institutions by creating a kind of free passage, either virtually or physically, to create opportunities for the students to actually do things together.
I think we’re all agreed this is a huge benefit of PharmAlliance that we can emphasise more.
6. Students from the UNC PharmAlliance team have expressed interest in being involved in research alongside UCL and Monash. Do you think this is feasible as a long term goal?
I think that anything is certainly feasible. The relationships are definitely very good and we also see student engagement as a real priority. What we’d have to look at is how that engagement would manifest. For example, would it involve UNC students coming over for a while and shadowing fourth year MPharm project students? There are many many different models but I think that there are no intrinsic barriers to achieving this goal.
7. We heard that you’re editing a special issue of Pharmaceutics* about nanofabrication. Could you tell us a bit about nanofabrication and how it’s useful in pharmacy?
Nanofabrication is a fairly broad term. A few years ago people were focusing on nanoparticles as there are a lot of incredible things you can do with these. We’ve become particularly interested in developing relationships with engineers — we have strong mechanical, chemical and biochemical engineering departments at UCL and we’ve been looking into things that the engineers can make but we can think of new and interesting healthcare-facing uses for.
A number of UCL School of Pharmacy staff, including myself, have an interest in making nanofibres. In fact, a couple of my fourth year students are actually working in this area at the moment. These are long fibres with diameters in the nano size range. These nanofibres can be made multi-layered so that you can actually have one drug in one inner layer and then a different drug in the outer layer.
*Pharmaceutics is an international, peer-reviewed journal that contains research papers on the latest developments in pharmaceutical technology.
8. Do you have any tips on editing for students who are involved in or interested in pharmacy media and journals?
You tend to think of editing in terms of sitting in front of a screen and changing things but in fact, the real skill with editing is in your relationships with other people.
Finding ways to suggest to somebody that you’d rather they did something in a different way without causing them offence. Finding ways of gathering ideas that trusted colleagues may have in a way that synthesises into something that’s actually practical. Changing the type is the easy bit. It’s getting the team together — getting the personal relationships and the trust sorted out — that leads to success.
9. What is your vision of UCL School of Pharmacy in ten years’ time?
Our school’s mission statement starts off by saying that we want to make a positive difference to pharmaceutical healthcare. We aim to accomplish this by producing excellent graduates, doing impactful research and by providing professional leadership.
In ten years’ time I would like somebody to look at what has been achieved in relation to these three cornerstones and for them to find that the school has made a real difference outside its immediate environment.
Thank you to Director Professor Craig for your time! We hope that the aspirations of both PharmAlliance and UCL School of Pharmacy will be achieved!