Tu Youyou's team has put on a big move! Aiming at the problem of "drug resistance" of artemisinin in some parts of the world in recent years, Tu Youyou and his team have made new breakthroughs in the aspects of "research on antimalarial mechanism", "cause of drug resistance" and "adjustment of treatment methods" after years of hard work. In the near future, they have put forward practical and feasible treatment schemes to deal with the problem of "artemisinin resistance", and have applied artemisinin in the treatment of lupus erythematosus and other indications. ” New progress has been made in the field of "going out of traditional Chinese medicine research works", which has been highly recognized by WHO and authoritative experts at home and abroad.
Deeply study the mechanism of anti-malaria and tackle the difficult problem of "artemisinin resistance"
Since Tu Youyou discovered artemisinin, artemisinin derivatives have been used as the most effective and complication-free combination drug for malaria. However, the latest World Malaria Report 2018 released by WHO shows that progress in global malaria control has stalled and malaria remains one of the world's leading causes of death. The phased goal of "reducing malaria infection and mortality by 40% by 2020" will be difficult to achieve. In addition to insufficient financial support for malaria control and insufficient coverage of core interventions, resistance of Plasmodium to artemisinin-based antimalarial drugs is the biggest technical challenge facing the world today.
Studies by WHO and Southeast Asian countries have shown that in Cambodia, Thailand, Myanmar, Viet Nam and other Mekong subregional countries, the three-day cycle of artemisinin combination therapy (artemisinin drugs combined with other antimalarial prescriptions) for malaria-infected people shows signs of slow elimination of malaria parasites and resistance to artemisinin.
"Artemisinin combination therapy is the first-line anti-malarial therapy vigorously promoted by WHO, and is the most important weapon of anti-malarial in the world at present. Once the malaria parasite is generally resistant to the drug, the consequences will be very serious. Scientists around the world are very concerned about the further deterioration of artemisinin resistance.
Tu Youyou believes that in order to solve the problem of "artemisinin resistance", it is necessary to understand the mechanism of artemisinin. Wang Jigang, a member of Tu Youyou's team and a researcher at the Artemisinin Research Center of the Chinese Academy of Traditional Chinese Medicine, said that the half-life of artemisinin in the human body (the time required for the drug to halve its concentration in the organism) was very short, ranging from 1 to 2 hours, while the recommended course of artemisinin combination therapy was three days, and the effective insecticidal window of artemisinin was limited to 4 to 8 hours. The existing drug-resistant strains take full advantage of the short half-life of artemisinin to change their life cycle or temporarily enter a dormant state in order to avoid sensitive insecticidal period. At the same time, malaria parasites can also produce obvious resistance to the adjuvant drug "antimalarial prescription" in artemisinin combination therapy, which makes artemisinin combination therapy "ineffective".
After more than three years of scientific research, Tu Youyou's team has made new breakthroughs in the aspects of "research on the mechanism of anti-malaria", "causes of drug resistance" and "adjustment of treatment methods", and proposed new treatment countermeasures: first, to extend the medication time appropriately, from three-day therapy to five or seven-day therapy; second, to replace adjuvant drugs that have produced resistance in artemisinin combination therapy, and the effect is immediate.
New England Journal of Medicine (NEJM), one of the leading international medical journals, recently published Tu Youyou's team's major research results and the "artemisinin resistance" treatment response plan, which attracted the attention of the industry.
Tu Youyou believed that it was of great significance to solve the problem of "artemisinin resistance". Firstly, it strengthened the direction of global artemisinin research and development, that is, artemisinin will remain the first choice of high-efficiency antimalarial drugs for human beings for a long time to come. Secondly, because artemisinin antimalarial drugs are inexpensive, only a few dollars per course of treatment is needed, which is more conducive to the realization of artemisinin antimalarial drugs in the vast poverty-stricken areas of Africa. Global goal of malaria eradication.
"Global malaria control and prevention is highly consistent with the main thrust of the initiative of the Chinese government to build a community of human destiny." "Billions of malaria cases have been cured by artemisinin combination therapy so far," said Pedro Alonso, director of the WHO Global Malaria Project. Tu Youyou's team has made remarkable contributions to anti-malarial research.
Artemisinin in the treatment of lupus erythematosus: cautious optimism in phase I clinical trials
Reporters learned that while new breakthroughs have been made in the study of "artemisinin resistance", Tu Youyou's team also found that dihydroartemisinin has a unique effect on the treatment of highly variable lupus erythematosus.
Zhang Boli, academician of the Chinese Academy of Engineering and former president of the Chinese Academy of Traditional Chinese Medicine, said that traditional treatment of lupus erythematosus can only be conservatively treated with immune agents, which is difficult to eradicate and has the risk of secondary infection.
According to the preliminary clinical observation of Tu Youyou team, the effective rates of artemisinin in the treatment of discoid lupus erythematosus and systemic lupus erythematosus were over 90% and 80% respectively. Pedro Alonso affirmed this possibility, and he also believed that the final conclusion could only be reached through well-designed and rigorously implemented clinical trials in accordance with international standards.
According to the Drug Clinical Trial Approval issued by the State Drug Administration, the application of "Dihydroartemisinin Tablets for the Treatment of Systemic Lupus Erythematosus and Discoid Systemic Lupus Erythematosus" submitted by the Institute of Traditional Chinese Medicine, Chinese Academy of Traditional Chinese Medicine, where Tu Youyou's team is located, has been approved. Kunyao Group Co., Ltd. is responsible for conducting clinical trials.
Xue Qiao, medical manager of Kun Pharmaceutical Group, said that under the guidance of Tu Youyou's team, the first phase of the clinical trial was officially launched in May 2018, with 120 design samples, including 15 hospitals in China, including Peking Union Medical College Hospital, the First Hospital of Peking University, the Affiliated Hospital of Inner Mongolia Medical University, the People's Hospital of Xinjiang Uygur Autonomous Region, the First Affiliated Hospital of Anhui Medical University and Qilu Hospital of Shandong University. Leading units jointly participate in the development.
"About 500 Chinese and foreign patients enrolled in the clinical trial have been strictly screened through the process of disease activity score, and the first batch of volunteer patients have been enrolled in the trial." Xue Qiao revealed that "from the current situation, no unexpected adverse events occurred in the volunteer patients."
Tu said: "Artemisinin has an effective trend in treating lupus erythematosus, and we are cautiously optimistic about the success of the trial."
Reporters have learned that clinical trials generally consist of three phases, and the second and third phases have a larger sample size, which requires at least seven to eight years. If the test is successful, new dihydroartemisinin tablets are expected to be approved for market as soon as 2026.
Artemisinin and other traditional Chinese medicine research works are expected to be included in Oxford Medical Textbook for the first time.
Reporters learned from the Chinese Academy of Traditional Chinese Medicine that Artemisinin and other traditional Chinese medicine scientific research works written by Tu Youyou team members and Liao Fulong, a researcher of the Chinese Academy of Traditional Chinese Medicine, are expected to be included in the forthcoming international authoritative medical textbook Oxford Medical Textbook (sixth edition) for the first time. The industry believes that this will become an important practical achievement of "going out" of traditional Chinese medicine culture.
According to Liao Fulong, the chapter entitled "Model of Traditional Chinese Medicine - Traditional Chinese Medicine" has been finalized, which is divided into four parts: what is traditional medicine, discovery history, mechanism and clinical application of traditional Chinese medicine such as artemisinin, holistic view of traditional Chinese medicine and differentiation of symptoms and signs, and "traditional Chinese medicine is cheap and accessible". In April this year, Oxford University Press, the publisher of the book, has started proofreading work and will reprint it in the second half of this year.
Professor Cox, editor-in-chief of Oxford Medical Textbook, said he was pleased that traditional Chinese medicine treatises would soon be included in the textbook. He said: "The chapter of traditional Chinese medicine is both important and profound. All this is the result of the outstanding efforts of Chinese scientists.
Pedro Alonso and other authoritative experts believe that Tu Youyou's team has built a bridge between traditional medicine and modern medicine, so that TCM therapy is not only widely used in China, but also recognized by more and more countries for its effective treatment. It is hoped that Chinese scientists will continue to make more voices on the international arena of artemisinin research.
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