Tu youyou's team has made a big move! In view of the problem of "drug resistance" of artemisinin in some parts of the world in recent years, Tu youyou and her team have made new breakthroughs in "Research on malaria resistance mechanism", "causes of drug resistance" and "adjustment of treatment methods" after years of hard work, and recently put forward a practical treatment plan to deal with the problem of "artemisinin resistance", New progress has been made in 'artemisinin for the treatment of lupus erythematosus and other indications' and' going out of traditional Chinese medicine scientific research ', which has been highly recognized by the World Health Organization and authoritative experts at home and abroad.
Deeply study the mechanism of malaria resistance and tackle the problem of artemisinin resistance
Since Tu youyou discovered artemisinin, artemisinin derivatives have been used as the most effective and uncomplicated combination drug for malaria. However, the latest World Malaria Report 2018 released by who shows that the progress of global malaria control has stalled, malaria is still one of the main causes of death in the world, and the phased goal of 'reducing malaria infection rate and mortality by 40% by 2020' will be difficult to achieve. The reason is that in addition to the insufficient financial support for malaria control and the coverage of core interventions, the resistance of Plasmodium to artemisinin antimalarial drugs is the biggest technical challenge facing global antimalarial.
A number of studies by who and Southeast Asian countries have shown that in Cambodia, Thailand, Myanmar, Vietnam and other countries in the Greater Mekong subregion, during the three-day cycle of artemisinin combination therapy ('artemisinin drug 'combined with' other antimalarial formula drugs' therapy) for malaria infected people, there are signs of slow clearance of malaria parasites and resistance to artemisinin.
Artemisinin combination therapy is the first-line antimalarial therapy vigorously promoted by who and the most important weapon against malaria in the world. Once malaria parasites become generally resistant to drugs, the consequences will be very serious, and scientists all over the world are very worried & lsquo; Artemisinin resistance & rsquo; Further deterioration. "
Tu youyou believes that in order to solve the problem of artemisinin resistance, we must 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 concentration to drop by half in the organism) is very short, only 1 to 2 hours, while the course of artemisinin combination therapy recommended clinically is three days, and the truly efficient insecticidal window of artemisinin is only limited to 4 to 8 hours. The existing drug-resistant strains make full use of the short half-life of artemisinin to change the life cycle or temporarily enter the dormant state, so as to avoid the sensitive insecticidal period. At the same time, malaria parasites can also produce obvious resistance to the auxiliary drug 'antimalarial formula' in artemisinin combination therapy, making artemisinin combination therapy 'ineffective'.
After more than three years of scientific research, Tu youyou's team finally made new breakthroughs in "Research on malaria resistance mechanism", "causes of drug resistance" and "adjustment of treatment methods", and put forward new treatment countermeasures: first, appropriately extend the medication time from three-day therapy to five-day or seven-day therapy; Second, replace the drug-resistant adjuvant drugs in artemisinin combination therapy, and the curative effect is immediate.
The international top authoritative medical journal New England Journal of Medicine (NEJM) recently published Tu youyou's team's major research results and 'artemisinin resistance' treatment response plan, which attracted the attention of the industry.
Tu youyou believes that solving the problem of "artemisinin resistance" is of great significance: first, it has strengthened the global R & D direction of artemisinin, that is, artemisinin will still be the first high-efficiency drug for human anti malaria for a long time in the future; Second, because artemisinin antimalarial drugs are cheap and cost only a few dollars per course of treatment, they are suitable for people in poor areas of Africa where the epidemic areas are concentrated, which is more conducive to achieving the goal of global malaria eradication.
"Global malaria control is highly consistent with the Chinese government's action initiative to build a community with a shared future for mankind." Pedro middot, director of the WHO global malaria project; Alonso said, "so far, the number of malaria patients cured by artemisinin combination therapy has reached billions. The antimalarial research work carried out by Tu youyou's team is outstanding and its contribution is immeasurable. "
Artemisinin in the treatment of lupus erythematosus: the results of phase I clinical trial are cautiously optimistic
The reporter learned that while the research on 'artemisinin resistance' has made a new breakthrough, Tu youyou's team also found that dihydroartemisinin has a unique effect on the treatment of lupus erythematosus with high variability.
Zhang Boli, academician of the Chinese Academy of engineering and former president of the Chinese Academy of traditional Chinese medicine, said that the traditional treatment of lupus erythematosus can only use immune agents for conservative treatment, which is difficult to cure, and there are risks of secondary infection.
According to the preliminary clinical observation of Tu youyou's team, the effective rates of artemisinin in the treatment of discoid lupus erythematosus and systemic lupus erythematosus exceeded 90% and 80% respectively. Pedro & middot; Alonso affirmed this possibility. At the same time, he also believes that the final conclusion can only be reached through carefully designed and strictly implemented clinical trials in accordance with international standards.
According to the approval document of drug clinical trial issued by the State Drug Administration, the application for "clinical trial of dihydroartemisinin tablets for the treatment of systemic lupus erythematosus and discoid systemic lupus erythematosus" submitted by the Institute of traditional Chinese medicine of the Chinese Academy of traditional Chinese medicine where Tu youyou's team is located has been approved. Kunming Pharmaceutical Group Co., Ltd. carries out clinical trials as the responsible unit.
Xue Qiao, medical manager of Kunming Pharmaceutical Group, introduced that under the guidance of Tu youyou's team, the first phase of the clinical trial was officially launched in May 2018, with a total of 120 design samples, including Beijing 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 Qilu Hospital of Shandong University and other 15 leading units in China participated in the implementation.
'about 500 Chinese and foreign patients enrolled in the clinical trial have passed & lsquo; Disease activity score & rsquo; The first batch of volunteer patients have been enrolled in the trial. " Xue Qiao revealed, 'from the current situation, there are no unexpected adverse events in volunteer patients.'
Tu youyou said, "artemisinin has an effective trend in the treatment of lupus erythematosus. We are cautiously optimistic about the success of the trial."
The reporter learned that clinical trials generally have three phases, and the sample size of phase II and III trials is larger, which will take at least 7 to 8 years. If the test is successful, it is expected that the new dihydroartemisinin tablets may be approved for marketing as soon as around 2026.
Artemisinin and other scientific research works of traditional Chinese medicine are expected to be included in the Oxford medical textbook for the first time
The reporter learned from the Chinese Academy of traditional Chinese medicine that the scientific research works on artemisinin and other traditional Chinese medicine written by Tu Youyou, a team member and Liao Fulong, a researcher of the Chinese Academy of traditional Chinese medicine, are expected to be included in the Oxford medical textbook (Sixth Edition), an international authoritative medical textbook to be republished 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 "a model of traditional medicine - traditional Chinese medicine" has been finalized, which is divided into four parts: "what is traditional medicine", "discovery history, action mechanism and clinical application of artemisinin and other traditional Chinese medicines", "holistic view and syndrome differentiation and treatment of traditional Chinese medicine" and "cheap and accessible traditional medicine". In April this year, Oxford University Press, the publisher of the book, started proofreading and will reprint it in the second half of this year.
Professor Cox, editor in chief of the Oxford medical textbook, said he was pleased that works on traditional Chinese medicine would be included in the textbook. He said: 'the chapter on traditional Chinese medicine is both important and in-depth. All this is the result of the outstanding efforts of Chinese scientists. "
Pedro & middot; Alonso and other authoritative experts believe that Tu youyou's team has built a bridge between traditional medicine and modern medicine, so that traditional Chinese medicine is not only widely used in China, but also recognized by more and more countries because of effective treatment. It is hoped that Chinese scientists will continue to make more voices on the international stage of artemisinin research.