is occasional or more regular, medications are part of our lives. Capsules,
tablets, syrups, gels, creams, the list goes on! But before arriving in our
medicine cabinets, there are many steps involved in their design. The first one
is the idea of the molecule that will be contained in each of these drugs. Let
us have a look back through a very long history.
Where do these molecules come from?
medical treatments, their uses and their methods of preparation have been
brought together in collections called pharmacopoeias. To understand their
origin, let's take a look back.
men of the Neolithic era were probably the first to have gone in search of
substances capable of relieving their illness. Scientists believe that permanent
settlements played an important role in the development of prehistoric medicine
because it could have led to the emergence of many diseases. In fact, sedentary
humans live closer to animals, leaving more possibilities for microbes
(bacteria, viruses) to pass from animals to humans. To treat themselves, they
mainly turned to what they had available, namely plants. Thus, herbal medicine,
which is now considered as an alternative therapy, was probably the basic
therapy in early humans. The use of plants at that time as a medicine, however,
remains hypothetical because no writing can certify it.
Pharmacopoeias rich in information
evidence of various substances usage for the purpose of healing dates back to
3500 BC, to the Sumerian tablets discovered in 1948 in ruins of the city of
Nippur. Written in cuneiform script, they are extremely precise. They list not
only the substances used at the time (plants, milk, honey, turtle scales, etc.)
but also the part of the plant used (seed, root, etc.), their methods of
preparation as well as the symptoms against which these treatments will work.
We can say that the Nippur tablets are the first pharmacopoeia in the world.
Figure 1. Cuneiform sumerian tablet
In ancient times, the Egyptians wrote their
pharmacopoeia on papyrus. Several sets covering the 17th and 18th dynasties
(between 1634 and 1292 BC) have survived to this day with 1,740 remedies written
on them! The Egyptians broadened the substance used to cure with minerals and
certain products of human origin.
Figure 2.Hippocrates by Pierre
Paul Rubens, 1638 (https://fr.wikipedia.org/wiki/Hippocrate)
Ancient Greek civilization gave birth to
the one considered to be the father of medicine: Hippocrates (460-377 BC). With
his theory of patient observation, he revolutionized medicine and at the same
time the treatments used. Hippocrates aimed for bodily balance and identified
the concept of dose of treatments used, further clarified by Paracelsus.
A little bit afterwards
lived the father of pharmacy, Claude Galien (129 or 131 - 201 or 216). He
simplified the writings of Hippocrates to make them more accessible and based
his practice on the combination of theory and experimentation. His belief was
that neither theory nor experimentation can lead to a positive outcome when
observed in isolation.
medicine and treatments evolve and progress, but there is always a certain part
of ineffectiveness to them. Thus, in the Middle Ages, in Europe, many currents
of witchcraft appeared in parallel with traditional medicine, most often based
on plants and animal products.
Renaissance, the discovery of America brought new life with the discovery of
plants that were very effective against certain diseases. Of particular
interest were quinine, then used in the treatment of severe fevers, as well as
curares which will later be used as anesthetics due to their paralyzing
revolution happened in the 18th and 19th centuries. We no longer seek to treat
a disease with an entire element but to isolate what is called the active
principle, the molecule which has an effect in a specific context when the
plant, mineral or animal substance is used. Morphine from poppy, salicyline
from willow bark and cocaine from coca are thus isolated. Thanks to the
isolation of the active ingredients by various methods (infusion, decoction,
maceration and other), we gain in efficiency by having a more targeted activity.
Figure 3. Chemical formula of saliciline
and its derivative the acetylsalicylic acid
Quickly after these discoveries, chemists
sought to fully synthesize these molecules in order to improve and optimize
them. One of the best examples is acetylsalicylic acid, none other than aspirin,
a synthesized derivative of previously extracted and isolated salicyline.
century is the era of pharmaceutical chemistry. Organic chemistry is in full
swing, knowledge is growing day by day. More and more molecules and their
derivatives are emerging, thus forming families of molecules with several
generations. Along with advances in medicine and surgery, these are the prime advancements
for human health.
synthetic pharmacy was slowly running out of steam in the late 19th
century, and yet some diseases were still fatal and without effective treatment.
Other sources had to be found for developing new drugs. It was in the 1920s that
the idea of using animal proteins to supplement humans emerged, especially in
pathologies such as diabetes with the production of pork or beef insulin. But
there is a problem of performance and logistics. It takes a lot of animals to
get enough insulin for every patient. Researchers in the 1970s found a way to
produce these human proteins by a recombinant method, made in another organism,
most often bacteria. These techniques have been extended to develop other
treatments such as growth hormone.
Figure 4. Schematic representation of
the production process of recombinant insulin using biotechnology
Towards a new era
antibody therapies is also booming since the 1970s and their therapeutic
arsenal is increasingly developing, in particular to treat cancers, autoimmune
diseases and even to prevent transplant rejection.
recent advances are the ones that have been talked about a lot lately:
messenger RNA vaccines. Even if vaccines are not strictly speaking drugs since
they do not aim to cure but to prevent diseases, the objective is to make the
human body produce a protein against which the immune system can react in order
to build up immune system memory.
has gone from medicine using plants and other animal substances, to treat
diseases with molecules extracted from these plants. Then by synthesizing
derivatives. And last discoveries using biotechnology allow treatments directly
by elements of the human organism, by specific protein supplementation or by
of medicine rests on cell therapy and gene therapy. Thanks to the growing
knowledge of researchers on the molecular and cellular mechanisms of the human
body, drugs are likely to undergo profound transformations and have a bright
future ahead of them.
Yves, Initiation à la connaissance du médicament, Ediscience, 2012
Jaussaud. Les pharmacopées. 2012. ffhalshs-00846866
d'histoire de la pharmacie, 52e année, N. 181-182, 1964