Thursday, February 4, 2021

Nobel Prize winner Tu Youyou— "Artemisinin - a gift of traditional Chinese medicine to the world"

Reporter : Wang Junping / http://news.sciencenet.cn/htmlnews/2020/9/445856.shtm / Direct translation / Images : Chinese Technology Centre and Wikipedia
 



Biography
 
Tu Youyou: Born in December 1930, from Ningbo City, Zhejiang Province, lifelong researcher of China Academy of Chinese Medical Sciences and director of Artemisinin Research Center. For more than 50 years, she led the team to overcome difficulties and made Artemisia annua world-famous; in 2015, she won the Nobel Prize in Physiology or Medicine; in 2017, she won the 2016 National Science and Technology Award; in 2019, she was awarded the "Medal of the Republic".
 
December 30, 2020 is Tu Youyou's 90th birthday. She received a special birthday gift: Researcher Tu Youyou's studio was unveiled at the Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences. She has devoted her life to only one thing-the research and development of artemisinin and its derivatives, and she still concentrates on this...
 
"After I studied medicine, I can not only stay away from illness, but also save more people."
 
"Yoyou Luming, Artemisia of the Wild Food". Tu Youyou's name is destined to be associated with Qinghao for life.
 
Tu Youyou was born in Ningbo, Zhejiang Province in December 1930. "Women's Book of Songs, Male's Songs of Chu" is an ancient Chinese naming habit. Tu Youyou's father extracted the word "youyou" from "The Book of Songs·Xiaoya". The father was right again, "The wormwood is green, and the spring is back." He did not expect that this "little grass" changed her destiny.
 
Tu Youyou's education was interrupted by an illness. At the age of 16, she unfortunately contracted tuberculosis and recovered after more than two years of treatment. This experience made her interested in medicine. "I learned medicine. Not only can I stay away from the pain, but I can also treat more people. Why not?" From then on, Tu Youyou decided to go to medicine...
 
In 1951, Tu Youyou was admitted to the Department of Pharmacy of Peking University School of Medicine (now the School of Pharmacy, Peking University School of Medicine), and chose an unpopular major-Pharmacognosy. Many years later, Tu Youyou said that this was her wisest choice.
 
After graduating from university in 1955, Tu Youyou was assigned to the Institute of Traditional Chinese Medicine of the former Ministry of Health (now China Academy of Chinese Medical Sciences) and has worked so far. After four years of work, Tu Youyou became a student of the "Third Phase of the Western Medicine Leaving School of Traditional Chinese Medicine Class of the Chinese Medicine Research Institute" organized by the former Ministry of Health. He systematically learned Chinese medicine knowledge and found the inspiration for artemisinin.
 
In addition to training, she often went to medicinal materials companies to learn Chinese medicine identification and processing techniques from veterans. She carefully studied and followed the authenticity of medicinal materials, quality identification, and processing methods. These daily accumulations laid a solid foundation for her future anti-malarial projects.
 
"I am the team leader, I am responsible for the first test drug"
 
In July 1972, a group of special "patients" were admitted to Beijing Dongzhimen Hospital. Researchers, including Tu Youyou, wanted to be "little mice" as test drugs. Tu Youyou said without hesitation, "I am the team leader, and I have the responsibility to be the first to test the drug!" This story starts with the "523" project.
 
In January 1969, 39-year-old Tu Youyou suddenly received an urgent task: as the leader of the research team, he worked with 60 scientific research units and more than 500 researchers across the country to develop new antimalarial drugs. The project was named after the meeting date on May 23, 1967, and was named the "523" project.
 
In the initial stage, the Institute arranged for Tu Youyou to work alone. She collected and sorted out more than 2,000 prescriptions in only 3 months, and compiled a "Malaria Single Secret Prescription Collection" based on 640 drugs, and sent it to the "523" office. After two years, her team has gradually grown. After hundreds of failures, Tu Youyou focused on the traditional Chinese medicine Artemisia annua: They found that the inhibition rate of Artemisia annua against malaria in mice reached 68%, but the effect was unstable...
 
Speaking of the hardships of research, Tu Youyou’s wife Li Tingzhao still remembers: In order to find the reasons for the unstable effect, Tu Youyou once again reviewed the ancient medical books. A few words in Ge Hong's "Earth Reserve Emergency Recipe" of the Eastern Jin Dynasty caught her attention: "One grip of Artemisia annua, two liters of water for soaking, squeeze the juice, and take it all."
 
"One is that there are varieties of Artemisia annua. There are many varieties of Chinese medicine. Which one of the genus Artemisia annua is? Second, the medicinal part of Artemisia annua, the twisted juice mentioned in the "Elbow Reserve Emergency Prescription" Which part is it? Third, what effect does the harvest season of Artemisia annua have on the efficacy? Fourth, what is the most effective extraction method?" Tu Youyou said.
 
Tu Youyou repeatedly considered these issues, and finally chose low-boiling ether for extraction. After many failures, finally on October 4, 1971, the ether neutral extraction sample No. 191, inhibited both mouse malaria and monkey malaria by 100%.
 
Despite the presence of ether neutral extracts, suspected side effects were found in the pathological sections of individual animals. It can be used clinically only after it is confirmed to be safe. Malaria is seasonal, and if you miss the clinical observation period that year, you have to wait another year. As a result, Tu Youyou submitted a voluntary test report to the leader and also drove his colleagues to participate.
 
"Although artemisinin was discovered almost half a century ago, its deep-seated mechanisms still need to be studied"
 
However, the first clinical observation of artemisinin was unfavorable.
 
In September 1973, in the first clinical observation of artemisinin tablets in Hainan, only one case of falciparum malaria in the first batch of experiments was effective, and two cases had some effects, but the malaria parasite was not completely killed. 2 cases were invalid.
 
A series of questions plagued Tu Youyou: It is not the purity of artemisinin, nor is it the problem of animal experiments and data, is it the dosage form? The Hainan clinical trial staff sent the tablets back to Beijing. Everyone felt that the tablets were too hard to be crushed with a mortar. Obviously, the degree of disintegration would affect the absorption of the drug. Therefore, Tu Youyou decided to put the original powder of the artemisinin drug directly into the capsule for another clinical trial. This time, the patient's body temperature returned to normal within an average of 31 hours after the medication, indicating that the efficacy of artemisinin capsules is consistent with the laboratory efficacy.
 
From chemical substances to drugs, the research of artemisinin is endless. In 1982, Tu Youyou received the certificate and medal of invention at the National Science and Technology Awards Conference as the first inventor of the new antimalarial drug-artemisinin. The successful development of artemisinin has brought good news to patients suffering from malaria all over the world. According to statistics from the World Health Organization, more than 200 million malaria patients worldwide benefit from artemisinin combination therapy every year, and the number of malaria deaths has steadily fallen from 736,000 in 2000 to 409,000 in 2019. The discovery of artemisinin saved millions of lives worldwide.
 
Tu Youyou won the 2015 Nobel Prize in Physiology or Medicine. On the Nobel Prize podium of Karolinska Institutet in Sweden, the voice of Qingzheng and gentle Chinese sounded for the first time; the title of Tu Youyou's academic report was "Artemisinin-A Gift of Traditional Chinese Medicine to the World" .
 
In the face of honor, Tu Youyou was as calm as ever. Before the "Republic Medal" was announced, the selection team had contacted Tu Youyou. At that time, she confirmed a series of questions over and over again: Am I qualified for such an important honor? Have you solicited your opinions on the organization? ... She didn't agree to accept it until the other party confirmed the guarantee repeatedly.
 
Living in an ordinary residential building in Chaoyang District, Beijing, Tu Youyou is still not used to being a "star" scientist, and her energy is still in research. Thanks to Tu Youyou's continuous efforts, in August 2019, the China Academy of Chinese Medical Sciences held a groundbreaking ceremony for the Artemisinin Research Center in Daxing, Beijing; the white main building of the research center in the vision is like a vibrant Artemisia annua.
 
"Although it has been nearly half a century since the discovery of artemisinin, its deep-seated mechanisms still need to be studied." Tu Youyou hopes that his younger generations will make a breakthrough.
 
April 25, 2019 is the 12th World Malaria Day. Scientists from the Artemisinin Research Center and the Institute of Chinese Materia Medica of the Chinese Academy of Chinese Medical Sciences put forward a reasonable response plan for "artemisinin resistance" in the New England Journal of Medicine. . Distinguished expert Wang Jigang was the first author, and Tu Youyou guided the team to complete. In the future, the anti-malarial mechanism of artemisinin will be the focus of her and her research team.
 
One plant to benefit the world, one to serve the country. In response to the new crown pneumonia epidemic, Tu Youyou urged: global scientific research and medical workers should invest in the prevention and control of major infectious diseases with an open attitude and a spirit of cooperation...
 
 
■Reporter's Notes
 
Power from inner peace
 
Tu Youyou's life is divided into two stages: one is to prepare for the study of artemisinin; the other is to study artemisinin. The cut-off point was in January 1969, she was appointed as the group leader of the "523" project "Anti-malarial Chinese herbal medicine research". After that, she never stopped until she won the Nobel Prize. Tu Youyou's "Secret Formula for Success" is derived from the "character formula" of the scientific masters: the power of inner peace, the state of indifferent to fame and fortune, the perseverance to pursue the truth, and the tireless persistence.
 
In her old age, Tu Youyou was still determined to study the underlying mechanism of artemisinin. Without inheritance, innovation will lose its foundation; without innovation, inheritance will lose value. Innovating in inheritance and inheritance in innovation, the ancient Chinese medicine can last forever.
 
In the face of the covid pandemic, the combination of Chinese and Western medicine and the combined use of Chinese and Western medicine are the characteristics of my country's epidemic prevention and control, and it is also a vivid practice of inheriting the essence of Chinese medicine and maintaining integrity. From anti-malarial to anti-epidemic and combating infectious diseases, traditional Chinese medicine has demonstrated its unique advantages. People of insight hope that after Tu Youyou, Chinese medicine practitioners will be able to pass on the fire, and the peaks will rise to discover more "artemisinin" and save more lives.

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