Herbal medicines, whether it's Chinese, Ayurveda or 'Unani', the general practice is to use a mixture of substances as a whole extract. This is quite different from modern medicines, which would rather work with single substances and molecular entities. The reason behind this is that we can then date individual events and understand them-a reductionist approach. Using a complex mixture confuses our understanding and this has stood in the way of our validation of traditional herbal medicines to some extent. But here too, the advances being made are encouraging.
Traditional Indian practice held that certain drugs should be formulated through the addition of chosen substances that help in the availability and absorption of the drug. These are what we would call in modern parlance as bioavailability enhancers. Traditional medicine men of India had suggested that the common black pepper, taken along with certain extracts, ensure increased potency.
Recent work, particularly in two Indian modern biological labs, has confirmed this bio-availability enhancing ability of pepper, and point to the active component as the molecule pipperine. Drs A. Khajuria, V. Zutshi and K. L. Bedi of the Regional Research Laboratory at Jammu have recently shown that pipperine is absorbed very fast across the intestinal barrier. It may thus act as a modulator of cell membrane dynamics and help the transport of drugs across this barriers, by forming a complex with drugs and helping them reach the target site rather than spreading out.
Professor Dipankar Chatterji of the Indian Institute Of Science at Banglore has preliminary data that show that pipperine act as a bio enhancer of the anti-tuberculosis drug rifampicin. Professor Chatterji finds that target site this case to be the enzyme RNA polymers of the tuberculosis germ. In the presence of pipperine the amount of the drug to be taken can be reduced in dosage, so that side effects of the drug can be minimized. This indeed is the greatest benefit of a bio enhancer substance-it helps reduce the drug dosage and thus the side effects, by directing the drug to reach the target site and not be lost on the way.
We have thus come a full circle. From potion or extract that contains a mixture, we moved in modern medicines to single molecule-rifampicin in this case. When given alone, it has to be given at a higher dose than necessary, in order to compensate for losses on the way to the target site. Mix some pipperine in the formulation and save on both the drug and the counter effects. The word 'synergy' used by herbal practitioners has been re-discovered by modern molecular pharmacodynamicists. Yes, by extracting the active ingredients Western medicine might have missed the second essential component of the synergistic couple. And it's high time, to learn from traditional and proven practices. There is a lot of work to be done, but there is a lot of hope and lot of gain to science in this endeavor of expanding the paradigm and widening our horizons of health care.
( Reprint from Science Reporter )