venerdì 14 ottobre 2011

Birth Control pills 1

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For many thousands of years, humans have used a variety of
agents to cure their ills, promote their well-being, relieve their
misery, and control their fertility. Until the beginning of the
twentieth century, these agents were all of natural origin,
including many of plant origin as well as naturally occurring
elements such as arsenic and antimony. The sixteenth century
alchemist and physician known as Paracelsus used mercury
and arsenic in his treatment of syphilis, worms, and other diseases
that were extremely common at that time; his cure rates
remain unknown. It is of interest, though, that arsenic trioxide
is still used today, albeit in limited fashion, as an anticancer
agent, and antimony derivatives are used in the treatment of
the tropical disease leishmaniasis.
Our story of modern drug discovery begins with the German
physician and scientist Paul Ehrlich. Born in 1854, Ehrlich
became interested in the ways in which synthetic dyes, then
becoming a major product of the German fine chemical industry,
could selectively stain certain tissues and cellular components.
He reasoned that such dyes might form the basis for
drugs that would selectively interact with diseased cells and
organisms. One of Ehrlich’s early successes was the arsenical
“606”—patented under the name Salvarsan—as a treatment
for syphilis. Ehrlich’s dream was to create the “magic bullet,” a
drug that would with absolute specificity target only the diseased
cell or the disease-causing organism and not affect
healthy tissues and cells. In this he was not successful, but his
research did lay the groundwork for the subsequent great discoveries
of the twentieth century, including the discovery of
the sulfonamide drugs and the antibiotic penicillin. The latter
agent saved countless lives during World War II.

From these original advances has come the vast array of
drugs that are available to the modern physician. We are
increasingly close to Ehrlich’s aim of a magic bullet: Drugs can
now target very specific molecular defects in a number of cancers,
and doctors today have the ability to interrogate the
human genome to more effectively match the drug with the
patient. In the next one or two decades, it is almost certain that
the cost of reading an individual genome will be sufficiently
cheap that such “personalized” medicines will become the rule
rather than the exception. These drugs do, however, carry very
significant costs of both discovery and delivery, thus raising
significant social issues of availability and equity of medical
treatments.
Despite these current discoveries, it is interesting to note
that a very significant fraction of the currently available drugs,
notably antibiotics and anticancer agents, are either natural
products or are derived from natural products. Such chemicals
have been forged in the crucible of evolution and have presumably
been derived by nature for very specific biological
purposes.
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