There have been many debates on the contributions of ancient Indian science in a variety of fields. Some claims are backed by authentic data, while some others are based on flights of imagination. But there is one example of a miracle drug, acknowledged as such globally for its potential, which India and its scientists have deliberated on extensively, but failed to make an impact in the world of practicing modern medicine.
The drug is curcumin, the active principle from the spice turmeric. This spice is a native of Asia, in particular India. It is grown almost entirely in India. Its use can be traced to Vedic culture, some 4,000 years ago in India. Turmeric is extensively used in Indian cooking and also finds uses as a dye, cosmetic and medical applications.
In Ayurveda, turmeric has wide uses. It is used to treat flatulence, dyspepsia, liver disorders (jaundice in particular), common colds, eye and ear infections, small-pox, chicken pox and above all a variety of skin diseases and inflammatory conditions. And all the modern research with curcumin has shown it to be beneficial in a wider set of ailments. Perhaps, there is no ailment against which curcumin has not been tested in some laboratory or other globally.
Although, a large segment of the studies is devoted to the use of curcumin to treat a variety of cancers, its beneficial use has been demonstrated with a wide range of diseases including Alzheimer’s, cystic fibrosis, arthritis, other systemic disorders and infectious diseases. It is equally intriguing that the molecular targets for curcumin are very diverse, ranging from genes to membranes. This defies the very concept of a modern drug, discovered using a variety of computational tools, animal and human trials to ensure specificity and safety.
Curcumin defies all these concepts, has pleiotropic action and is safe both as a dietary component as well as orally administered drug (up to 8 grams/day was shown to be non-toxic in humans). There are stray examples of side effects such as nausea on long-term therapy with curcumin, but the overwhelming evidence is in terms of its beneficial effects.
Another argument against curcumin is that it is poorly absorbed and metabolized very fast. But, again it is effective despite defying all the classical requirements in terms of pharmaco-kinetic and dynamic parameters. It appears that tiny concentrations for short periods are adequate for long-term effects. For example, we have found its antimalarial activity long after it has disappeared from circulation, indicating that it is capable of inducing a memory effect. At the same time, nanocurcumin preparations are now available to enhance bioavailability, if required.
The fact remains that curcumin is not an approved drug even for a single ailment, although USFDA has classified it as a GRAS (Generally Regarded As Safe) molecule. Data is available from over 100 clinical trials (completed and ongoing), including cancers and other diseases, using curcumin alone or in combination with existing therapy. The data indicate positive trends, but with the invariable conclusion that larger clinical trials with appropriate randomized designs are needed.
This is the stage we have reached and remained after decades of research; curcumin was discovered in 1815! A molecule that is beneficial for a variety of ailments, based on a science that cannot explain its diverse drug targets, an action that defies pharmacological parameters and above all a drug that is cheap and not easily patentable as such, will never make the grade in the eyes of multinational pharmaceutical companies.
But, what is preventing Indian drug companies from looking at curcumin as an approved drug for specific ailments in the clinic? It is here that there is an opportunity for the Indian Council of Medical Research (ICMR) to step in and take steps to promote curcumin as a unique molecule to treat specific diseases.
The best option appears to conduct clinical trials with curcumin as an adjunct therapy with the existing drugs. It can work synergistically as an anti-inflammatory molecule and can decrease the toxicity and resistance to the primary drug. It can be a unique antidote to treat and prevent drug resistance. This will be a great contribution which India can make to the cause of affordable therapy with justifiable pride in the wisdom of ancient Indian medicine.
( The authors are from the Department of Biochemistry, Indian Institute of Science, Bengaluru)
