Curcumin, anyone?

When the topic comes around to traditional vs. western medicine, I tend to side pretty consistently with the western medicine camp. It's not that I'm anti-Ayurveda in particular; I just believe in a firm line between science and faith. In my view, one or another medicine cited in Ayurveda might actually be effective, but until it's been tested in a well-designed double-blind trial, and the results published in a rigorously peer-reviewed journal, I'm generally not interested in using it as anything other than a supplement.

Now, however, the line between eastern "folk remedy" and western science is getting just a bit blurrier, as accredited scientists have recently begun to formally study the effects of things like Turmeric using the scientific method, and blogger Ashutosh has an interesting post at Desipundit summarizing a recent article in Cell on the active ingredient in Turmeric, Curcumin. First, the hype, which is considerable:

Turmeric’s beneficial effects as recorded in Ayurveda are impressive. It is a multitalented molecule, and in its particular case, many of its effects have stood up to the hype. It shows among other things, potential antiinflammatory, anticancer, digestive, respiratory, pro immune system, and cardio and neuroprotective (anti-Alzheimer’s) effects. With such a profile, curcumin would be extremely alluring as a drug, almost seeming like a magic cure. (link)

That's a lot of potential benefits! Emphasis on "potential": there are some serious scientific hurdles that have to be jumped before the drug's effectiveness can be fully understood, or deployed to best possible use, and Ashutosh outlines those as well. Indeed, the fact that Curcumin's benefits are so generalized might actually be part of the problem:

However, the very varied tricks that curcumin can perform also makes it a somewhat problematic molecule as a drug. A drug usually needs to be very potent, and selective for one particular disease that you are trying to cure. Almost all drugs exert their beneficial effects by either speeding up, or more commonly, inhibiting the activity of a protein that’s involved in a disease. For example, many proteins are perpetually “turned on” in cancer cells leading the cells to incessantly proliferate, and many anticancer drugs work by blocking the activity of these proteins and therefore bringing rampant cell division under control. What we, and pharmaceutical companies are looking for, is a molecule that is potent, selective, and safe. All these qualities are of paramount importance. Potency is important for the very action of the drug, and also so that doses can be small; a weakly potent drug may have to be administered in intolerably large amounts to work. Selectivity is perhaps even more important, because if the drug hits other proteins or targets, it is going to cause unwanted side effects. As we all realise when we take a pill, no drug is completely selective, and there are always side effects, but an effort has to be made to keep them mild and to a minimum. Which naturally brings us to the last point; safety, without which you cannot convince any patient to take a drug, no matter how effective it may be.

In case of curcumin, it shows beneficial effects, but it is not particularly potent for one specific disease. To make it potent for one disease, first of all it would have to be known which protein(s) it blocks or interacts with in the body. Then, knowing the structure of the drug and the protein, chemists can make efforts to modify the structure and increase the potency, and also to reduce the above quoted off-target effects. In case of curcumin therefore, much work needs to be done, before if it can be turned into, say, an effective anticancer drug. In addition, there will need to be extensive animal and finally clinical testing of the modified molecule before it can be approved and marketed. Not surprisingly, the effort required for this whole process has been compared to the expended in putting a man or woman on the moon and getting him or her back. The current estimates are staggering; upto a billion dollars, and 10-12 years, from conception of an idea for a drug (say, curcumin) to finished marketed product, with a success rate of about 5%! No wonder that making drugs is an extremely risky business in all its aspects. This is also the reason why companies are obssesed with patents, because that is the only way for them to recover all this money that has been spent and make a profit to fuel further research.

Anyone have a billion dollars and 10-12 years to invest in deciphering the medical benefits of curcumin?

Googling around, one does find reference to other studies involving Curcmuin, including a UCLA study that suggested Curcumin might help reduce the likelihood of contracting Alzheimer's Disease (though no full-scale study on humans has been conducted yet). I also came across reference to a Johns Hopkins study suggesting that Turmeric/Curcumin might help reduce the number of precancerous colon polyps. And there may be other serious studies that explore other ways in which circumin might be beneficial (or not); readers, any tips?

Incidentally, I believe the article at Cell Ashutosh mentions is available here (subscription needed).