Traditional Chinese Medicine

Team members: Ensy CarolineFarhath Jabien

FellyMelisa

Nishachand Vohreh

What is Traditional Chinese Medicine?

•Originating in China around 2000-3000 years ago.

•Combination of natural plants → Treatment for illness and relieve symptoms of different diseases.

•In contrast to Modern medicine → TCM fewer and less severe side effects than single pure drugs.

The principle of Chinese herbal effectiveness:

• Imperial herb

• Ministerial herb

• Assistant herb

• Servant herb

Changes in composition and different imperial herb → different pharmacological action.

• Acupuncture – inserting fine needle to specific points → increase circulation and balance energy of the body.

• Qigong- slow movement and relaxation exercise → circulate energy and overall health.

• Cupping – placing several glass “cups” on the body.

• Chinese herbal medicine- the primary therapeutic of internal medicine

• Ginseng (Panax ginseng)

• Ginkgo

• Cinnamon

• Ginger

• Licorice

• Qi

• All manifestations of energy, from the most material aspects of energy (such as the earth, flesh and blood) to the most immaterial aspects (light, nerve impulses, thought, and emotion).

• It is universal, it is neither created nor destroyed; it simply changes in its manifestation.

Fundamental Concepts of TCM • Yin and Yang• Interdependent relationship of opposing

but complementary forces.

• Yin aspects of Qi that are relatively material, substantial, solid, heavy, cold, dark, passive and quiescent.

• Yang aspects of Qi that are relatively immaterial, amorphous, hollow, light, hot, dry, bright, aggressive, and active.

• Yin and Yang aspects of Qi are in harmony health, well-being and contentment.

• Yin and yang are in disharmony illness, pain and suffering.

• TCM maintains the harmony by recognizing and curing the disharmony.

Relationship between Qi, Yin and Yang

TCM

DIFFERENCES BETWEEN TCM AND WESTERN MEDICINE

WESTERN MEDICINE

•For maintaining health and treatment of diseases (focus on curing the root of diseases)

•Similar disease different treatment

• Fewer side effects

•For treatment of diseases (focus on curing the symptoms)

•Same treatment for similar disease

•Greater side effects

TCM WESTERN MEDICINE

•Use more conventional and simple method and machine less expensive.

•Lack of standardization

•Use Hi-tech machine more expensive.

•Have high standardization

“GINSENG”

INTRODUCTION

• The name ginseng comes from the Chinese term called renshen which literally means “man root”.

• The most commonly used species are Asian ginseng, called Panax ginseng

• In Greek, panax means “heal all”

Evolutionary history • Kingdom Plantae – Plants• Subkingdom Tracheobionta – Vascular plants• Superdivision Spermatophyta – Seed plants• Division Magnoliophyta – Flowering plants• Class Magnoliopsida – Dicotyledons• Subclass Rosidae • Order Apiales • Family Araliaceae – Ginseng family• Genus Panax L. – ginseng• Species Panax ginseng C.A. Mey. – Chinese

ginsenghttp://plants.usda.gov/java/profile?symbol=PAGI2

CDS and Protein sequences • The complete coding sequence for proteins in Panax Ginseng

is know to contain 372 bp CDS region from base 18 to 389. So there are 18 non coding sequence. >gi|31455577:18-389 Panax ginseng GBR5 (GBR5) mRNA, complete cds

ATGGGTTCCAATAAGGCATTTCTTTTACTTGGTCTTTCTCTGGCTATTGTTCTTCTGATTAGTTCAGAGGTCGCAGCTAGAGAGTTGGCTGAAGCTCAGACCACCACTACCAACAAAAACACTGAGGCAGCTACTGTTGATGGGAGGAGCGGATATAATGGCTACGGCGGTGGAGGCTACCACGGCGGTGGAGGCTACCACGGCGGTGGTGGTTACCACGGCGGTGGAGGTTACCACGGCGGTGGAGGTTACCATGGTGGTGGTGGCCATGGCGGTGGTGGGTGCAGTCACGGATACTGCCGTTATAGGTGCTGCAACTATGCAGGTGAGGTGGTGGACGCAGAGACTACCGGAGTCAAGCCTCAAAACTAG

• Moreover, these active gene is know to produce 124 various proteins with this sequence:

>gi|31455578|gb|AAP55852.1|AF485332_1 GBR5 [Panax ginseng]MGSNKAFLLLGLSLAIVLLISSEVAARELAEAQTTTTNKNTEAATVDGRSGYNGYGGGGYHGGGGYHGGGGYHGGGGYHGGGGYHGGGGHGGGGCSHGYCRYRCCNYAGEVVDAETTGVKPQN

Main Active Agents

• The main active compounds which are found in Panax ginseng are so-called as Ginsenosides (ginseng saponin)

• There are more than 20 kinds of ginsenoside which are known now.

• Ginsenosides: -Ro,-Ra1,-Ra2,-Rb1,-Rb2,-Rb3,-Rc,-Rd, -Re, -Rf20Gluco,-Rf,-Rg1,-Rg2,-Rh1, etc

Chemical Structure

http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=100018&loc=ec_rcs

-Ro -Ra1 -Ra2

-Rc

Uses of Ginseng

• for stimulating the mind• strengthening the body• improving memory• increasing vitality• extending endurance• cleansing the body of stress• fighting fatigue• to control diabetes• etc

DRUG DESIGN

• Ginsenoside Rb2 which is one of the components of ginseng saponin, also exhibits the effect of lowering blood sugar level.

• Firstly tested in a diabetic rat (Mus musculus)

• In this study, when diabetic rats were treated with ginsenoside Rb2 of Panax ginseng, there was a significant reduction in blood glucose.

(Ramawat,K.G.etal.(2008) Biotechnology of Medical Plants: Ginseng. France:Laboratories et Biotechnologie)

• It was found that the ginsenoside Rb2 binds on the gene which is responsible for diabetes mellitus disease which is know as retinoblastoma_like 2. This gene is also known as Rb2,p130,Rbl2

• Retinoblastoma_like 2 or Rb12 is the gene which found on chromosome : 8

location : 8 C5; 8 40.99cM

on the organism Mus Musculus

Binding site of GinsenosideRb2 in Rat

http://www.ncbi.nlm.nih.gov/sites/entrez?db=gene&cmd=retrieve&dopt=full_report&list_uids=19651

Drug Target on homo sapiens

• In homo sapiens, this gene is found on

chromosome :16

location :16q12.2

• The name is slightly different, not RBl2 but RBL2

Genomic contextchromosome: 16; Location: 16q12.2

http://www.ncbi.nlm.nih.gov/sites/entrez?db=gene&cmd=retrieve&dopt=full_report&list_uids=19651

Interesting Fact of Ginseng Wild ginsengs are rare and much esteemed and, in Korea, a person who finds even a single hundred year old wild root can become a millionaire.

Basic Facts• The only living species of the genus Ginkgoaceae

• Can be traced back to the Jurassic Era

• Native in China

• Its leaves and seeds are of medicinal values and have been used by traditional medicinal practitioners since 1974

• Has a long history of fossils

• All of its ancestors have disappeared from all continents

• The only remaining is Ginkgo Biloba available only in Asia

Evolutionary History

• Began during Jurassic era

• The genus changed very little for than 80 million years

• Can be seen that the leaves changed from many lobes to single

• The seeds also from being clumped together to a single seed

Phylogenetic Tree

FOSSILS

Sequences in FASTA format • Maturase K •

CAGAACCAGACCTCGTGCAAGGAATGAAACGGATGGGAGATGTATATTATATACATCGATAGATATGTAATATGCTCATCTATTCCAATGTGATAATTGTGAAATAAGATCAAATCAATTCATGGTTAAGTCAAATGAGTCAATGGATAAAGCTGGATGGCTTTAATCATAGGTAAAACCAGAGGAACGAGCTTCTGTTCCTCATTTCAATGAGGAATTCCCGTTACTAATTAGAAGTTAAGAGCATATTGGTGTCCGATATGGGGGAGGTTTTTCCCGTGAGTAGATCAGGGATTGATTCGCCTAGAATGAGTCCTAGGTATTCGAGGAAAAATGTGTAAGAAAAATAGTTTACTGACCAAGTCAATTTATTCTACAAGTCAGGAGAGCGATCAGGTCGCCAATATAAAGTCTTTTCATCATCCCTCATGACGAACGATATCTTTGAATAGAAGATCTCTTGAATAGAATCCCTATCTTTCAGATAGATCATTATCTATTCCGTCCTGACCGGATCGCACCGTGTATTATTTCATAACCCAAGAAGTTACTCTCACAAGGGCCATAGCCAAGGTTTTATTCAAAATGGATAAGTTCAAAAGAGACGGAGAAGAATATATATCCTATCAA

• Ginkbilobin-2, GAFP, The Novel Antifungal Protein From Gingko Biloba Seeds ANTAFVSSACNTQKIPSGSPFNRNLRAMLADLRQNTAFSGYDYKTSRAGSGGAPTAYGRATCKQSISQSD CTACLSNLVNRIFSICNNAIGARVQLVDCFIQYEQRSF

Drug Design

• Many organic and inorganic components present in Gingko

• Most important are terpenes and flavoids that causes the leaf extracts to be used as traditional remedies for issues like fungal infections.

• The protein Ginkbilobin-2, GAFP found in extract binds to Benzodiazepine receptors of mitonchondria.

http://upload.wikimedia.org/wikipedia/commons/9/99/Bilobalide.png http://www.scielo.br/img/revistas/rbfar/v17n3/02x01.gif

Uses of Traditional Medicine • Gingko leave extracts are mainly used (the combined activity

of the terpenes and flavoids)

• Releases EDRF

• Acts as antioxidant

• Laboratory studies have shown that GBE improves blood circulation by dilating blood vessels and reducing the stickiness of blood platelets (terpenes)

• Acts as an anti-fungal herb

How effective are TCM compared to modern drug?

http://personaltrainerluxembourg.com/wp-content/uploads/2009/04/relaxgym-300x296.jpg

http://images.google.com.sg/imgres?imgurl=http://www.life123.com/bm.pix/health-alt-naturopathy-meditation.s600x600.jpg&imgrefurl

Ginseng versus anti Inflammatory drugs ( aspirin)

• Target: CXCL-10 gene• Protein sequence : Panax Ginseng Vs Glucocorticoid

RNS1_PANGI GVQTEVEASTVQKLYAGLLLDIDDILAFPQAIKSSEIIEGVKLVT22D3_HUMAN-MNEMYQTMEVYQLHN---FSIS-FFLLGGDVVSVKLDNGVAID :: :: * :*: :.*. :: : : * :: : ** : RNS1_PANGI NMKQRIDAIKALTYSIIDILLDIIIVNHFTIVPTPDGGS-IVKTIT22D3_HUMAN NIEQAMDLVNLMYAREVEILKEQILVEKNSQLERENTLLKTLAEQ*::* :* :: : : :** : *:*:: : : : : RNS1_PANGI YNIGVIPEENIKDAEKAKAVEYLLT22D3_HUMAN LEFQLSPEEPAPESQVPEAPGSAV:: : *** ::: .:* :

Gingko versus Caspofungin

• Target: benzodiazepine receptor of mitochondria• Protein sequences of Ginkbilobin2 GAFP vs Lactobacilus

GKBL_GINBI NTFSSAHNQKIGAFNRNLRAMLDRQDYR_LACCA AAFYAKQHDQIGTFKDDVDTLLTRL :* : ::::**:*: :: ::* * GKBL_GINBI NAFAGDYR_LACCA ASFEG :* *

Current issues on TCM usage• Researchers involved in pharmacokinetics did a study to

observe how the body reacts to TCM like Ginseng and Gingko.

• Drugs:

• Firstly ,participants were given mixture of drugs.

• The five drugs in the cocktail provide measurements of the pathways that determine the pharmacokinetics of over 90 percent of prescription drugs.

• The scientists measured the presence of these drugs or their metabolites in each subject's blood and urine to establish a platform.

Current issues on TCM usage• TCM:

• After some time, the same group of people were tested with herbs.

• the 1st group received a ginseng supplement and a placebo(fake) for ginkgo biloba.

• the 2nd received ginkgo biloba and a placebo for ginseng.

• the 3rdv received both ginseng and ginkgo biloba supplements.

• the 4th received placebos for both supplements.

• The prescription drug cocktail was again given and blood and urine samples taken and compared with the previous test.

• Results:

• No significant differences were observed when a person takes one or both or none of the herb supplement.

• Ambiguity:

• Researchers conducted the test to find out what happens to the drug after being consumed but did not take into account the effect of drug on the body.

Conclusion:• Based on the test conducted, it can be observed that,

consuming both TCM and western medicine together does not enhance the effect of the modern drugs.

• both TCM and western medicine have similarities on curing a common ailment.

• Our stand: it is solely an individual’s right to choose which treatment he wishes to have. However, the responsibility lies in his hands to outweigh the benefits and losses of which ever treatment he chooses.

THANK YOU ALL FOR YOUR KIND ATTENTION!!