After more than 3,000 years, willow bark has become a miracle drug. Aspirin is so ubiquitous, but how much do you know about it? Let’s look at the legend and controversy of aspirin.
The history of the miracle drug aspirin is as long as human civilization, from its initial anti-inflammatory and analgesic to the prevention of cardiovascular and cerebrovascular diseases, to its latest research progress in tumors and other fields. There is no doubt that aspirin can be called a "miracle drug". However, this "miracle drug" seems to be on the verge of falling off the "altar"
1500-1800 BC, Willow Bark - a grassroots period of confusion and confusion< /p>
In 1534 BC, the ancient Egyptians used willow for anti-inflammatory and analgesic purposes; in 400 BC, the ancient Greeks gave women willow leaf sencha to relieve labor pains; in 200 BC, the ancient Chinese used willow bark for treatment Pains are common in all kinds of life; in 1758, a British priest discovered that dried willow bark was effective in treating malaria fever and pain.
The ancient Chinese recorded the indications of willow bark earlier and more completely. "Shen Nong's Materia Medica" says that the roots, bark, branches and leaves of willow can be used as medicine. It has the effects of eliminating phlegm and improving eyesight, clearing heat and detoxifying, diuresis and preventing wind. External application can cure toothache. "Compendium of Materia Medica" states that decoction of willow leaves can treat hemorrhage, relieve pain, and treat scabies; willow branches and root bark can be boiled in wine to rinse toothache and decocted to treat jaundice and white turbidity; catkins can stop bleeding, treat dampness in the spleen, and contracture of limbs. urgent.
What opportunity did the grassroots seize to be able to change their destiny and become popular in every family, rich or poor? In the 17th and 18th centuries, during the European Renaissance, the rapid development of organic chemistry solved the eternal mystery of willow bark
The molecule responsible for its efficacy - salicylic acid.
The vertical history of the discovery of aspirin from 1820 to 1900
In 1828, the French pharmacologist Leroux and the Italian chemist Piria successfully purified salicin (Salicin), and aspirin was officially invented. Stage; In 1838, Piria extracted a more powerful compound from the crystals and named it salicylic acid. In 1852, Canadian chemistry professor Gerhart discovered the molecular structure of salicylic acid and used chemical methods to synthesize salicylic acid for the first time. However, the compound was impure and unstable, so no one was interested.
In the late 19th century, salicylates began their long clinical research journey; in 1876, British doctor Maclagan published the first clinical study containing salicylates in The Lancet. This study found that salicin can relieve fever and joint inflammation in rheumatism patients, and sodium salicylate began to be used for antipyretic analgesia and treatment of diseases such as arthritis and gout.
In 1897, the German chemist Hoffmann reacted with salicylic acid and acetic anhydride to synthesize acetylsalicylic acid; in 1899, the invention patent application for aspirin was approved; the German Bayer Pharmaceuticals officially produced it, taking Named Aspirin, aspirin has since become the best-selling drug in the world; Bayer has set up aspirin production bases around the world.
The ill-fated fate of Bayer's patents and trademarks
In 1914, World War I broke out and swept across Europe, Asia, and the Americas. Bayer quickly became a victim of the war. Production and sales were seriously affected; in 1919, Germany was defeated, and Bayer's overseas assets (patents, trademarks) were acquired by the victorious Britain, France, and the United States as war compensation.
After the war, in the United States and Canada, Sterling Drug acquired Bayer's assets for $5 million, including the right to use the Bayer name and famous trademark. It had to use another name in the United States. Sales of aspirin; in 1994, Bayer bought back the property rights of aspirin from the United States for US$1 billion.
Aspirin’s status as a “magic drug”
Aspirin is often regarded as a “panacea” and is used as an analgesic, antipyretic and anti-inflammatory drug to prevent platelets from aggregating at damaged blood vessels. , has an anticoagulant effect and can treat certain inflammatory diseases, such as Kawasaki disease, pericarditis, rheumatic fever, etc. High-risk patients take long-term use to prevent heart disease, stroke and thrombosis, and prevent certain types of cancer, especially rectal cancer. , approved by more than 30 countries and regions around the world for the primary prevention of cardiovascular and cerebrovascular events.
Controversy about this "miracle drug"
Aspirin has been controversial in its widely used primary prevention. In 2019, it was included in 13 RCT trials, ***164225 A meta-analysis of patients showed that it has a certain effect in preventing diseases, but it also significantly increases the incidence of bleeding, intracranial hemorrhage and severe upper gastrointestinal bleeding. In short, the risk of bleeding side effects from long-term use is greater than its potential to prevent bleeding. How to view miracles and controversies, its role in primary prevention is still crucial. Before use, the risk of cardiovascular and cerebrovascular diseases/bleeding should be evaluated according to the disease condition. Individualized and standardized treatment is the king.
New clinical uses of aspirin
Relevant research continues to show its new clinical indications, preventing cognitive decline and Alzheimer's disease, and improving depression and schizophrenia. , significantly slowing down the process of liver fibrosis in patients with chronic liver disease, and its application in other tumors is also being studied.