"Milestones" in the medical field over the past century: These five drugs have improved human life

The core of modern medicine is the various "life-saving drugs" developed by chemists. On August 11, the American Chemical Society's journal Chemical & Engineering News listed five milestone drugs that have emerged in the past century in a special issue commemorating the 100th anniversary of the society. These drugs have changed medical practice, drug discovery science, and society.

Penicillin: Saved Millions of Lives

Penicillin is one of the earliest antibiotics and has saved millions of lives since its introduction.

In 1928, British bacteriologist, biochemist and microbiologist Alexander Fleming discovered the drug in a moldy petri dish. Eleven years later, Howard Walter Florey and Ernst Chain of Oxford University confirmed the bactericidal properties of penicillin in mice and began testing it on humans. In 1941, a policeman in Oxford, England, became the first person to be treated with penicillin, but he eventually died due to insufficient supply of the antibiotic.

In 1945, Fleming, Chain and Florey jointly won the Nobel Prize in Physiology or Medicine for their discovery, research and improvement of penicillin and its successful use in treating patients.

To this day, penicillin remains one of the most commonly used antibiotics in the world, although scientists have developed many other antibiotics.

Chlorpromazine: Direct treatment of mental illness

Chlorpromazine is one of the first drugs designed to directly treat mental illness. It was first synthesized by chemists at the French chemical group Rhone-Poulenc in December 1950. At that time, treatments for mental illnesses such as schizophrenia were not only ineffective, but also often came with risks.

But chlorpromazine was not originally developed to treat mental illness. In January 1952, French doctor Henri Laborie persuaded his colleagues to give chlorpromazine and several other drugs to a 24-year-old mental patient. After three weeks of treatment, the patient successfully recovered to the point where he could be discharged from the hospital.

After that, many mental patients around the world began to use chlorpromazine for treatment. Smith, Crane and Franso (the predecessor of GlaxoSmithKline) purchased the rights to sell the drug in North America. Chlorpromazine was approved by the US Food and Drug Administration (FDA) in 1954 and became one of the most successful new drugs, earning the company $10 million in one year.

Although newer antipsychotics have emerged, chlorpromazine is still in use today. Its success demonstrated that psychosis could be treated chemically, ushered in a new era of psychopharmacology, and forever changed the practice of psychiatry.

Oral contraceptive pills: empowering women to plan their own families

The oral contraceptive pill is hailed as an important discovery that has influenced the course of human history.

As early as the 1920s, scientists knew that injecting animals with reproductive hormones such as progesterone could prevent them from becoming pregnant, but using progesterone directly as a drug faced multiple challenges because progesterone must be injected or taken orally in large quantities to produce an effect in the human body.

In 1951, chemists Carl Djerassi, Luis Miramontes, and George Rosenkranz synthesized the first progesterone analog, norethindrone, which was effective at low oral doses and opened the door to the development of oral contraceptives. A year later, chemist Frank Korton synthesized a similar compound, norethindrone.

In 1957, the U.S. FDA approved the first Enovid, a combination of norethindrone and mestranol, to treat menstrual disorders, and in 1960 it was first approved as an oral contraceptive, giving women the right to family planning.

Antiretroviral drugs: turning a deadly disease into a manageable chronic condition

Tenofovir alafenamide, emtricitabine, and dolutegravir are three of more than 30 antiretroviral therapy (ART) drugs used to treat HIV. ART has transformed HIV from a dreaded, fatal disease to a manageable, chronic condition.

The success of ART is due to the efforts of countless researchers in academia, government and industry. In the 1980s, AIDS was discovered, which made people "shudder". In 1987, the US FDA approved the first antiviral drug zidovudine, which provided the first weapon for humans to fight against HIV. It prevents viral replication by inhibiting the reverse transcriptase of the virus.

Scientists realized that in order to control HIV, they needed to target multiple stages of the viral replication cycle. In 1995, the FDA approved the first protease inhibitor, saquinavir, to treat HIV. The following year, doctors reported that HIV levels in patients receiving cocktail therapy dropped rapidly to undetectable levels. Between 1996 and 1999, AIDS mortality rates in the United States and Europe fell by more than 50%.

Since then, more antiretroviral drugs have become available with fewer and fewer side effects. Doctors now start antiretroviral treatment as soon as HIV infection is diagnosed, which not only reduces morbidity and mortality but also reduces the chance of spreading the virus. People at high risk of infection can also take these drugs as a preventive measure.

Imatinib: Opening the door to precision cancer treatment

Cancer is characterized by the uncontrolled growth and spread of a group of abnormal cells. Targeted therapies have revolutionized cancer treatment, increasing patients' survival rates and improving their quality of life.

Imatinib (Gleevec) is one such therapy. It is one of the first precision medicines designed to target specific genetic mutations that cause cancer, inhibiting the growth of cancer cells by selectively targeting specific molecules involved in cancer cell growth.

In 2001, the FDA first approved imatinib for the treatment of chronic myeloid leukemia (CML). Results showed that this drug exhibited miraculous efficacy, increasing the five-year survival rate of CML patients from 30% to about 90%, successfully opening a new era of precision cancer treatment.