From the poison that killed Wu Dalang to a global anti-cancer star, how did arsenic make such a dramatic turn?

If we rank poisons, arsenic would be the most well-known to Chinese people.

When I was a child, I watched Water Margin. The scene of Wu Dalang being poisoned by arsenic left a deep shadow on my childhood. Who would have thought that 900 years after Wu Dalang was poisoned, arsenic would become a star anti-cancer drug. It really proved the old saying: "Thirty years in the east, thirty years in the west."

Arsenic, whose scientific name is arsenic trioxide, is synonymous with poison in martial arts novels, and Wu Dalang pushed the toxicity of arsenic to the peak. In traditional Chinese medicine, there is a saying called "fighting poison with poison", so some traditional Chinese medicine doctors tried to use arsenic to treat some diseases. Among them, there was a traditional Chinese medicine family. Arsenic in their ancestral prescriptions had a good therapeutic effect on certain diseases. Later, a doctor in this traditional Chinese medicine family studied Western medicine and found that the disease that was effective against arsenic was called leukemia. However, due to the limited scientific research conditions at the time, he did not further study the principle of the effectiveness of arsenic until later, when Academician Chen Zhu read a lot of classics, visited many experienced traditional Chinese medicine practitioners, and conducted more detailed scientific research on the treatment of leukemia with arsenic through scientific methods, and finally made a breakthrough.

Academician Chen Zhu found that arsenic is very effective for acute promyelocytic leukemia, but not for other types of leukemia. This research was like a thunderbolt, causing a sensation in the medical community. Doctors found that the response rate of combined treatment of acute promyelocytic leukemia with arsenic trioxide and all-trans retinoic acid was close to 100%, and the 2-year survival rate was 99%!

Therefore, the traditional poison arsenic made a great comeback after entering the 21st century and became a star in the fight against cancer. I wonder what Wu Dalang would feel when he knew this news.

Why is arsenic so effective against acute promyelocytic leukemia? Leukemia, also known as blood cancer, is a disease caused by the abnormal proliferation of white blood cells in the blood, which produces a large number of ineffective white blood cells, causing the human body to lose its resistance to the outside world. There are many independent proteins on human chromosomes, among which PML and RARα are on chromosomes 15 and 17 respectively. Separate PML and RARα are non-pathogenic, but once an accident occurs, they fuse and become a strong oncogene PML-RARα. It is the existence of PML-RARα that causes people to suffer from leukemia.

The strong oncogene PML-RARα, which is fearless, is just afraid of our arsenic trioxide. Arsenic can just inhibit the PML part of the fusion protein, leading to the death of cancer cells. As a result, arsenic, which has been infamous for thousands of years, has become the earliest targeted drug. Another targeted drug for the treatment of acute promyelocytic leukemia, all-trans retinoic acid, combines with the RARα part. They are like a pair of swords, and the effect on acute promyelocytic leukemia is surprisingly good. The efficacy of arsenic + all-trans retinoic acid combined therapy is close to 100%.

Be careful not to dismiss traditional Chinese medicine with one stroke. A similar story also happened to artemisinin. Tu Youyou won the Nobel Prize for treating malaria with artemisinin. Both arsenic and artemisinin were extracted from traditional Chinese medicine and applied to Western medicine.

In reality, many people praise traditional Chinese medicine as a treasure, and many people devalue it as scum. Both are wrong. Traditional Chinese medicine and Western medicine are two different theoretical systems, but they are related. We should apply the rigor of modern scientific research to carry forward the good prescriptions in traditional Chinese medicine and ultimately benefit patients all over the world.