History as a Tool in Identifying “New” Old Drugs

Abstract

When Merck released a new drug, finasteride, with the proprietary name of Proscar^® for benign prostatic hypertrophy (BPH), they were surprised, delighted even, when they learned that users reported the promotion of hair growth. Soon they filed with the FDA for the release of the same drug (although lower dosage) with a new name, Propecia^®, for treating alopecia or male pattern baldness. Often the West makes its discoveries seemingly serendipitously or, less frequently, through insightful hunches. An example of the latter is the brilliant research of Jean Wilson, and Donald Coffey and his collaborators, who discovered a synthetic intracellular enzyme that converts testosterone into an active androgen, a reductase inhibitor for treatment of BPH (Horton, 1992; Wilson, 1972). These modern endocrinologists and chemists apparently did not know that ancient peoples knew the same action (not necessarily the same mechanism of action) which they found in nettle (Urtica dioica L.) and saw palmetto (Serena repens Bartr.). A 1997 study postulated the mechanism for saw palmetto’s and stinging nettle’s action on BPH. For a decade now we have known that these two plants (plus the African prune, Prunus africana Hook) mimic the action of the popular prescription drug finasteride (Awang, 1997). Dennis Awang advances the hypothesis that components in stinging nettle, saw palmetto and African prune shift the androgen/estrogen ratios, involving estrogen and estradiol production from androstenedione, or, in other words, the same action as Wilson postulated.