Plants and human health in the twenty-first century

Ilya Raskin, David M. Ribnicky, Slavko Komarnytsky, Nebojsa Ilic, Alexander Poulev, Nikolai Borisjuk, Anita Brinker, Diego A. Moreno, Christophe Ripoll, Nir Yakoby, Joseph M. O'Neal, Teresa Cornwell, Ira Pastor and Bertold Fridlender

Trends in Biotechnology 2002, 20:522-531

The concept of growing crops for health rather than for food or fiber is slowly changing plant biotechnology and medicine. Rediscovery of the connection between plants and health is responsible for launching a new generation of botanical therapeutics that include plant-derived pharmaceuticals, multicomponent botanical drugs, dietary supplements, functional foods and plant-produced recombinant proteins. Many of these products will soon complement conventional pharmaceuticals in the treatment, prevention and diagnosis of diseases, while at the same time adding value to agriculture. Such complementation can be accelerated by developing better tools for the efficient exploration of diverse and mutually interacting arrays of phytochemicals and for the manipulation of the plant's ability to synthesize natural products and complex proteins. This review discusses the history, future, scientific background and regulatory issues related to botanical therapeutics.

For centuries people have used plants for healing. Plant products – as parts of foods or botanical potions and powders – have been used with varying success to cure and prevent diseases throughout history. Written records about medicinal plants date back at least 5000 years to the Sumerians [1], and archeological records suggest even earlier use of medicinal plants. The strong historic bond between plants and human health began to unwind in 1897, when Friedrich Bayer and Co. introduced synthetic acetyl salicylic acid (aspirin) to the world. Aspirin is a safer synthetic analogue of salicylic acid, an active ingredient of willow bark, and was discovered independently by residents of both the New and Old worlds as a remedy for aches and fevers [2].

The twentieth century became a triumph for the synthetic-chemistry-dominated pharmaceutical industry, which replaced natural extracts with synthetic molecules that often had no connection to natural products. The spectacular rise of the pharmaceutical industry had a tremendous impact on disease treatment and prevention, saved countless lives and became one of the outstanding achievements of the twentieth century. However, the benefits of modern drugs are felt primarily in developed countries, and developing countries continue to rely on ethnobotanical remedies as their primary medicines, leaving almost 75% of the world population without access to the modern healthcare products taken for granted in the West. It is easy to overlook the fact that human medicines still contain phytochemicals – valued at US$22 608 million in 1997 and projected to reach a value of US$30 688.5 million in 2002 – with prescription products and over-the-counter (OTC) herbal remedies each comprising approximately 50% of the market [3].

The severed bond between plants and health was felt not only in the area of medicines. By providing a 'pill option', the pharmaceutical industry also diminished the historical connection between food and the treatment of disease. 'An apple a day keeps the doctor away' is the advice one usually gets from a mother, not from a professional health organization. Although plants are slowly making a comeback in several areas of human health (i.e. functional foods, dietary supplements and recombinant protein manufacturing), they are still losing importance in areas such as the traditional drug discovery process.

The plant therapeutic agents presented in this review are summarized and defined in Table 1. Although these definitions might not be ideal, they are helpful in structuring the discussion of the re-emerging connection between plants and human health. For the purposes of this review, the term 'plant' includes only seed plants (superdivision Spermatophyta), excluding the major contributions made by fungi and lower plants to human health and pharmaceutical discovery.

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20th November - 3rd December 2002

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