Snap, Modify, and Cure – Building Blocks of Modern Medicine

Do you remember playing with LEGO blocks as a child? Blocks of different shapes, colors, and sizes, where each one could snap into another to create something entirely new. As a kid, I often found it tricky to build from scratch. My brother would help by giving me a half-built base, and I’d just add a few pieces according to my choice to finish the final model. It felt like magic, and it felt like mine.

Years later, I realized something fascinating, surprisingly, modern medicine works in a similar way. Creating entirely new drugs from scratch is a very complex, expensive, and time-consuming process. But in nature, plants have been crafting intricate molecular “base structures” for millions of years. These natural molecules serve as ready-made scaffolds that exhibit built-in bioactivity. So instead of starting from zero, we take these plant-derived scaffolds as starting points. We snap on a chemical group, modify the function thereafter, and cure the disease.

Let’s take a closer look at some real-world examples of how this “snap, modify, cure” approach can help us understand modern medicine on a simpler level.

Artemisinin was once used in traditional Chinese medicine to treat fevers. Surprisingly, it later emerged as a powerful antimalarial. But the pure compound had its limits, it didn’t stay in the body for long, wasn’t easily absorbed, and wasn’t ideal for all forms of treatment. So scientists tweaked it. By snapping on new chemical groups to its core structure, they created improved versions:

  • Artesunate (water-soluble, injectable)
  • Dihydroartemisinin (more potent)
  • Artemether (lipid-soluble, better absorbed)

These modifications made artemisinin-based therapies the new standard for malaria treatment. Excitingly, some of its analogs also show possible applications in cancer treatment, reminding us how a small tweak can unlock big possibilities.

If this seems entirely unfamiliar to you, take something very common, the painkiller aspirin. Long before modern-day pills, people chewed willow bark to ease pain and fevers, thanks to a compound present in the bark called salicin. But salicin wasn’t really perfect; it could upset the stomach and wasn’t very stable. Scientists modified its structure to create acetylsalicylic acid, better known today as aspirin. This simple tweak made it more effective and easier on the body and turned a traditional remedy into one of the most widely used medicines in the world.

Today, aspirin is used not just for pain, but also to reduce inflammation, reduce fever, and even prevent heart attacks, all from a plant-based molecule that just needed a little modification to reach its full potential.

While aspirin proved useful for getting rid of everyday ailments, other natural molecules were found to tackle much more intense pain. Morphine is one such drug. In fact, morphine was one of the first plant-derived drugs ever isolated. Its ability to block pain made it a blockbuster molecule of the age- but like others, it came with its downsides: addiction, tolerance, and overdose risks.

To make it safer and more versatile, scientists modified its core structure. These small changes led to the discovery of a whole family of related drugs, each serving a different purpose. Consider the following, for instance:

  • Codeine (milder pain reliever, cough suppressant)
  • Oxycodone (more potent, longer-lasting)
  • Naloxone (antidote against opioid overdose)

Not just fevers and pain relief, we saw the same approach in something as serious as cancer. In the 1960s, researchers found a remarkable compound in the bark of the Pacific yew, paclitaxel. It later came to be known as Taxol. It was found to have the ability to stop cancer cells from growing. At the same time, it was realized that the extraction of paclitaxel was difficult and environmentally unsustainable. So, scientists modified their scaffold. With a few tweaks, they created semi-synthetic versions like docetaxel, which retained the anti-cancer property while improving supply, stability, and delivery. Today, paclitaxel and its analogs are used to treat breast, ovarian, and lung cancers. It’s an example of how a compound from a tree deep in the forest can become a revolutionary base for modern oncology, with just the right modifications.

Nature has provided us with molecular blueprints, complex, bioactive scaffolds evolved over millions of years. Our science builds upon these raw materials, adding a group here, removing one there, to create something better, safer, and more effective.

Who knows? The next life-saving drug might be hiding in a plant we haven’t discovered yet, or a block we’ve never thought to snap into place. Sometimes, the most powerful cures come not from building new blocks but from looking at the old ones differently.

Piyush Nikam,
SY B. Pharm