Learnings from First Nations traditional medicine could enhance the effectiveness of regenerative medicine.

By Jimmy Yu and supervised by Dr Chih Wei Teng

Introduction

Traditional medicine (TM) and practices of Australian Aboriginal people and Torres Strait Islander or Australia’s First Nations embody a world imbued with ancient wisdom, intricate rituals, and spiritual beliefs that have long eluded the grasp of Western medicine. Due to a lack of understanding and cultural differences [1], the Western scientific community has previously viewed First Nations TM with deep scepticism. First Nations TM is not a practice that results from applying the scientific method, nor is its efficacy objectively observed or measured. Additionally, including spiritual beliefs, rituals, and ceremonies as integral components of healing practices raised eyebrows and gave rise to further scepticism. The smoke ceremony, for instance, with its spiritual significance and cleansing properties, challenged Western notions of evidence-based medicine [1]. The cultural gap between the Western scientific approach and First Nations healing traditions hindered acceptance within the scientific paradigm, and the differences seemed insurmountable.

Despite the community’s point of view, the Western scientific approach, bound by a reductionist and rigorous lens, is an appropriate tool to help comprehend and validate the efficacy of First Nations TM. Modern advancements in scientific and analytical methods can be used to assess the safety, efficacy, and underlying science behind First Nations TM [2]. With a more nuanced appreciation for indigenous cultures, we have a transformative opportunity to bridge the gap between cultures and allow a more informed and respectful integration of First Nations TM into regenerative medicine.

First Nations Traditional Medicine and Practices

TM in First Nations culture encompasses a holistic approach to healthcare, addressing physical healing and spiritual well-being [3, 4]. The Ngangkari, esteemed healers within First Nations communities, play a vital role and are considered as effective as doctors. They inherit healing abilities and wisdom through generations, employing personalised techniques like smoking ceremonies, bush medicines, and spirit realignment to reconnect individuals to their cultural roots and spiritual essence [3, 5, 6]. Medicines are prepared using burning, mashing, or boiling plant leaves [6]. Specific plants like Eremophila species and Melaleuca alternifolia (tea tree) have shown efficacy in treating respiratory issues and wound repairs, demonstrating the effectiveness of traditional First Nations TM. These practices highlight the profound wisdom embedded within Indigenous healing traditions [2].

The Regenerative medicine perspectives of TM-derived biologics

Plant-derived biologics have emerged as promising candidates in regenerative medicine, offering many therapeutic benefits, including antibacterial, antioxidant, anti-inflammatory, and wound-healing agents.  For example, within the rich biodiversity of Australian plant species, numerous plants contain biologically active extracts and compounds that possess remarkable wound-healing properties [7]. The Carpobrotus rossii leaf extract has demonstrated significant anti-inflammatory activity by inhibiting cytokine release [7]. Melaleuca alternifolia, commonly known as tea tree oil, has been extensively studied for its potential anti-inflammatory properties, inhibiting the production of inflammatory cytokines and prostaglandins [2, 7]. The regulatory effects of tea tree oil on inflammatory mediators, such as TNFa and IL-1b, hold promise for modulating the inflammatory response in regenerative medicine [8]. Furthermore, specific compounds derived from Pilidiostigma glabrum, Myoporum montanum, Geijera parviflora, and Rhodomyrtus psidioides have been found to influence collagen expression in human skin fibroblasts, highlighting their significance in wound healing and the treatment of skin conditions [9]. By synthesising the production and activity of these mediators, these biologics may offer new therapeutic approaches for treating inflammatory diseases and promoting tissue regeneration, thus extending new avenues in the field.

Oil derived from the emu has gained significant attention for its potential application in tissue engineering and regenerative medicine [10]. Traditionally used topically by First Nations Australians for pain alleviation, wound healing, and inflamed joints is now commercially available for topical and oral administration. Rich in unsaturated fatty acids and various compounds such as carotenoids, flavones, polyphenols, tocopherol, and phospholipids, emu oil possesses therapeutic and antioxidant properties. It reduces pro-inflammatory cytokines, promotes tissue regeneration, and offers pain relief, wound healing, and inflammation management [10].

A recent study [11] focused on adipose tissue-derived stem cells (ASCs) using a polymeric nanofibrous scaffold blended with emu oil as a bioactive material. The study found that the ASCs exhibited improved adhesion, higher bioactivity, increased proliferation, and preserved stemness markers compared to other groups. These findings underscore the potential of emu oil-containing scaffolds in promoting cell adhesion, mechanical strength, ASC proliferation, and maintaining their stemness, thus offering promising opportunities for expanding ASCs in vitro and advancing stem cell therapy and tissue engineering [12].

Traditional healers and Western scientists

Integrating traditional healers and physicians trained in Western medicine and combining pharmaceutical and plant medicine is challenging, recognising the complexity of merging two medical systems under a single regulatory system as experienced with registering Traditional Chinese Medicine. For First Nations TM, practices to be integrated into the healthcare system requires empowering traditional healers and elders [13]. However, barriers like limited funding, accreditation standards, and the absence of a national Ngangkari register can hinder the inclusion of traditional First Nations medicine in mainstream medical practice [4]. Efforts are needed to overcome these challenges and maximise the potential benefits of collaboration between traditional healers and Western medical professionals.

'The Kuuku I'yu Medicinal Plants Project, ' a collaboration between the Chuulangun Aboriginal Corporation and the University of South Australia, explores the medicinal properties of Aboriginal plant species [14]. Joint patents, publications, and contributions to teaching programs have been achieved. Ngangkari healers in South Australia work alongside doctors in community clinics and hospitals, offering expertise in pain management and spiritual balance [5]. Establishing the Anangu Ngangkari Tjutaku Aboriginal Corporation coordinates traditional healing services, exemplifying self-determination.

Respectful engagement with First Nations communities and knowledge holders is crucial for preserving and utilising traditional knowledge. Indigenous community-driven research fosters collaboration and is guided by participatory action methodologies [1, 5]. Cultural sensitivity is vital in developing and commercialising traditional medicine biologics [1]. Scientific data supporting customary practices fosters cultural pride, provides culturally appropriate healthcare, and creates industry opportunities. Elders value traditional medicine for strengthening culture and empowering First Nations people [13]. Establishing trust, respecting worldview, and maintaining confidentiality are essential for engaging with traditional medicine and First Nations communities, ensuring meaningful collaboration and the preservation of knowledge.

Considerations for intellectual property

Efforts to integrate TM into modern healthcare have faced intellectual property, bioprospecting, and benefit-sharing obstacles, hindering collaboration between traditional healers and biomedical scientists [1, 5, 6]. Intellectual property rights (IPR) in conventional medicine are intricately tied to access to biological resources and indigenous knowledge [16]. Goals and strategies often clash, such as publishing traditional medicinal know-how and incentivising healers while ensuring fair benefit sharing [17, 18]. Conventional IPR must improve in protecting traditional knowledge, but alternative concepts like a breach of confidence can help. Legal action, though costly, has successfully safeguarded sacred First Nations understanding [18]. Contracts and agreements formalise permissions and responsibilities. However, the inability to obtain IP patents for traditional medicine biologics may be a blessing. Sharing and co-creation are intrinsic to conventional medicine, rooted in global cultural storytelling. By refraining from strict IP protection, ongoing collaboration advances knowledge and preserves healing properties. This approach recognises traditional medicine's shared heritage, telling the story of First Nations conventional medicine.

Conclusion

In conclusion, integrating TM with modern scientific approaches hold a significant promise for promoting holistic healthcare and addressing health disparities within Indigenous communities; by combining traditional knowledge of medicinal plants with scientific advancements in biologics, a synergistic approach can be achieved to enhance patient outcomes and scientific knowledge. Embracing this integration transforms healthcare practices, benefits Indigenous communities, and promotes a more inclusive and equitable healthcare system. Through collaborative partnerships, increased funding, education, and policy initiatives, we can forge a path towards comprehensive healthcare that combines the wisdom of traditional healing with the advancements of modern science. By honouring and integrating traditional knowledge, we celebrate the rich cultural heritage of Indigenous communities and pave the way for a collaborative future.                                                                                                                               

References

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