Reefs and Pharmaceuticals
Corals that Cure
The prospect of finding a new drug in the sea, especially among coral reef species, may be 300 to 400 times more likely than isolating one from a terrestrial ecosystem.
The U.S. Forest System says, "A full 40 percent of the drugs behind the pharmacist's counter in the Western world are derived from plants that people have used for centuries, including the top 20 best-selling prescription drugs in the United States today". Those natural resources are now shifting towards a different environment: the ocean. Coral reefs are wondrous underwater communities teeming with life and possibility. One of the many ways coral reefs can benefit us is through medicine and pharmaceuticals. 40-50 percent of our pharmaceuticals come from natural resources, mostly terrestrial and often found in rainforests . Currently under-represented, marine compounds have the potential to make up a large part of these pharmaceuticals. The marine ecosystem represents 95 percent of all biodiversity on earth with a majority of that percentage taking place on coral reefs. Thus the majority of our drugs are coming from only five percent of the much larger biodiversity we could have access to . It's estimated that we are 300 to 400 times more likely to find the next drug in the ocean, especially coral reefs, compared to finding one in terrestrial ecosystems. Oceans contain not only the majority of the earth's biodiversity but also much larger amounts of phylogenetic diversity. These underwater organisms use defense mechanisms, excrete chemicals, and essentially wage war with bioactive compounds unlike anything found on land . With so much ocean left undiscovered, it’s easy to imagine a plethora of cures just waiting to be found. Coral reefs, the rainforests of the ocean, are even more likely to hold the next cure or drug resource. Even simpler products, such as makeup and skincare products are starting to use the ocean as their main resource.
Reefs Used for Traditional Medicine
As early as the 14th century, eastern cultures recognized beneficial properties of coral reef ecosystems. One example is the use of seahorse extracts in China, Taiwan, and Japan for sexual disorders, pain, skin problems, kidney and liver diseases, circulatory and respiratory problems. However many seahorse populations are being rapidly depleted as demand for seahorse in traditional medicine grows. Seahorse populations declined by 50 percent worldwide between 1990 and 1995, showing the great need for conservation and protection of the marine environment .
Using reef organisms for their medicinal properties even traces back to the times of Hippocrates and Plato in the west. Hippocrates and Plato believed snail mucus helped with pain relief “related to burns, abscesses, and other wounds”. Snails have continued to be used to help with various medical problems, including for external dermatological use in the 18th century .
Diseases that Reefs Hold Potential Cures for Today
Peter Moeller from NC State University recently discovered a sea sponge that naturally fights off bacteria that could possibly be used to fight infectious diseases with antibacterial resistance, like MDR-Tuberculosis. He was snorkeling with colleagues in the Caribbean when they noticed a sponge thriving in a clump of dead coral. Moeller studied the sponge more closely and realized that it was using a type of biofilm to protect itself from bacteria. This biofilm actually has the capability to dissolve the outerlayer of bacteria that makes it resistant to antibiotics .
Bone grafts have been created from coral since 1970. Bone grafts are basically bone replacements that one would require if they had a bone disease that caused their bones to deteriorate. Usually, bone tissue is resilient and regenerates, but in extreme cases such as disease as mentioned above, tumors, infections, or some skeletal abnormalities, replacements such as bone grafts or surgery may be necessary. Bone grafts might also be used after someone breaks a bone in order to make the bones more dense. Autologous bones, or bones transplanted from other areas of the body like the chin or rib, are traditionally used as bone grafts, but are often in limited supply and depend on organ donors in order to acquire them. Bones derived this way commonly yield little bone and can also be painful, but as an alternative to this unrewarding and unpleasant process, cnidarian coral skeletons seem to show some promising results for short-term bone substitutes.
Coral can be grown in labs and is now being used as bone grafts in place of autologous bones. Coral is very permeable which means that the mortality rate of the bone graft procedure is lowered, because the coral has more of a chance of being tolerated by the body. Not only does the permeability make coral structures a great candidate for bone grafts, but the unique structure, architecture, and shape resembling bones allow for high applicability . Researchers at the University of Galway have started to test the potential of coral to treat people with bone injuries. Its "compatibility with human cells and its bone-forming potential" make it an excellent option for bone replacement. Marine coral is composed of minerals and salts, some of the same properties that bones contain. The company hopes to make this technology more widely used and reliable.
One of the reasons that coral is proving to be effective in bone substitutions is shown from experiments of in situ resorption that show coral replacements synchronize with the endogenous regeneration of new bone. This means that coral can recruit bone-forming cells and help bridge the gap between the regeneration of new bone and the coral substitution. Even the crystallinity of the two is similar; coral is made of calcium carbonate while bone is calcium phosphate but hydrothermally, calcium carbonate can be converted into calcium phosphate, which reinforces how these structures can work in conjunction with one another to provide a temporary replacement for lost bone due to disease, surgery, deformities, etc. 
Some of the most structurally similar coral genera include Porites, Geniopora, Acropora, and Lobophylia. Coral skeletons also have high bioactivity with bone cells, and the bioactivity, shape, and structure allow for seamless, strong mending with the host-regenerated bone. There has even been a coral bone graft created that replaces a bone and then helps that bone regrow together before dissolving . Though some genera are excellent candidates for bone regeneration, not all corals are viable candidates. For example, Acropora specializes only in minor defects and in regions of high mechanical loadings; because of its compactness and low porosity, the structure can support osteogenic, or the formation of the bone, of the mesenchymal stem cells. Still further research is needed to understand the long-term ability of corals to serve as bone replacements and the effects of using these substitutions for numbers of years. Also more data should be done to understand all of the species of corals that are most compatible candidates for bone replacements and regeneration.
Florida was the first state to initiate cancer research from a marine life perspective. In the 1950s they began to research several molecules found from natural marine wildlife, and in the past 20 years, the US Food and Drug Administration has passed several anticancer drugs of marine origin .
At least a dozen compounds that come from marine sources are in trial for use as anticancer agents that could cure breast cancer, liver cancer, and leukemia . One such compound makes up the drug Dolastatin 10, which is isolated from an Indian Ocean sea hare and has the potential to be used for treatment of leukemia, tumors, and liver and breast cancer. While phase 2 clinical trials have already been completed and found lacking in performance against solid tumors, more trials are underway and it remains a good candidate for combination drugs used to fight cancer and the above listed .
Sinularia querciformis, a soft coral genus, which has been known to have anti inflammatory properties has also recently shown anti-cancer abilities as well. In an experiment a combination of nitrogen diterpene, lobanes, and cembranes isolated from Simularia were used which resulted in a 50% inhibition of the growth of tumors. Secondly, Sacrophyton crassocaule, another soft coral genus, has shown cytotoxic activity against bladder cancer cells. These two corals help show some success in the growing research of anti-cancer abilities of corals.
The US National Sea Grant Program recently discovered a group of antiviral drugs extracted from sponges and soft coral that has the potential to cure different types of viruses including HIV/AIDS. AZT is the name of the AIDS treatment which is composed of arabinosides that come from the sea sponge Tethya crypta. The fatty acid surrounding the sea sponge is made up of compounds that allows it to fight foreign infections. The HIV virus attacks white blood cells and weakens the immune system of humans, and so by using this fatty acid, the HIV virus could be potentially be stopped.
Previous research has shown that an "aqueous extract of Synthecium sp. showed anti-HIV activity and yielded 3 novel anti-HIV proteins." According to O’Keefe and his colleagues, who presented their findings at the Experimental Biology 2014 meeting in San Diego on April 29, 2014, the "coral’s protein bind[s] to the virus and prevent[s] it from fusing to the membrane of the T cell. Without this contact, the virus can’t infect a host's immune system, as T cells play a direct role in regulating the body's immunity." 
Secosteroids, an enzyme used by corals to protect themselves from disease, is used to treat asthma, arthritis and other inflammatory disorders. Pseudopterosins, a class of natural products, also comes from coral and has anti-inflammatory and analgesic properties. It is now used in skin care products, including products by Estee Lauder . These anti-inflammatory properties are found naturally in a Bahamian soft coral called Pseudoterigorgia elisabethae. There is also research underway suggesting the Caribbean sea whip may have some organic chemicals that help with anti-inflammatory effect on human skin . Diterpenes are one specific class of molecules isolated from corals such as Eunicea Fusca that have been shown to exhibit anti-inflammatory therapeutic benefits. Another clinical application of coral natural products is alleviating arthritis. Sinularia querciformis has been evaluated for its anti-inflammatory potency in vitro as well as in adjuvant-induced arthritis (AIA) in rats.
Others diseases potentially cured by coral include: Asthma and Heart Disease
Mitigating Coral Reef Degradation with Biotechnology
While there is an increasing amount of knowledge surfacing about the pharmaceutical benefits that coral reefs can provide on top of their roles in the oceans as nurseries and hotspots of biodiversity, there is an ever-growing need for timely protection and conservation of these areas as they are rapidly declining due to a changing climate and human impacts. One way humans can mitigate coral reef degradation is through the use of biotechnology and what is called "assisted evolution" to create more climate change-resistant corals. Faster adaptation and evolution are necessary for corals as climate change and anthropogenic effects are happening at unprecedented rates, and corals are unable to keep up by natural selection alone. This process of "assisted evolution" can be done by selective breeding tactics, preconditioning corals to sublethal stressors, inoculation (immunization) through the use of symbiont algae, and manipulating coral-associated prokaryotes which can contribute to immune defenses.
Maintaining a healthy microbiome is essential to fundamental life functions for coral, and these can be altered by many processes such as temperature, pH, nutrients, pollution, other organisms, light, depth, and seasonal changes. While a healthy microbiome seems necessary to protect the host from environmental changes, modifications of this microbiome may allow for more flexible and, therefore, climate resistant corals. For example, there are already studies showing that coral transplantation of Acropora hyacinthus into different thermal environments allows microbial communities to adjust and thus become more temperature resistant. Similarly, corals exposed to short-term heat stress were less prone to bleaching and overall had a more stable microbiome.
Not only is there optimistic evidence about altering microbiomes to create more climate-resistant coral, but changing the microbial communities of prokaryotes could increase the tolerance of corals to environmental stressors. Already in the aquaculture industry, probiotics are used to reduce or inhibit pathogens, increase resilience to stress, and promote growth, and this tactic may apply to larger scales, such as coral reefs, to produce some of the same benefits. Prokaryotes strengthen coral immune defenses by taking up entry niches and secreting antimicrobial peptides. These prokaryotes can be altered in inoculations of specific taxa, as seen in Musismilia, hart ii, where this coral was exposed to oil spill-like conditions, and the prokaryotes inoculated with probiotic bacteria responded better to disturbances than those without.
The role of biotechnology in engineering or altering corals is to see which genes are being turned up or down in response to the unfavorable conditions they were raised in and if these epigenetic mutations or changes are hereditary and passed down to further offspring. Instead of exposing corals to different environments, genetic material can also be directly inserted into new coral polyps with a microscopic needle and using CRISPR-Cas9 editing tools. While CRISPR is commonly used to engineer new organisms, for corals, it could be used to knock out, rendering a gene disabled, the genes correlated with corals and heat/stress.
There are still many risks to consider with these genetically modified corals as the hybrids, focusing on heat stress, may compromise other traits such as coping with cold or pollution impacts. Still, many scientists, including those at the Australian Institute of Marine Science, stress that continued research needs to be done in the use of genetic engineering for if the risks delay coral restoration further, it may become the only option, or it may be too late entirely.
Other Uses of Coral
- A new sunscreen pill is in the process of being created that would protect people from the sun in the same way that certain corals protect themselves from UV rays. The pills would be made of a certain UV protecting compound found in coral .
- Makeup: From seaweed to plankton to caviar, to even algae, there are endless opportunities to use the ocean's properties in your everyday skincare routine. Many of these products are vegan and sourced ethically, meaning that you can now take advantage of the amazing resources without worrying about the possible harm of it.
- Pacifique Sud, a French cosmetic company, recently announced their use of a "White Coral Powder" that contains calcium with "radiance, coverage and matifying properties" .
- The Amala Rejuvenating Collagen Mask contains green algae which helps promote collagen production and smooth fine lines on skin. The mask works to restore elasticity. Lola implexa, a type of green algae used in this product, makes it so effective.
- The Rainforest Of The Sea Highlighting Eyeshadow Palette Vol. III, created by Tarte, is hypoallergenic, vegan, and is packed with antioxidants. The palette contains algae and marine flower extracts, hence being named the "rainforest of the sea".
- A Complete, a modern makeup company, created a Youth Preserve Deep Cleanser. The product acts as a hydrating and smoothing cleanser that uses Hydasine from the sea. The company claims that it "hydrates more than hyaluronic acid".
- A Marine Food Gel Mask, created by Skinfood, contains pearl extracts and a blue marine complex. The mask is used for hydration, similar to many other products above.
- Biotherm's Life Plankton Mask uses fermented plankton. The product is a gel mask that "hydrates overnight".
Reef-dwelling cone shells are found to produce venomous peptides that “offer possibilities for controlling nerves, are valuable as biological probes, and can potentially be used for treating intractable pain, urinary incontinence, stroke, epilepsy, anxiety, and high blood pressure” . Clinical trials now are underway and look promising. In controlled clinical trials a synthetic peptide derived from snail venom decreased pain by 53 percent, much higher than the widely-used placebo which only decreases pain by 18 percent .
Other medical uses of coral include: Labor pain relief, New drugs, and Ulcers
Getting Involved with Marine Bioprospecting
Bioprospecting is the study and search for finding naturally occurring substances in nature with medical properties and uses. Indigenous populations have been using bioprospecting to find coral with pharmaceutical properties for centuries. For example, the Chinese have been using dried seahorse powder to cure erectile dysfunction in men for the past 600 years .
Today, using coral reefs for pharmaceutical purposes and finding these cures through bioprospecting is becoming more and more popular as diseases evolve and new medicines are needed . Countries like USA, Canada, Japan, Europe, Fiji, India, China, Australia, Philippines, and Hawaii are all experimenting with coral reefs and their potential cures in science research .
Organizations like the Convention of Biological Diversity (CBD) have also realized the need for bioprospecting and have created national legislation to help guide how this research should be done. They work to connect bioprospectors to natives who already use the reefs for pharmaceutical practices. With help from the natives, bioprospectors are able to learn what corals have been used for in the past and what approaches work best when it comes to researching the coral without endangering it. For example, article 8 of the CBD states that it is necessary to "respect, preserve and maintain knowledge, innovations and practices of indigenous and local communities embodying traditional lifestyles…. to promote their wider application… and encourage the equitable sharing of the benefits arising from the utilization of such knowledge, innovations and practices" .
Traditional knowledge holders such as tribes and rural communities are often the key stakeholders in access and benefit sharing agreements that are becoming more prevalent as the bioprospecting field expands. Well laid guidelines that will curb biopiracy of marine organisms as well as provide recognition to the traditional knowledge holding communities are needed as demand for use of marine resources grows.
Unfortunately though, bioprospecting research is still highly underestimated. It is in need of fresh new scientists ready to delve into the secrets of the sea . Do you love to scuba dive? Are you an environmental science major? Do you like helping people? A profession in bioprospecting might be perfect for you!
A Promise Lost?
In the absence of effective management of coral reefs and the resources they contain, many species that are promising as new sources of biochemical materials for pharmaceuticals and other products may be lost before scientists have the opportunity to evaluate them. 
Just in the past few years, over 2,000 new compounds have been established from marine sources. Improvements in technology, funding, and collaboration among scientists, researchers, institutions and pharmaceutical companies have brought about this dramatic increase in knowledge about underwater environments. Many compounds have already been put into everyday use while others have undergone clinical trials and still many more are in preclinical stages . In order for these trials to continue and new cures to be found, coral reefs and the marine ecosystem must be protected. Partnership is needed among governments, companies, academia, communities, and locals to invest in research and offer incentives to do so. The need for conservation of coral reef ecosystems requires immediate action and more than what is now being done.
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