GMW: Nobel for stomach ulcer discovery raises questions

[Guest guest]

GMW: Nobel for stomach ulcer discovery raises questions

" GM WATCH " <info

Mon, 3 Oct 2005 15:10:25 +0100

 

 

 

 

GM WATCH daily

http://www.gmwatch.org

---

What's so interesting about the award of the Nobel prize to these two

Australian scientists, Robin Warren and Barry Marshall, is that when in

the early 1980s they suggested that the underlying cause of the

excessive acid secretion that causes peptic ulcers was a chronic

infection,

they were met with derision.

 

A presentation at an international conference by Dr Marshall was even

greeted with laughter. His audience told him the bacteria must have

contaminated the stomach samples after the stomach tissues had been

removed. Or maybe the bacteria were harmless and unrelated to the

ulcers. Or

maybe the bacteria were able to colonize the stomach as a result of the

ulcer.

 

Marshall compared the scientists' plight to being in a small boat

signalling desperately to people on a large ocean-going liner that

they're

headed in completely the wrong direction. In fact, the liner heading

away from Barry Marshal was not just a large one - it was extremely

luxurious.

 

Oversecretion of stomach acid was generally believed to occur in people

with overanxious, frustrated personalities. The standard treatment was

a bland diet, tranquilizers, psychotherapy, sometimes surgery, but

mainly the prescription of lots and lots of antacids. People with ulcers

had to take the $100-a-month antacids almost continuously.

 

The standard treatment of ulcers had turned antacids into the

biggest-selling prescription drugs in the world, so the Australian

scientists*

discovery, if accepted, was extremly bad news for the companies selling

them. It stood to deprive some of the world's largest corporations of

billions of dollars in revenue. If ulcers were caused by the bacterium

Helicobacter pylori, a simple two-week course of antibiotics might

permanently cure millions of people.

 

It took a decade of dogged determination for the two scientists to

begin to persaude others that Helicobacter was at the root of a range of

diseases, including gastric and duodenal ulcers and stomach cancer, and

that its eradication produced dramatic results. Marshall had to resort

to some startling tactics along the way, including drinking a solution

of the bacterium, thus producing inflammation of his own stomach -

confirmed by gastroscopy - and then successfully treating it.

 

But a decade after Warren and Marshall's discovery, Americans were

still buying $4.4 billion worth of antacids, though by then the drug

companies were hastily developing new diagnostic tests for H. pylori

as well

as new antibiotics to treat the infection. Biotechnology companies,

meanwhile, were trying to develop a vaccine, to be given in childhood.

Even by 1996, however, two-thirds of doctors were still prescribing

antacids for their ulcer patients.

 

Another decade on and Warren and Marshall have been awarded the Nobel

prize, while Lord May, the President of the Royal Society, bestows his

blessing upon the two " mavericks " (see below).

 

The article below also notes that the Nobel citation praises the

doctors for their tenacity, and willingness to challenge prevailing

dogmas.

---

Nobel for stomach ulcer discovery

http://news.bbc.co.uk/1/hi/health/4304290.stm

 

Two Australian scientists have been awarded the Nobel prize for

medicine for their discovery that stomach ulcers can be caused by a

bacterial

infection.

 

Robin Warren and Barry Marshall showed the bacterium Helicobacter

pylori plays a key role in the development of both stomach and intestinal

ulcers.

 

Thanks to their work these ulcers are often no longer a long-term,

frequently disabling problem.

 

They can now be cured with a short-term course of drugs and

antibiotics.

 

In 1982, when H. pylori was discovered by Dr Marshall and Dr Warren,

stress and lifestyle were considered the major causes of stomach and

intestinal ulcers.

 

It is now firmly established that the bacterium causes more than 90% of

duodenal (intestinal) ulcers and up to 80% of gastric (stomach) ulcers.

 

Dr Warren, a pathologist from Perth, paved the way for the breakthrough

when he discovered that small curved bacteria colonised the lower part

of the stomach in about 50% of patients from which biopsies had been

taken.

 

Key observation

 

He also made the crucial observation that signs of inflammation were

always present in the stomach lining close to where the bacteria were

seen.

 

Dr Marshall became interested in the findings and together they

initiated a study of biopsies from 100 patients.

 

After several attempts, Dr Marshall succeeded in cultivating a hitherto

unknown bacterial species - H. pylori - from several of these biopsies.

 

Together they found that the organism was present in almost all

patients with gastric inflammation, duodenal ulcer or gastric ulcer.

 

Even though stomach ulcers could be healed by inhibiting gastric acid

production, they frequently relapsed, since bacteria and chronic

inflammation of the stomach remained.

 

Dr Marshall and Dr Warren showed patients could only be properly cured

when H. pylori was eradicated from the stomach.

 

Infected himself

 

Dr Marshall proved that H. pylori caused gastic inflammation by

deliberately infecting himself with the bacterium.

 

The Nobel citation praises the doctors for their tenacity, and

willingness to challenge prevailing dogmas.

 

" By using technologies generally available they made an irrefutable

case that the bacterium H. pylori is causing disease.

 

" By culturing the bacteria they made them amenable to scientific

study. "

 

It is thought that H. pylori infection can trigger an ulcer by

stimulating increased acid production in the stomach, leading to

damage to the

stomach or intestinal lining.

 

Lord May of Oxford, President of the Royal Society, said: " The work by

Barry Marshall and Robin Warren produced one of the most radical and

important changes in the last 50 years in the perception of a medical

condition.

 

" Their results led to the recognition that gastric disorders are

infectious diseases, and overturned the previous view that they were

physiological illnesses. "

 

 

 

 

 

----------------