No pain, no gain for ulcer pioneers

World news from The Times and the Sunday Times - Times Online :: Nigel Hawkes:

A researcher who risked his life for science has been awarded the Nobel Prize for Medicine

"DELIBERATELY swallowing a potentially deadly bacterium is not usually the sign of genius, but a researcher who risked his life and the wrath of his wife was yesterday won the Nobel Prize for Medicine. In methods usually associated with the earliest days of medical research, Barry Marshall, 54, decided the only way to prove his extraordinary ideas to a disbelieving medical establishment was to infect himself.

Convinced that peptic ulcers were caused by the bacterium Helicobacter pylori and not stress, diet or excess acid, as was commonly assumed, Dr Marshall swallowed a solution containing the bug.

He continued working 14 hours a day as a doctor as well as carrying out his research at night, aided by his colleague Robin Warren at the Royal Perth Hospital in Western Australia. A week after infecting himself Dr Marshall started vomiting and suffering painful symptoms of gastritis.

Dr Marshall’s thesis was proved, but his wife, Adrienne, was not impressed. “That’s a very Barry thing to have done,” she said. Fearing for his health and the impact of the experiment on their four young children, Mrs Marshall finally snapped. “I told him he had to stop it and get some treatment,” she said.

Her husband cured his symptoms with antibiotics, completing one of the most significant medical breakthroughs of the past 50 years. “He’s always being stupid, bad jokes, puns, that sort of thing,” said Mrs Marshall. “He really enjoys everything he does. He’s probably a bit more of a boy than a man; a lot of researchers are like that.”

In a tribute, Lord May of Oxford, president of Britain’s 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.” Dr Marshall’s deliberate self-infection was an “extraordinary act that demonstrated outstanding dedication and commitment to his research”, he added.

The award of the prize to the two Australians for the work they started in the early 1980s has been awaited for at least a decade. Yesterday they heard the news while dining together at a restaurant in Perth.

“I’m amazed and a bit shocked, to tell you the truth, after all these years,” said Dr Warren, 68. “The main thing is that it finally puts the seal of approval on my work.” Dr Marshall said yesterday that his decision to swallow the bacteria was a natural choice.

“Any new discovery is going to be controversial and initially most people won’t believe it because you are going to be knocking over some kind of dogma, and that’s where we were,” he said.

Ulcers had been a major medical problem for decades, filling hospital beds and subjecting sufferers to bland diets in an attempt to control them. In the early 20th century stress was blamed, then a spicy diet, and finally the overproduction of gastric acids. Antacids and drugs to block acid production became the standard therapy.

Such drugs still have an important role today, but it has now been firmly established that Helicobacter pylori causes more than 90 per cent of duodenal ulcers and up to 80 per cent of gastric ulcers.

The two winners will share a £715,000 prize. “Thanks to the pioneering discovery by Marshall and Warren, peptic ulcer disease is no longer a chronic, frequently disabling condition, but a disease that can be cured by antibiotics and acid secretion inhibitors,” said the Nobel Assembly of Stockholm’s Karolinska Institute.

As a result of their work, ulcers are now commonly treated with a course of antibiotics, plus drugs to control the production of acid in the stomach or heal any damage done by the ulcer."