两澳大利亚人获诺贝尔医学奖(2)

Robin  Warren  (born  1937),  a  pathologist  from  Perth,  Australia,  observed  small  curved  bacteria  colonizing  the  lower  part  of  the  stomach  (antrum)  in  about  50%  of  patients  from  which  biopsies  had  been  taken.  He  made  the  crucial  observation  that  signs  of  inflammation  were  always  present  in  the  gastric  mucosa  close  to  where  the  bacteria  were  seen.

Barry  Marshall  (born  1951),  a  young  clinical  fellow,  became  interested  in  Warren's  findings  and  together  they  initiated  a  study  of  biopsies  from  100  patients.  After  several  attempts,  Marshall  succeeded  in  cultivating  a  hitherto  unknown  bacterial  species  (later  denoted  Helicobacter  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.  Based  on  these  results,  they  proposed  that  Helicobacter  pylori  is  involved  in  the  aetiology  of  these  diseases.

Even  though  peptic  ulcers  could  be  healed  by  inhibiting  gastric  acid  production,  they  frequently  relapsed,  since  bacteria  and  chronic  inflammation  of  the  stomach  remained.  In  treatment  studies,  Marshall  and  Warren  as  well  as  others  showed  that  patients  could  be  cured  from  their  peptic  ulcer  disease  only  when  the  bacteria  were  eradicated  from  the  stomach.  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  a  short  regimen  of  antibiotics  and  acid  secretion  inhibitors.

Peptic  ulcer  –  an  infectious  disease!

This  year's  Nobel  Prize  in  Physiology  or  Medicine  goes  to  Barry  Marshall  and  Robin  Warren,  who  with  tenacity  and  a  prepared  mind  challenged  prevailing  dogmas.  By  using  technologies  generally  available  (fibre  endoscopy,  silver  staining  of  histological  sections  and  culture  techniques  for  microaerophilic  bacteria),  they  made  an  irrefutable  case  that  the  bacterium  Helicobacter  pylori  is  causing  disease.  By  culturing  the  bacteria  they  made  them  amenable  to  scientific  study.   (责任编辑：泉水)

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两澳大利亚人获诺贝尔医学奖(2)