October 3, 2005

Ulcer bug Australians win Nobel medicine prize

By Patrick Lannin

STOCKHOLM (Reuters) - Two Australians won the Nobel prize for medicine on Monday for showing that a bacterium rather than stress causes stomach inflammation and ulcers, after one of them drank a witches' brew of bacteria to prove the point.

Experts said the discovery of the Helicobacter pylori bacterium by Barry Marshall and Robin Warren in 1982 was met with skepticism by the medical community, which did not think bacteria could survive in the acid conditions of the stomach.

Marshall resorted to drinking a culture of the bacteria to give himself an ulcer and then to treat himself. The findings eventually forced drug firms to rethink treatment of a condition that affects millions of people in a market worth billions of dollars.

"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," said the Nobel Assembly of Stockholm's Karolinska Institute.

Warren, 68, and Marshall, 54, share the 10 million crowns prize for their "remarkable and unexpected discovery," the Nobel Assembly said.

Lord May of Oxford, president of Britain's Royal Society of leading scientists, said Marshall's "extraordinary act" of becoming his own guinea pig showed outstanding dedication.

With some scientists calling their findings "preposterous," Marshall drank a broth of bacteria to show that the presence of H pylori in people with ulcers was no coincidence.

"I planned to give myself an ulcer, then treat myself, to prove that H. pylori can be a pathogen in normal people," he told a scientific review. "I thought about it for a few weeks, then decided to just do it. Luckily, I only developed a temporary infection."

Suffering stomach pain, nausea and vomiting, he underwent an endoscopy which showed the distinctive spiral-shaped E pylori crowding around the inflammation in his stomach. His wife urged him to think of his children and get treatment -- which he did.


Professor Brian Spratt, a molecular microbiologist at Imperial College London, said they had "a hell of a job" convincing people about their research.

"Drug companies had to radically change their approach from containing ulcers with antacids to treating with antibiotics. Ulcers predispose people to gastric cancer -- so antibiotics also prevent cancer," he added.

Australians have been on Nobel Medicine prize-winning teams previously -- Sir Howard Florey in 1945, Sir Frank Macfarlane Burnet in 1960, Sir John Eccles in 1963 and Peter Doherty in 1996. But this is the first time an all-Australian team has won.

Warren and Marshall were working at the Royal Perth Hospital in Western Australia when the made the H pylori discovery.

Due to the Australians' work a common treatment for ulcers is a course of antibiotics, plus drugs to control the production of acid in the stomach or heal any damage done by the ulcer.

The market for stomach treatments is worth $20 billion a year, said a spokesman for Anglo-Swedish group AstraZeneca


Other manufacturers are Abbott Laboratories Inc 9ABT.N: of the United States and Japan's Takeda 94502.T:, which have a joint venture.

The bacterium causes more than 90 percent of duodenal ulcers and up to 80 percent of gastric ulcers.

About two thirds of the world's population is infected with H pylori but most people never suffer any symptoms.

It also predisposes people to stomach cancer, which is the second most common cause of cancer death.

The Nobel Assembly said the two men's work had stimulated the search for microbes as possible causes of other inflammatory conditions, such as Crohn's disease, ulcerative colitis, rheumatoid arthritis and atherosclerosis affecting arteries.

(Additional reporting by Niklas Pollard, Stephen Brown, Daniel Frykholm and Peter Starck)