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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Images courtesy of Wikimedia Commons

20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

In his last will and testament, Swedish philanthropist Alfred Nobel (a chemist who invented dynamite) bequeathed the funds to create a series of prizes. These included the Nobel Prize in Physiology or Medicine, to be awarded to "the person who shall have made the most important discovery within the domain of physiology or medicine." This prize has been awarded to 214 individuals between 1901 and 2017, only 12 of whom are women.[1] The following slides (in chronological order) highlight some of the prize winners whose innovations have most influenced medical practice and outcomes.

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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Emil Adolf von Behring (1901)

"For his work on serum therapy, especially its application against diphtheria, by which he has opened a new road in the domain of medical science and thereby placed in the hands of the physician a victorious weapon against illness and deaths." [2]

The recipient of the inaugural Nobel Prize in Physiology or Medicine, German bacteriologist Emil Adolf von Behring—alongside Paul Ehrlich, Robert Koch, Louis Pasteur, and other big names in 19th century science—helped advance our understanding of the immunology of bacterial diseases.[3] His work on the diphtheria antitoxin led to a significant drop in child mortality.[4]

Image courtesy of National Institutes of Health

20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Ivan Pavlov (1904)

"In recognition of his work on the physiology of digestion, through which knowledge on vital aspects of the subject has been transformed and enlarged." [2]

Ivan Pavlov, a Russian physiologist, expanded our knowledge of digestion and identified the role of the nervous system in the secretion of gastric juices and their ability to affect movement in the intestinal canal.[5] A master surgeon,[5] he believed that surgery on conscious animals was key to greater physiologic understanding of organ systems.[6] His research on the digestive systems of dogs won Pavlov the Nobel Prize, although today he is most often remembered for his experiments in classical conditioning.

Images courtesy of National Institutes of Health

20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Camillo Golgi and Santiago Ramón y Cajal (1906)

"In recognition of their work on the structure of the nervous system." [2]

Camillo Golgi's examination of the structures and functions of the nervous system was made possible by his discovery of silver nitrate staining of nerve cells.[7,8] In disagreement with Santiago Ramón y Cajal, he argued that "all nerve cells in the nervous system constituted a continuous, interconnected network."[7]

Celebrated as the key architect of neuron theory,[9] Santiago Ramón y Cajal identified the independent nature of nerve cells and the role of synapses in the transfer of nerve impulses between nerve cells.[10] He published his observations of neurologic degeneration and regeneration in a comprehensive histology of the nervous system.[9]

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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Emil Theodor Kocher (1909)

"For his work on the physiology, pathology and surgery of the thyroid gland." [2]

Emil Theodor Kocher's body of work was key in advancing knowledge of the role of the thyroid gland in metabolism.[11] Known for his meticulous surgical technique, Kocher also contributed to our understanding of how good hygiene and minimal blood loss help to improve surgical outcomes.[1,12] He is also remembered for inventing a forceps designed for hemostasis during surgery, now known as the Kocher clamp.[13]

Image courtesy of National Institutes of Health

20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Willem Einthoven (1924)

"For his discovery of the mechanism of the electrocardiogram." [2]

Through the advances he made in ECG technology, specifically his invention of the spring galvanometer, Willem Einthoven provided clinicians with the first reliable means to depict the heart and its functions and illnesses.[14,15] His instrument recorded five electric potentials of the heart in waves, which Einthoven named P, Q, R, S, and T.[16]

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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Karl Landsteiner (1930)

"For his discovery of human blood groups." [2]

Austrian physician and immunologist Karl Landsteiner helped pave the way for successful blood transfusions by identifying the existence of different blood groups among people, which he classified as A, B, AB, and O.[17,18] Landsteiner was the first to realize that blood groups could be used in cases of doubtful paternity. He also conducted immunologic studies in the fields of syphilis and poliomyelitis and discovered the rhesus factor.[18]

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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Alexander Fleming, Ernst Chain, and Howard Florey (1945)

"For the discovery of penicillin and its curative effect in various infectious diseases." [2]

Perhaps the most well-known scientific feat to be rewarded by the Nobel Prize in Physiology or Medicine, the discovery of penicillin was transformational. Fleming's research on what became known as penicillin provided the foundation for treating bacterial infections.[19] Chain and Florey developed a more stable and purer form of penicillin which could be used as a reliable pharmaceutical product.[20]

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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Hermann Muller (1946)

"For the discovery of the production of mutations by means of X-ray irradiation." [2]

Geneticist Hermann Muller's studies of fruit flies helped unveil the dangers related to exposure to x-rays and ionizing radiation. He showed that the higher the exposure, the greater the occurrence of genetic mutations.[21] Muller's discovery of the mutagenic effects of x-rays has had wide-ranging repercussions and has provided the framework for new spheres of research.[22]

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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Selman Waksman (1952)

"For his discovery of streptomycin, the first antibiotic effective against tuberculosis." [2]

While studying the effect of soil microorganisms on tubercle bacteria, Selman Waksman and his laboratory discovered the effect of the bacterium Streptomyces griseus.[23] With the collaboration of Albert Schatz, who isolated streptomycin, an effective medication for tuberculosis was born,[23,24] followed by the development of a submerged culture technique that enabled large-scale production of streptomycin.[25]

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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Francis Crick, James Watson, and Maurice Wilkins (1962)

"For their discoveries concerning the molecular structure of nucleic acids and its significance for information transfer in living material." [2]

Building on Oswald Avery's research which identified DNA as the bearer of genetic code, Francis Crick and James Watson famously determined the molecular structure of DNA.[26] The contributions of Maurice Wilkins and Rosalind Franklin (who died 4 years before the Nobel was awarded) were fundamental to the identification of the molecular structure, the long double helix.[27]

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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Robert Holley, Har Gobind Khorana, and Marshall Nirenberg (1968)

"For their interpretation of the genetic code and its function in protein synthesis." [2]

Building on the finding that genetic information is transferred from DNA to RNA to protein, Robert Holley, Har Khorana, and Marshall Nirenberg were awarded the Nobel Prize for their work in "cracking" this genetic code.[28,29] Holley isolated and mapped the structure of tRNA.[28] Khorana built different RNA strains using enzymes, which enabled the production of proteins.[29] Nirenberg, alongside Heinrich Matthaei, produced a long RNA chain consisting of a single nucleotide.[30]

Image from AP/Shutterstock

20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Barbara McClintock (1983)

"For her discovery of mobile genetic elements." [2]

Barbara McClintock—the only woman to win without a collaborator—was awarded the Nobel for her discovery of genetic transposition, a discovery that challenged the belief that genes were fixed entities arranged in a linear pattern on chromosomes.[31] By studying hereditary characteristics in corn, McClintock proved that when genetic elements change location on a chromosome, they can cause nearby genes to become active or inactive.[32]

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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Stanley Cohen and Rita Levi-Montalcini (1986)

"For their discoveries of growth factors." [2]

The discovery of growth factors paved the way for better understanding of tumors, senile dementia, deformities, and wound healing.[33,34] Italian developmental biologist Rita Levi-Montalcini identified nerve growth factor,[33,34] and American biochemist Stanley Cohen discovered a growth factor active in the cells of the skin and cornea.[35]

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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Joseph Murray and E. Donnall Thomas (1990)

"For their discoveries concerning organ and cell transplantation in the treatment of human disease." [2]

Joseph E. Murray and E. Donnall Thomas developed techniques that turned organ transplantation from a pipe dream to a reality. Murray was able to prevent organ rejection following transplantation using total-body irradiation and cytotoxic drugs.[36] Thomas managed to diminish the graft-versus-host reaction with methotrexate. Murray conducted the first successful kidney transplant in 1954.[37] Thomas developed the processes by which new bone marrow cells can be created.[38]

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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Edmond Fischer and Edwin Krebs (1992)

"For their discoveries concerning reversible protein phosphorylation as a biological regulatory mechanism." [2]

Fundamental to metabolism and other functions, American biochemists Edmond Fischer and Edwin Krebs discovered how reversible protein phosphorylation activates proteins and acts as a regulatory mechanism in numerous cellular processes and immune responses.[39-41]

Image from AFP/Getty Images

20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Paul Lauterbur and Peter Mansfield (2003)

"For their discoveries concerning magnetic resonance imaging." [2]

The research of Paul Lauterbur and Peter Mansfield is the cornerstone of one of the most important medical diagnostic tools: MRI. Lauterbur is credited with developing variations in the magnetic field and Mansfield with creating novel calculation methods—discoveries which permitted the creation of images of the inside of the body.[42-44]

Image from AFP/Getty Images

20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Barry Marshall and J. Robin Warren (2005)

"For their discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease." [2]

The research of Australians Barry Marshall and J. Robin Warren has helped remove gastric ulcers from the list of chronic illnesses. Warren discovered the existence of bacteria at gastric ulcer sites, which Warren identified as Helicobacter pylori. Together they demonstrated that removing the bacteria cured patients of their ulcers.[45,46]

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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Harald zur Hausen (2008)

"For his discovery of human papilloma viruses causing cervical cancer." [2]

German virologist Harald zur Hausen's research showed the role of human papillomavirus (HPV) in cervical cancer and led to the development of a vaccine against that cancer. His work has also provided a better understanding of the connection between infectious and chronic diseases.[47,48] The 2008 Nobel prize was shared with Françoise Barré-Sinoussi and Luc Montagnier.

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20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Françoise Barré-Sinoussi and Luc Montagnier (2008)

"For their discovery of human immunodeficiency virus." [2]

Françoise Barré-Sinoussi and Luc Montagnier discovered the retrovirus (later named the human immunodeficiency virus) responsible for causing AIDS.[49-51] In 1983 at the Pasteur Institute, Barré-Sinoussi and Montagnier isolated the virus from a French patient with swollen lymph nodes. They also detected activity of an enzyme called reverse transcriptase, proof that the infectious agent was a retrovirus.[52] Their work was pivotal in advancing our understanding of the syndrome and paving the way for treatment options for patients.

Image from PA/Getty Images

20 Nobel Prizes That Changed Medicine Forever

Steven Rourke | September 26, 2018 | Contributor Information

Robert G. Edwards (2010)

"For the development of in vitro fertilization." [2]

From his understanding of sperm activation and of how eggs mature, and through his work with Patrick Steptoe to harvest eggs from the ovaries, Robert Edwards developed the process of fertilizing an egg in a test tube and replacing it in the uterus.[53] The first human conceived through in vitro fertilization was born in 1978. Edwards' research has provided new options for conception[52] while earning him the epithet "the father of assisted reproductive technology."[54]

Pictured above with Prof Edwards are 2-year-old twins Jack and Sophie, whose births resulted from IVF.

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