• Hugo Creeth

Nobel Prize News: Physiology or Medicine

Three scientists have been awarded the Nobel prize for Physiology or Medicine for discovering how the body responds to changes in oxygen levels, specifically hypoxia. It is one of the most fundamental processes that is essential for life.


William Kaelin Jr at the Dana-Farber Cancer Institute and Harvard University in Massachusetts, Sir Peter Ratcliffe at Oxford University and the Francis Crick Institute in London, and Gregg Semenza at Johns Hopkins University in Baltimore, Maryland, worked out how cells sense falling oxygen levels and respond by making new blood cells and vessels.


The discovery not only paved the way to helping explain how certain animals are able to thrive in some of the highest-altitudes in the world, but became critical in the development for novel treatment methods for anaemia, cancer and heart disease.



The three laureates will share the 9m Swedish kronor (£740,000) prize equally, according to the Karolinska Institute in Stockholm. Professor Ratcliffe when asked what he intended to do with the windfall, said: “I’ll be discussing that with my wife in private. But it’ll be something good.” A party was on the cards, he said, but not immediately. “I’m trying to stay sober because it’s going to be a busy day.”


It was only 3 years ago that the trio won the prestigious Lasker prize in 2016. Their work, which spanned more than two decades, teased apart the vital aspects of how cells in the body first sense and then respond to low oxygen levels. Oxygen is used by tiny structures called mitochondria found in nearly all animal cells to convert food into useful energy.


The scientists demonstrated that when oxygen is in short supply, a protein complex called hypoxia-inducible factor, or HIF, builds up in nearly all the cells in the body. The rise in HIF ramps up the activity of a gene used to produce erythropoietin (EPO), a hormone that in turn boosts the creation of oxygen-carrying red blood cells.



HIF is essential right from conception. If an embryo doesn’t have the HIF gene it won’t survive past very early embryogenesis. Similarly even the womb needs this gene to do everything it does to keep a growing fetus alive.


The work has led to a huge influx of drug development in the area. Two drugs, roxadustat and daprodustat, which treat anaemia by fooling the body into thinking it is at high altitude, making it churn out more red blood cells. Roxadustat is on the market in China and is being assessed by European regulators.


Similar drugs aim to help heart disease and lung cancer patients who struggle to get enough oxygen into their bloodstream. More experimental drugs based on the finding seek to prevent other cancers growing by blocking their ability to make new blood vessels.


It is for any number of these reasons that the panel decided the trio were deserving of Nobel prize as their work will undoubtably be influencing medicine and science for decades to come.

© 2018 by Periodic Publishing

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