- The 2005 Nobel Prize in Physiology or Medicine for BACTERIA
as a CAUSE of STOMACH ULCERS
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- Has been awarded to: Barry Marshall and Robin Warren
from Australia.
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- This is the first recognition (via a Nobel Prize) that
BACTERIA can lead to CANCER!! Of course, this idea has been "medical
heresy" for more than a century.
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- Perhaps someday physicians will recognize the fact that
BACTERIA are involved in MANY FORMS OF CANCER (see the work of "FOUR
WOMEN" attached)
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- Alan Cantwell MD
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- The 2005 Nobel Prize in Physiology or Medicine
- 10-3-5
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- The Nobel Assembly at Karolinska Institutet has today
decided to award The Nobel Prize in Physiology or Medicine for 2005 jointly
to Barry J. Marshall and J. Robin Warren for their discovery of "the
bacterium Helicobacter pylori and its role in gastritis and peptic ulcer
disease"
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- Summary
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- This year's Nobel Laureates in Physiology or Medicine
made the remarkable and unexpected discovery that inflammation in the stomach
(gastritis) as well as ulceration of the stomach or duodenum (peptic ulcer
disease) is the result of an infection of the stomach caused by the bacterium
Helicobacter pylori.
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- 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.
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- 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.
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- 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.
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- Peptic ulcer -- an infectious disease!
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- 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.
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- In 1982, when this bacterium was discovered by Marshall
and Warren, stress and lifestyle were considered the major causes of peptic
ulcer disease. It is now firmly established that Helicobacter pylori causes
more than 90% of duodenal ulcers and up to 80% of gastric ulcers. The link
between Helicobacter pylori infection and subsequent gastritis and peptic
ulcer disease has been established through studies of human volunteers,
antibiotic treatment studies and epidemiological studies.
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- Helicobacter pylori causes life-long infection
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- Helicobacter pylori is a spiral-shaped Gram-negative
bacterium that colonizes the stomach in about 50% of all humans. In countries
with high socio-economic standards infection is considerably less common
than in developing countries where virtually everyone may be infected.
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- Infection is typically contracted in early childhood,
frequently by transmission from mother to child, and the bacteria may remain
in the stomach for the rest of the person's life. This chronic infection
is initiated in the lower part of the stomach (antrum). As first reported
by Robin Warren, the presence of Helicobacter pylori is always associated
with an inflammation of the underlying gastric mucosa as evidenced by an
infiltration of inflammatory cells.
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- The infection is usually asymptomatic but can cause peptic
ulcer
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- The severity of this inflammation and its location in
the stomach is of crucial importance for the diseases that can result from
Helicobacter pylori infection. In most individuals Helicobacter pylori
infection is asymptomatic. However, about 10-15% of infected individuals
will some time experience peptic ulcer disease. Such ulcers are more common
in the duodenum than in the stomach itself. Severe complications include
bleeding and perforation.
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- The current view is that the chronic inflammation in
the distal part of the stomach caused by Helicobacter pylori infection
results in an increased acid production from the non-infected upper corpus
region of the stomach. This will predispose for ulcer development in the
more vulnerable duodenum.
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- Malignancies associated with Helicobacter pylori infection
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- In some individuals Helicobacter pylori also infects
the corpus region of the stomach. This results in a more widespread inflammation
that predisposes not only to ulcer in the corpus region, but also to stomach
cancer. This cancer has decreased in incidence in many countries during
the last half-century but still ranks as number two in the world in terms
of cancer deaths.
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- Inflammation in the stomach mucosa is also a risk factor
for a special type of lymphatic neoplasm in the stomach, MALT (mucosa associated
lymphoid tissue) lymphoma. Since such lymphomas may regress when Helicobacter
pylori is eradicated by antibiotics, the bacterium plays an important role
in perpetuating this tumour.
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- Disease or not -- interaction between the bacterium and
the human host
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- Helicobacter pylori is present only in humans and has
adapted to the stomach environment. Only a minority of infected individuals
develop stomach disease. After Marshall's and Warren's discovery, research
has been intense. Details underlying the exact pathogenetic mechanisms
are continuously being unravelled.
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- The bacterium itself is extremely variable, and strains
differ markedly in many aspects, such as adherence to the gastric mucosa
and ability to provoke inflammation. Even in a single infected individual
all bacteria are not identical, and during the course of chronic infection
bacteria adapt to the changing conditions in the stomach with time.
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- Likewise, genetic variations among humans may affect
their susceptibility to Helicobacter pylori. Not until recently has an
animal model been established, the Mongolian gerbil. In this animal, studies
of peptic ulcer disease and malignant transformation promise to give more
detailed information on disease mechanisms.
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- Antibiotics cure but can lead to resistance
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- Helicobacter pylori infection can be diagnosed by antibody
tests, by identifying the organism in biopsies taken during endoscopy,
or by the non-invasive breath test that identifies bacterial production
of an enzyme in the stomach.
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- An indiscriminate use of antibiotics to eradicate Helicobacter
pylori also from healthy carriers would lead to severe problems with bacterial
resistance against these important drugs. Therefore, treatment against
Helicobacter pylori should be used restrictively in patients without documented
gastric or duodenal ulcer disease.
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- Microbial origin of other chronic inflammatory conditions?
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- Many diseases in humans such as Crohn's disease, ulcerative
colitis, rheumatoid arthritis and atherosclerosis are due to chronic inflammation.
The discovery that one of the most common diseases of mankind, peptic ulcer
disease, has a microbial cause, has stimulated the search for microbes
as possible causes of other chronic inflammatory conditions.
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- Even though no definite answers are at hand, recent data
clearly suggest that a dysfunction in the recognition of microbial products
by the human immune system can result in disease development. The discovery
of Helicobacter pylori has led to an increased understanding of the connection
between chronic infection, inflammation and cancer.
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- http://nobelprize.org/medicine/laureates/2005/press.html
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- Alan Cantwell MD
- alancantwell@sbcglobal.net
- http://www.ariesrisingpress.com
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- FOUR WOMEN AGAINST CANCER
- Bacteria, Cancer and the Origin of Life
- Cantwell, Alan. 2005
- Aries Rising Press, Los Angeles, CA
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- Back in the 1950s a group of four women scientists began
to work together to uncover the microbiology of cancer. Rather than being
received with enthusiasm, their published cancer research was largely ignored
or overlooked. In this highly controversial book, Alan Cantwell, MD, presents
the revolutionary cancer research of physician Virginia Livingston, MD;
microbiologist Eleanor Alexander-Jackson; cell cytologist Irene Diller;
and world-famous biochemist Florence Seibert - all of whom discovered an
easily detectable bacterial agent in cancer -a microbe whose existence
is still totally denied by the medical establishment. Unlike any infectious
agent known to science, the cancer microbe has characteristics of both
bacteria and viruses-and produces a remarkable hormone that allows life
to continually reproduce and renew itself. This book should prove of interest
to readers who want to learn more about the bacteriology of cancer, and
how this knowledge could prove useful in the conquest of cancer.
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