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Pylori Story #3: Drug Wars – The Lab Strikes Back

Scientists plotted in their labs, looking for a chemical target to stop the acid. The first lead was a hormone trigger for acid. John Edkins found gastrin in 1905.

Cover of drug wars - the lab strikes back

 

 

Scientists looked for a chemical target to stop the acid

 

The first lead was a trigger hormone for acid, gastrin

 

Rod Gregory and Hilda Tracy used thousands of hog stomachs to isolate the first gastrin

 

The first winner in the drug wars was the H2-RA

 

James Black tested hundreds of compounds to find it, and got the Nobel prize

 

A Swedish company hit the jackpot - a good proton pump inhibitor (PPI) that reduces acid pumped into the stomach

 

Painkillers helped acid eat through the stomach - untold thousands would die

 

PPIs and H2-RAs came to the rescue - meanwhile an even bigger battle had begun

 

Concludes in #4. (Click on links to other installments below.)

 

Link to Number 1Link to number 2Number 3Link to Pylori Story 4

~~~~

 

The first H2-RA (Histamine-2 receptor antagonist) was cimetidine (brand name Tagamet), although the H2-RA that became the world’s best-selling drug in the 1980s was ranitidine (brand name Zantac).

The first proton pump inhibitor (PPI) was omeprazole (first brand name Losec, now Prilosec), and for a time it became the world’s best-selling drug.

Bibliography

Cappell MS, Wayne JD, Farrar JT, Sleisenger MH. Fifty landmark discoveries in gastroenterology during the past 50 years: a brief history of modern gastroenterology at the Millennium: Part I. Gastrointestinal procedures and upper gastrointestinal disorders. Gastroenterology Clinics of North America 2000; 29: 223-263.

Carlsson E. The Omeprazole story: how endurance in research may pay off. Kruse CG, Timmerman H (meds). Towards drugs of the future: key issues in lead finding and lead optimization. IOS Press, Solvay Pharmaceuticals Conferences. 2008: 101-110. (Includes photo of Ylva Ortengren’s lab notebook of the day 168/68 – Omeprazole/Losec – was first synthesized.)

Griffin MR. Epidemiology of non steroidal anti-inflammatory drug-associated gastrointestinal injury. Am J Med 1998; 104: 23S-29S.

Gustafson J, Welling D. “No acid, no ulcer” – 100 years later: a review of the history of peptic ulcer disease. J Am Coll Surg 2010; 1: 110- 116.

Lewis JD, Bilker WB, Brensinger C, Farrar JT, Strom BL. Hospitalization and mortality rates from peptic ulcer disease and GI bleeding in the 1990s: relationship to sales of nonsteroidal anti-inflammatory drugs and acid suppression medication. Am J Gastroenterology 2002; 97: 2540-2549.

Modlin IM, Sachs G, Wright N, Kidd M. Edkins and a century of acid suppression. Digestion 2005; 72: 129-145.

 

The comic in this post is my own (CC-NC-ND-SA license). (More of my cartoons at Statistically Funny and on Tumblr.) With apologies for the lack of the resemblance to the actual people depicted!

The chemical structure of gastrin used here is minigastrin, by Edgar181 in Wikimedia Commons.

* The thoughts Hilda Bastian expresses here at Absolutely Maybe are personal, and do not necessarily reflect the views of the National Institutes of Health or the U.S. Department of Health and Human Services.

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