Over the last few weeks, the 2013 Nobel Prizes have been awarded to many notable and deserving individuals. In his will -- the document that established this prestigious annual ritual -- Alfred Nobel noted that the prizes should be awarded to individuals "who, during the preceding years, shall have conferred the greatest benefit on mankind." Regrettably, this much-coveted honor is never awarded posthumously, and as a result, many scientists whose research has conferred great benefit on mankind will never take the stage in Stockholm. Today I would like to honor two of my colleagues who did not win Nobel Prizes during their lifetimes, but who will always be -- in my opinion -- health care revolutionaries whose dedication to their respective fields of research and the discoveries that came from their efforts have truly changed the way we all think about health and disease.
Most recently -- in September -- Dr. Candace Pert passed away. In 1974 Candace Pert earned her Ph.D. in pharmacology from Johns Hopkins University School of Medicine under the direction of Dr. Solomon Snyder. Her Ph.D. work was remarkable in that she discovered the brain's opiate receptor. During her illustrious career she authored more than 250 scientific articles on specific protein neurotransmitters and their role in the function of the immune system. In essence her work helped to dawn the age of understanding of what is now termed the "neuroendocrine-immune system," which is a super system in the body that connects the immune, hormone-producing endocrine and nervous systems together through cross communication created by the release of chemical messengers from each of these organs that "talk" to the other organs within this super system. It was this series of discoveries that led her to write the frame-shifting book Molecules of Emotion: The Science Behind Mind-Body Medicine in 1999.
We lost Dr. Tony Pawson in August. Tony Pawson earned his Ph.D. degree in 1976 at King's College London, and did research at the Imperial Cancer Research Fund (now Cancer Research U.K.), where he made fundamental discoveries about the messages within cells that control their metabolism and the expression of their genes. These discoveries gave birth to the new scientific field of research termed "intercellular signal transduction" or how messages are communicated from outside a cell to the interior where the genes reside. Over the past 35 years he authored more than 400 scientific papers and was considered the "father" of signal transduction and its contribution to the birthing of network biology.
I had the good fortune of meeting and getting to know both Dr. Pert and Dr. Pawson, and my thinking has been profoundly influenced by them, as has the thinking of many tens of thousands of other scientists and clinicians influenced by their work over the past three decades.
As I reflected on their premature passing (Candace was 67 and Tony was 60), I recognized that although they traveled in very different scientific and social circles, their discoveries had significant synergy in changing our opinions about how individuals get sick. With Candace, it was about the signals that we received from our culture, environment and lifestyle that altered the messenger molecules that ultimately controls our immune system function as well as our mood, mind and emotion that impact both our mental and physical health.
Her work expanded on the pioneering book that Dr. Kenneth Pelletier wrote in 1977, Mind as Healer, Mind as Slayer, in which he discussed the emerging understanding of the role of the brain in influencing the function of the immune system. The theme of the work of Dr. Pert and Dr. Pelletier was that "signals" coming from our environment could be "translated" in our body into changes in the function of the immune, endocrine and nervous system, and once one component of the super system was influenced all the other components would be affected as well. It was the remarkable basic science discoveries of Dr. Pert that demonstrated that specific neurohormones initiate the cross talk among the various components of the system through activation of specific receptors for their message that are found on the surface of cells that make up the nervous, immune and endocrine systems.
Tony Pawson's discoveries extended the story of "signals" that influence physiological function to that of a mechanistic explanation as to how many of the messages received by the cell get transferred from the surface of the cell to the deep interior of the cell where they can "speak to the genes" and create altered genetic expression and the function. This process called signal transduction has now been identified to help explain the mechanism by which many chronic diseases originate.
The model of disease that has come from the work of Pert and Pawson and many others who followed them over the past 30 years -- in virtually every field of medical research -- is that signals in our environment from stressful life experiences, radiation exposure, infectious organisms (such as bacteria and viruses), xenobiotic chemicals, allergens, intestinal bacterial metabolites and food-derived bioactive substances (including phytochemicals), all have influence on messages received by our genes that then influences their expression. The expression of our genes in turn controls our health and disease outcome.
As I review the major shift in thinking in 21st-century medicine it is precisely the concept of signals and how they are transduced into cellular response that is shaping the new medicine. It is clear that presently we cannot change our genes, but we can change the messages that are being sent to our genes. It is these signals that Pert and Pawson discovered that we now recognize as the upstream cause of many chronic diseases that represent the pandemic global health issues we are now dealing with. We should all include Dr. Pert and Dr. Pawson in the pantheon of remarkable people in science whose research has conferred great and lasting benefit on mankind.
Dr. Jeffrey Bland is the author of the upcoming book The Disease Delusion, scheduled for release by HarperWave, a division of HarperCollins Publishers, in Spring 2014.
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