December 2016 | Issue 27
Against all odds: Nobel Laureate Barry Marshall drinks infectious cocktail to prove point

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By Sean Firoz, Senior Executive, Communications & External Relations

Just like comic book superheroes Captain America and Iron Man, who submitted their bodies to science to become human kind’s super-powered protectors, LKCMedicine’s newly appointed Nanyang Visiting Professor Barry Marshall infected himself with bacteria to bring to an end countless people’s needless suffering.

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Nobel Laureate Professor Barry Marshall talking about his Nobel Prize discovery in a recent interview with The Straits Times (photo credit: NTU Singapore)

The events that led up to this heroic act started in the early 1980s. As a young registrar working on the medical wards of the Royal Perth Hospital, Prof Marshall encountered many patients who were suffering from gastritis and ulcers, painful holes in the stomach lining.

At the time, everyone believed that these ulcers, which affected some 10 per cent of adults, were caused by psychological stress and spicy food. Treatment options included long-term medication with antacids or in severe cases, stomach resections.

When Dr Robin Warren, a pathologist at the same hospital, alerted Prof Marshall about a discovery he made two years earlier, the first germ of a new hypothesis about ulcers sprouted. Dr Warren had discovered that despite the stomach’s acidic environment, bacteria could grow there, in particular a bacterium called Helicobacter pylori (H. pylori).

Determined to understand the link between this mysterious corkscrew-shaped bacterium and stomach ulcers, Prof Marshall biopsied patients’ ulcers and cultured H. pylori in the lab. He soon found that not only was H. pylori the cause of stomach ulcers but also stomach cancer. The most effective treatment? A simple course of antibiotics.

But clinicians, researchers and the pharmaceutical industry dismissed this notion. The idea that antibiotics could treat stomach ulcers was seen as ludicrous. For Prof Marshall, it was a torment to see these patients suffering and even dying, when the answer was right in front their noses.

Making it his mission to prove the causal relationship between H. pylori and stomach ulcers, Prof Marshall cultured some H. pylori taken from the gut of a patient, brewed it into a broth and drank it.

Within days he developed symptoms of stomach ulcers; constant vomiting, bad breath and feeling nauseous and exhausted. As his sickness worsened, repeat endoscopies revealed that H. pylori was indeed the cause of stomach ulcers. Swiftly, he took a round of antibiotics and within days was cured.

Referring to his ordeal, Prof Marshall said at a recent interview in Singapore, “I was very interested in showing that all the medical books were wrong. Not only were they wrong but they were so certain that no bacteria lived in the stomach.”

And as if out of the pages of a super hero comic book, Prof Marshall’s self-experiment and discovery earned him the most coveted of prizes - the 2005 Nobel Prize for Medicine or Physiology which he shares with Dr Warren. Since then, antibiotics have become the main treatment for stomach ulcers, improving the lives of patients everywhere and H. pylori-related stomach cancers have been virtually eliminated.

But the work does not stop there for Prof Marshall, who is also Professor of Clinical Microbiology at the University of Western Australia (UWA). He founded the Helicobacter Research Laboratory, located within the Marshall Centre for Infectious Diseases Research and Training at UWA, which continues to develop methods for non-invasive studies on the molecular epidemiology of H. pylori.

Flipping the table on his old enemy, Prof Marshall has turned to using dead bacteria to find new treatments. Results from his latest work have shown that dead H. pylori is as effective as live bacteria in suppressing the immune system. He intends to further study the potential of the dead H. pylori HPS2 strain to create a range of prebiotic products to prevent allergies and asthma in young children. Currently in early phase testing, these natural immune modulatory products are a promising tool in the fight against rising rates of childhood allergies and asthma.

He is also interested in exploring how traditional Chinese medicine could affect H. pylori, in the hope of finding an alternative to antibiotics. Working with traditional Chinese medicine experts in China, he is keen to study the Chinese population and conduct clinical trials to evaluate the efficacy of these treatments using evidence-based best practice.

In Singapore, Prof Marshall intends to study H. pylori in Asian demographics, working especially with scientists from NTU on genomics and the evolution of H. pylori.

“When people get re-infected by H. pylori, I’m interested in finding out if the strain of bacterium is an old or new one and where they caught it. There are tools here in Singapore that could help with that mission,” said Prof Marshall, who started his Singapore appointment by giving an inspiring lecture to a packed Learning Studio at LKCMedicine’s Experimental Medicine Building on 9 November.

Titled “Man vs Helicobacter: The past 50,000 years and the next 50”, Prof Marshall shared his fight to get the world to take notice and end the suffering of millions of people who were affected by stomach ulcers.

Image 4 - Professor Barry Marshall, NTU Nanyang Visiting Professor. Photo by NTU Singapore (Custom).JPG
Prof Barry Marshall giving his first lecture in LKCMedicine on his discovery of H. pylori

Setting the scene for the talk, LKCMedicine Dean Professor James Best highlighted in his opening remarks the magnitude of the discovery. He said, “Prof Marshall was a clinician, and a relatively junior clinician at the time of this discovery, making it one of the most exciting discoveries in medicine of all time.”

“We are absolutely delighted [about this appointment] and look forward to further interaction with Prof Marshall in the coming years,” Prof Best added.

Over the two-year term of his appointment as Nanyang Visiting Professor, Prof Marshall will participate in major education and research events in the field of microbiology, infection and immunity at NTU, particularly across LKCMedicine, NTU’s School of Biological Sciences and the Singapore Centre for Environmental Life Sciences Engineering. He will also be interacting with the School’s medical students here in LKCMedicine as well as seeing a few patients in an advisory role.

Speaking about his appointment, Prof Marshall said, “I am excited to become a part of the faculty in NTU, and I hope to do more research within the university and maybe one day win a Nobel Prize in NTU as well.”