Science

Nobel prize in medicine awarded to hypoxia researchers


Three scientists have shared this year’s Nobel prize in physiology or medicine for discovering how the body responds to changes in oxygen levels, one of the most essential processes 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, showed how cells sense when oxygen levels have dropped and respond by making new blood cells and vessels.

Beyond describing a fundamental physiological process that enables animals to thrive in some of the highest regions on Earth, the mechanism has given researchers new routes to treatments for anaemia, cancer, heart disease and other conditions.

Professor Ratcliffe was summoned from a lab meeting in Oxford to take the call from Stockholm. “I tried to make sure it wasn’t some friend down the road having a laugh at my expense,” he told the Guardian. “Then I accepted the news and had a think about how I was going to reorder my day.”

Ratcliffe had spent the weekend working on an EU synergy grant and despite winning the prestigious Lasker prize with Kaelin and Semenza in 2016, had not imagined his morning taking the turn it had. “When I got up this morning I didn’t have any expectation or make any contingency plans for the announcement at all,” he said.

On finishing the call, he returned to his meeting and, at the request of the Nobel committee, carried on without a word. At least one scientist had her suspicions however, having noticed that he left a coffee in the room and returned with a tea. “She’s s scientist so trained to draw deductions from the things she observes,” Ratcliffe said. “I’d decided I needed a little less agitation rather than more.”

The three laureates will share the 9m Swedish kronor (£740,000) equally, according to the Karolinska Institute in Stockholm. Asked what he intended to do with the windfall, Ratcliffe said: “I’ll be discussing that with my wife in private.” But it’ll be something good.”

The discovery has already led to potential drugs that aim to treat anaemia by fooling the body into thinking it is at high altitude, making it send more oxygen-carrying red blood cells around the body. Other drugs that work on the biological process are expected to help fight cancer and treat heart disease.

In work that spanned more than two decades, the researchers teased apart different aspects of how cells in the body first sense and then respond to low oxygen, a gas that is crucial for converting food into useful energy.

When the amount of oxygen available to cells drops, levels of a protein complex named HIF rise. This ramps up the activity of a gene used in the production of erythropoietin (EPO), a hormone that in turn boosts the creation of red blood cells.

Randall Johnson, professor of molecular physiology and pathology at Cambridge University, said this year’s Nobel laureates “have greatly expanded our knowledge of how physiological response makes life possible.”

A drug that boosts the body’s production of red blood cells by tapping into the molecular machinery identified by the winners has already been approved in China and is under consideration by regulators in Europe. It could help people who lose blood in accidents or during surgery.

The role of HIF is crucial from the earliest days of life, Randall said. “If an embryo doesn’t have the HIF gene it won’t survive past very early embryogenesis. Even in the womb our bodies need this gene to do everything they do.”

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