幽門螺旋桿菌導致胃炎及腸胃潰瘍的研究 本界奪醫學諾獎的發現

與林哲民

醫治SARS改變人類肺部傳染疾病的發明簡直是小巫見大巫

澳2科學家拔頭籌 奪醫學諾獎

[2005-10-04]

Ulcer researchers win Nobel Prize

Australians Barry Marshall and Robin Warren won this year's Nobel Prize in physiology or medicine yesterday for discovering that bacteria, not stress, was the main cause of painful stomach ulcers.

本年度諾貝爾各個獎項昨日開始揭曉，澳洲醫學研究員馬歇爾及沃倫先拔頭籌，憑著發現幽門螺旋桿菌導致胃炎及腸胃潰瘍的研究，勇奪今年諾貝爾醫學獎。兩人除了共享1,000萬瑞典克朗(約1,000萬港元)的獎金，還可得到證書、金牌以及12月10日和瑞典國王握手的機會。

2005年諾貝爾醫學獎

　瑞典諾貝爾獎委員會表示，68歲的沃倫及54歲的馬歇爾於1982年的這個重大發現，將慢性腸胃潰瘍疾病，轉變為可以用少劑量抗生素及其他藥物治癒的疾病。委員諾馬克在記者會上表示：「他們的發現與當時普遍的想法大相徑庭，當時的人相信壓力過大及不良的生活習慣，才是腸胃潰瘍的元兇。」現時已經確定，幽門螺旋桿菌引致超過9成的十二指腸潰瘍，以及最多8成的胃潰瘍。

激發其他炎症研究

　委員會又指沃倫及馬歇爾的發現，激發起其他研究員尋找引致其他炎症的細菌，包括局部迴腸炎、潰瘍性結腸炎、風濕性關節炎及動脈硬化等。此外，各大藥廠在研發潰瘍藥時，亦會密切留意兩人的研究，有藥廠估計，全球每年的胃藥市場營業額高達200億美元(約1,560億港元)。

　當年沃倫在一半病人的活組織檢查中，發現一種細小的弧形細菌寄居於人類胃部的下半部分，其後更發現細菌旁的胃部黏膜常常發炎。馬歇爾對沃倫的發現深感興趣，遂一起展開涉及100名病人的活細胞切片研究。經過幾次嘗試後，馬歇爾成功培養當時無人所

知、現時稱為幽門螺旋桿菌的病菌，他們在幾乎所有患上胃炎、十二指腸潰瘍或胃潰瘍的病人體內發現這種病菌，是炎症研究上的一大突破。

　委員格里勒表示，發現幽門螺旋桿菌的過程有點「意外」，馬歇爾起初未能培養出該菌，但他在復活節5天假期前意外遺下培養樣本於實驗室。當他5天後回實驗室時，發現培養出幽門螺旋桿菌。

以身犯險驗證想法

　諾馬克更指出，馬歇爾當年為了驗證其假設是否成立，不惜自己上陣充當白老鼠，飲下含有幽門螺旋桿菌的培養液，他因此患上嚴重的胃炎，但病況很快轉好，卡羅林斯卡醫學院的腸胃學教授埃納爾松表示：「馬歇爾對此感到有點失望。」

　馬歇爾來自澳洲西部的卡爾古利，並於珀斯的尼德蘭玆區的伊麗莎伯二世醫療中心作研究。沃倫來自澳洲南部的阿德萊德，現時住在珀斯，1999年前在當地的皇家珀斯醫院當病理學家。 　■路透社/綜合外電消息

Ulcer researchers win Nobel Prize

AP , STOCKHOLM AND SYDNEY
Tuesday, Oct 04, 2005,Page 1

Australians Barry Marshall and Robin Warren won this year's Nobel Prize in physiology or medicine yesterday for discovering that bacteria, not stress, was the main cause of painful stomach ulcers.

The 1982 discovery transformed peptic ulcer disease from a chronic, frequently disabling condition to one that can be cured by a short course of antibiotics and other medicines, the Nobel Prize committee said.

Warren, 68, and Marshall, 54, found that Helicobacter pylori played a role in gastritis and peptic ulcers.

"This was very much against prevailing knowledge and dogma because it was thought that peptic ulcer disease was the result of stress and lifestyle," Staffan Normark, a member of the Nobel Assembly at the Karolinska institute, said at a news conference announcing the winners.

"Warren, a pathologist from Perth, Australia, observed small curved bacteria colonizing the lower part of the stomach in about 50 percent 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," the Nobel Assembly said yesterday.

Marshall became interested in Warren's findings and together they initiated a study of biopsies from 100 patients.

Marshall and Warren celebrated yesterday with champagne and beers with family members in the Western Australia state capital, Perth.

"For about a hundred years, or a thousand years, the standard teaching in medicine was that ... the stomach was sterile and nothing grew there because of corrosive gastric juices," Warren said. "So everybody believed there were no bacteria in the stomach."

"When I said they were there, no one believed it," he said.

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