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HomeBlogThe crucial role that chance plays in the creation of life-saving drugs

The crucial role that chance plays in the creation of life-saving drugs

By: Medix Team
The crucial role that chance plays in the creation of life-saving drugs

It’s not something that scientists typically like to draw attention to, but it’s often serendipity that leads to medical breakthroughs

Is it any surprise that scientists don’t like to highlight the fact that so many drugs are discovered by chance? On the surface it appears to go against the very grain of what the discipline is supposed to stand for: the systemic study of the structure and behaviour of the physical and natural world.

 

Announcing that something has happened by accident might sow seeds of doubt about the rigour of a scientist’s approach, or trust in their findings. Oxford University’s Jenner Institute and the pharmaceutical giant, AstraZeneca, faced just such a controversy after a dosing issue during the recent trials for their Covid-19 vaccine.

 

Complications arose after their Italian manufacturer used a different technique to check the vaccine concentration before they shipped vials over. So the Oxford University team decided to give trial participants a half-dose first shot as a precaution in case the concentration was actually double strength.

 

It turned out that it was not. But what they discovered, instead, was better efficacy. A half dose followed by a normal dose offered higher protection than two normal doses.

 

Systemic and serendipity are words that can work well together when the scientific study of one thing leads a curious mind to discover an unexpected but beneficial application, sometimes for something else altogether. Such has been the case for so many common life-saving drugs.

 

Academic research reveals that up to a quarter of marketed drugs can be traced back to happy accidents. The figure is even higher for cancer drugs, estimated at 35%.

 

Here are some of the most famous breakthroughs for the most common diseases:

 

Antiprotozoals - quinine

 

The 16th century’s great age of exploration was a dangerous time for all concerned as diseases spread from one continent to another. Thanks to the Jesuits, however, a treatment was discovered for one insect-borne illness: malaria.

 

Quinine is a bitter compound that comes from the bark of the quina-quina tree. Its use represented the first time that a chemical compound was deployed against an infectious disease.

 

Europeans initially described it as Jesuits’ bark in honour of the monks who brought it back from Spain’s new empire in South America. This is where it had a much older lineage. 

 

According to folklore, an Andean Indian got lost in the jungle suffering from malaria. In a feverish state, he tried to sate his thirst by drinking from a pool of water at the base of a quina-quina tree. He thought the bitter-tasting water would make him worse. Instead it cleared his fever.

 

Antibiotics - penicillin

 

Millions died during two world wars in the 20th century, but millions more were saved in the war against a far more deadly and longstanding foe: bacteria. This was thanks to a Scottish doctor called Alexander Fleming, later Sir because of his pioneering work.

 

In 1928, Fleming returned from a two-week holiday to find that he’d forgotten to throw away a petri dish containing the Straphylococcus aureus bacteria.

 

In his absence, a mould had grown on it. Not only that, but the mould had formed a bacteria-free ring around itself.

 

After further investigation, Fleming honed in on a particular fungus whose spores had settled on the dish and killed the bacteria. He named its active ingredient penicillin. Fleming had created the first antibiotic.

 

Cancer: chemotherapy

 

Mustard gas was one of World War 1’s most terrible legacies and it was banned as a chemical weapon in the mid-1920s. Tragedy struck again during World War 2 when a bombing raid over the Italian seaport of Bari led to the explosion of an Allied ship carrying mustard gas that was being stored as a precaution against potential Nazi chemical attacks.

 

However, the disaster gave birth to a frontline cancer treatment. A US physician, called Dr Stewart Alexander, was sent to the scene to perform autopsies on the sailors who’d died. He discovered that the mustard gas had suppressed hematopoiesis (the process through which the body manufactures blood cells).

 

He wondered whether a similar process could be used to stop cancer cells from replicating too. He was correct. Subsequent clinical trials showed that nitrogen mustard combatted several malignancies including leukemia.

 

Cardiovascular - warfarin

 

The millions of people who take warfarin as a blood thinner have cows, rats and the Great Depression to thank for the life saving drug. Its discovery began when cows started dying of internal bleeding across the American Great Plains. The cause was sweet clover hay that had gone mouldy and farmers hadn’t thrown out because they couldn’t afford to.

 

In 1932, a Wisconsin farmer drove a dead cow 200 miles to an experimental agricultural station hoping for answers. Thanks to funding from the Wisconsin Alumni Research Foundation (WARF) the scientists there were able to isolate the compound, which caused the internal bleeding. They called it warfarin and used it to develop a rat poison.

 

The next step along the road to human use happened in 1951 when a US army inductee tried to commit suicide by drinking it. He was saved after being dosed with vitamin K in hospital.

 

Scientists realised warfarin’s therapeutic benefits as an anti-coagulant. One of the first beneficiaries was US president, Dwight Eisenhower, who was given it after a heart attack in 1955.

 

Central nervous system – lithium

 

The common English phrase – human guinea pig – describes someone on the receiving end of a medical experiment that may not work out for the best. It comes from the practise of using guinea pigs as laboratory animals since the 17th century.

 

For the Australian psychiatrist, John Cade, guinea pigs were the key to unlocking a drug to combat bipolar disorders. During World War 2, Cade had been incarcerated in Singapore’s Changi prisoner-of-war (POW) camp.

 

While he was there he tried to understand why some POWs developed psychiatric conditions and others didn’t despite suffering the same levels of stress. When he was liberated, he started to experiment on guinea pigs, injecting them with human urine to try and identify a toxic element that might cause mania. Instead, the toxicity killed the guinea pigs.

 

He turned to lithium salt to try and reduce the toxicity. It had a remarkable effect but not the one he intended. The previously fidgety guinea pigs rolled on their backs and stared at him quite placidly. The lithium had had a calming effect.

 

Cade tried it on himself and then on human patients hospitalised with mania. The first one administered with lithium settled down within three weeks and was discharged three months later. 



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