- Person
- Gertrude Elion
- Lived
- 1918–1999
- Field
- Pharmacology
- From
- American
The story
Early kidney transplants worked only between identical twins, because the recipient's immune system attacked any organ that was not a perfect genetic match. Surgeons needed a way to calm that response without destroying the patient's defences entirely.
Gertrude Elion and George Hitchings had already shown at Burroughs Wellcome that their purine compounds could slow the division of fast-growing cells, and 6-mercaptopurine had become a leukaemia drug in the early 1950s. 6-mercaptopurine also turned out to suppress the immune response, and researchers began testing it against transplant rejection.
In 1957 Elion and Hitchings synthesised a close chemical relative of 6-mercaptopurine, designed to release it in a masked form. They named it azathioprine, and it was later sold as Imuran. It was first used as a chemotherapy drug before its value for transplant patients became clear. The British transplant surgeon Roy Calne had been experimenting with 6-mercaptopurine to prevent rejection; when he asked Elion for related compounds, she suggested azathioprine, which proved superior. In the words of the Nobel Assembly, it replaced mercaptopurine as an inhibitor of the immune response.
Combined with steroids, azathioprine made the breakthrough possible. In April 1962 kidneys were successfully transplanted into unrelated recipients for the first time, and the National Inventors Hall of Fame notes that the drug, patented in 1962, enabled kidney transplants from unrelated donors. According to the Nobel Assembly, for a long time azathioprine was the only drug available to prevent the rejection of transplanted organs, turning transplantation from an experiment into a practical treatment.
Azathioprine also found a lasting place in the treatment of autoimmune diseases, where the immune system turns on the body's own tissues. It is used for severe rheumatoid arthritis, lupus and inflammatory bowel disease, among other conditions, and it is on the World Health Organization's List of Essential Medicines. Newer anti-rejection drugs have since joined it, but much of modern transplant medicine grew from the foundation that Elion's chemistry laid.
Why it matters
By making organ rejection controllable, azathioprine opened the era of kidney transplantation between unrelated people and still helps patients with autoimmune diseases today.
About Gertrude Elion
Chemist without a doctorate who pioneered rational drug design and created drugs for leukaemia, transplants, gout and herpes, sharing the 1988 Nobel Prize in Physiology or Medicine.
More about Gertrude Elion
- Gertrude Elion's 6-MP gave children with leukaemia a chanceIn the early 1950s Gertrude Elion synthesised 6-mercaptopurine, one of the first effective drugs against acute leukaemia, then almost always fatal in children.
- Elion's team created acyclovir, a pioneering antiviralIn the 1970s Gertrude Elion's group developed acyclovir, the first selective and effective antiviral drug, which attacks herpes viruses while sparing healthy cells.
- Gertrude Elion's allopurinol still treats gout todayAllopurinol, developed in Gertrude Elion's laboratory, blocks the build-up of uric acid and remains a mainstay treatment for gout.
- Researchers Elion trained helped develop AZTAfter Gertrude Elion retired in 1983, scientists she had trained, using her methods, developed AZT, one of the first drugs used to treat HIV/AIDS.
- Elion's chemistry also fought malaria and infectionsGertrude Elion's work with George Hitchings contributed to pyrimethamine against malaria and trimethoprim against bacterial infections.
- Gertrude Elion spent her later years mentoring studentsFrom 1971 Gertrude Elion taught at Duke University, mentoring medical and graduate students and publishing more than 25 papers with them.
- Gertrude Elion won a Nobel Prize without a doctorateTurned away from graduate funding, Gertrude Elion never completed a PhD, yet her rational drug design produced leukaemia, transplant and antiviral drugs and won the 1988 Nobel Prize.
Sources
- Gertrude B. Elion Wikipedia
- Gertrude Elion Jewish Women's Archive Encyclopedia
- The Nobel Prize in Physiology or Medicine 1988: Press release NobelPrize.org
- Azathioprine Wikipedia
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