12 days of xmas: Drug discovery

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1 Partridge in a Pear Tree

Aspirin is a salicylate derived from the bark of willow trees. It is an anti-inflammatory, anti-coagulant and painkiller. Its roots lie at least as far back as the Ancient Greeks and even animals are known to strip willow of its bark for pain relief.

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2     Turtle doves

The life-cycle of the malaria parasite was discovered after observing the avian form of malaria. Further experiments and microscopy work in the 1890’s showed this malaria was transmitted through mosquito bites, which has been vital to our understanding of this infectious disease. Ronald Ross won a Nobel prize for his work.

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3     French hens

In the early 1900’s a Danish scientist was investigating whether poultry could synthesise de novo cholesterol. Unexpectedly some of the birds developed internal haemorrhaging as a result of blood clotting failure, however this could be reversed by feeding the chickens compounds from green leafy vegetables. The Danish for coagulation is Koagulation and the compound was named Vitamin K – it is still used in hospitals to reverse anticoagulant overdose.

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4     Colly birds

“Calling birds” is a corruption of the original verse containing ‘colly birds’ or black birds. Colly dervies from the old English for coal. In the 1800’s anilines from coal were being investigated for their anti-irritant properties, however it was serendipitously discovered that these compounds were also very effective at lowering fevers (which plagued this era) and providing pain relief. The early compounds were highly toxic but famed enough that several laboratories went on to refine products that could be used safely… heralding the birth of paracetamol.

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5     Golden rings

Antibiotics are the foundation of medical care today but penicillin’s infamous discovery was utterly accidental. Studying moulds, Fleming saw some of the batches had been contaminated with bacteria and was going to discard them when he realised there were rings surrounding the mould spores where the bacteria wouldn’t grow. He isolated the compound responsible, penicillin, and revolutionised healthcare.

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6     Geese a-laying

West Nile virus is another mosquito borne disease that also affects bird species. Goose flocks were decimated by outbreaks in Minnesota recently, however those that survived were strongly resistant.Farms began extracting their antibodies and treating their remaining birds; the death rate on one farm went from 34,000 to 1,000. Scientists are looking at purifying the antibodies that are excreted in these birds’ eggs in order to help prevent an equivalent human disease.

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7     Swans a-swimming

The gold standard test for the new development of anti-depressants is seeing how well they make rats a-swim; when dropped into a water tank and forced to swim to a platform for an exit (the ‘forced swim test’), depressed mice will simply bob there until they are rescued whilst normal rodents will swim and seek escape. Anti-depressants encourage this swim and seek behaviour – their effectiveness in this test correlates well with how they will perform in humans.

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8     Maids a-milking

In the 1800’s Edward Jenner noted that milkmaids who had been exposed to cowpox seemed relatively protected from catching smallpox – a far more dangerous disease to humans that killed up to 60% of adults and 80% of children. By transferring some of the pus from a milkmaid’s lesions, Jenner conferred the resistance to new individuals and triggered widespread vaccination. An official announcement in 1979 confirmed that smallpox has now been eradicated.

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9     Ladies dancing

In Victorian Britain ammonium compounds in the form of ‘smelling salts’ were used to revive swooning ladies. Nowadays they are still used for pregnant women when they get faint. At the other end of the spectrum, they are used to revive boxers who have been knocked unconscious in a fight.

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10     Lords a-leaping

Opiates once held a certain allure in the aristocracy as  recreational drugs and entire dance halls used to be devoted to partaking in its pleasure. Opiates were developed for medicinal use into derivatives like morphine and it remains our most potent painkiller.

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11     Pipers piping

Various members of the plant genus Piper have been found to have an array of insecticidal, antifungal and anti-parasitic properties. In particular Piper aduncum (spiked pepper) has been shown to have activity against certain species of mosquito (in the prevention of malaria) and against c. albicans; a fungus that causes thrush and various other infections from oral contamination to bronchial involvement in the immunosuppressed.

12 Drummers Drumming

12     Drummers drumming

The four features of a physical examination in medicine are inspection, palpation, percussion and auscultation. This stepwise process is a legacy passed down by the physicians of the last few centuries and is still routine, however percussion and auscultation took a while to become established in medicine. Percussion is the act of ‘drumming’ across suspected areas of pathology by tapping two fingerpads on two outstretched digits of the other hand. Sounds may be resonant or dull – indicating solid tissue, fluid or air beneath the skin. It was brought to the table in the 1700’s by a young Dr Auenbrugger who had observed his father checking the fluid level in kegs by tapping on them in this way, and he was able to use it to tap out the outline of the heart. Nowadays it is used to quickly detect areas of pneumonia,TB, pulmonary embolism, pneumothorax, pleural effusion, tracheal deviation, cardiomegaly, hepatomegaly, splenomegaly, urinary retention and ascites, as well as used to elicit key signs of gallbladder pathology, appendicitis and peritonitis…in a matter of seconds.

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