Barry Marshall

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Barry Marshall
AC FRACP FRS FAA
Barry J Marshall.jpg
Marshall in 2021
Born
Barry James Marshall

(1951-09-30) 30 September 1951 (age 73) [1]
Kalgoorlie, Western Australia
Alma mater University of Western Australia (MBBS) [1]
Known for Helicobacter pylori
Spouse
Adrienne Joyce Feldman
​
​
(m. 1972)​
[1]
Children4 [1]
Awards
Scientific career
Fields
Institutions
Website www.uwa.edu.au/marshall-centre

Barry James Marshall (born 30 September 1951) is an Australian physician, Nobel Laureate in Physiology or Medicine, Professor of Clinical Microbiology and Co-Director of the Marshall Centre [4] at the University of Western Australia. [5] Marshall and Robin Warren showed that the bacterium Helicobacter pylori (H. pylori) plays a major role in causing many peptic ulcers, challenging decades of medical doctrine holding that ulcers were caused primarily by stress, spicy foods, and too much acid. This discovery has allowed for a breakthrough in understanding a causative link between Helicobacter pylori infection and stomach cancer. [6] [7] [8]

Contents

Early life and education

Marshall was born in Kalgoorlie, Western Australia and lived in Kalgoorlie and Carnarvon until moving to Perth at the age of eight. His father held various jobs, and his mother was a nurse. He is the eldest of four siblings. He attended Marist College, Churchlands for his secondary education and the University of Western Australia School of Medicine, where he received a Bachelor of Medicine, Bachelor of Surgery (MBBS) in 1974. [1] He married his wife Adrienne in 1972 and has four children, a son and three daughters. [9] [10] [11]

Career and research

In 1979, Marshall was appointed Registrar in Medicine at the Royal Perth Hospital. He met Dr. Robin Warren, a pathologist interested in gastritis, during internal medicine fellowship training at Royal Perth Hospital in 1981. Together, they both studied the presence of spiral bacteria in association with gastritis. In 1982, they performed the initial culture of H. pylori and developed their hypothesis on the bacterial cause of peptic ulcers and gastric cancer. [9] It has been claimed that the H. pylori theory was ridiculed by established scientists and doctors, who did not believe that any bacteria could live in the acidic environment of the stomach. Marshall was quoted as saying in 1998 that "everyone was against me, but I knew I was right." [12] On the other hand, it has also been argued that medical researchers showed a proper degree of scientific scepticism until the H. pylori hypothesis could be supported by evidence. [13]

In 1982 Marshall and Warren obtained funding for one year of research. The first 30 out of 100 samples showed no support for their hypothesis. However, it was discovered that the lab technicians had been throwing out the cultures after two days. This was standard practice for throat swabs where other organisms in the mouth rendered cultures unusable after two days. Due to other hospital work, the lab technicians did not have time to immediately throw out the 31st test on the second day, and so it stayed from Thursday through to the following Monday. In that sample, they discovered the presence of H. pylori. They later found out that H. pylori grows more slowly than the conventional two days required by other mucosal bacteria, and that stomach cultures were not contaminated by other organisms. [14]

In 1983 they submitted their findings thus far to the Gastroenterological Society of Australia, but the reviewers turned their paper down, rating it in the bottom 10% of those they received that year. [14]

After failed attempts to infect piglets in 1984, Marshall, after having a baseline endoscopy done, drank a broth containing cultured H. pylori, expecting to develop, perhaps years later, an ulcer. [15] He was surprised when, only three days later, he developed vague nausea and halitosis, due to the achlorhydria. There was no acid to kill bacteria in the stomach and their waste products manifested as bad breath, noticed by his wife. [16] On days 5–8, he developed achlorhydric (no acid) vomiting. On day eight, he had a repeat endoscopy, which showed massive inflammation (gastritis), and a biopsy from which H. pylori was cultured, showing it had colonised his stomach. On the fourteenth day after ingestion, a third endoscopy was done, and Marshall began to take antibiotics. [17] Marshall did not develop antibodies to H. pylori, suggesting that innate immunity can sometimes eradicate acute H. pylori infection. Marshall's illness and recovery, based on a culture of organisms extracted from a patient, fulfilled Koch's postulates for H. pylori and gastritis, but not for peptic ulcers. This experiment was published in 1985 in the Medical Journal of Australia [18] and is among the most cited articles from the journal. [19]

After his work at Fremantle Hospital, Marshall did research at Royal Perth Hospital (1985–86) and at the University of Virginia, USA (1986–present), before returning to Australia while remaining on the faculty of the University of Virginia. [3] He held a Burnet Fellowship at the University of Western Australia (UWA) from 1998 to 2003. [20] Marshall continues research related to H. pylori and runs the H. pylori Research Laboratory at UWA. [21]

In 2007, Marshall was appointed Co-Director of The Marshall Centre for Infectious Diseases Research and Training, founded in his honour. In addition to Helicobacter pylori research, the Centre conducted varied research into infectious disease identification and surveillance, diagnostics and drug design, and transformative discovery. His research group expanded to embrace new technologies, including Next-Generation Sequencing and genomic analysis. Marshall also accepted a part-time appointment at the Pennsylvania State University that same year. [22] He established the Noisy Guts Project in 2017 – a research team dedicated to investigating new diagnostics and treatments for Irritable Bowel Syndrome. This resulted in a spin-out company Noisy Guts Pty Ltd [23] which develops functional food products. In August 2020, Marshall, along with Simon J. Thorpe, accepted a position at the scientific advisory board of Brainchip INC, a computer chip company. [24]

Awards and honours

In 2005, the Karolinska Institute in Stockholm awarded the Nobel Prize in Physiology or Medicine to Marshall and Robin Warren, his long-time collaborator, "for their discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease". [25]

Marshall also received the Warren Alpert Prize in 1994; the Australian Medical Association Award and the Albert Lasker Award for Clinical Medical Research in 1995; the Gairdner Foundation International Award in 1996; the Paul Ehrlich and Ludwig Darmstaedter Prize in 1997; the Golden Plate Award of the American Academy of Achievement, [26] the Dr A.H. Heineken Prize for Medicine, the Florey Medal, and the Buchanan Medal of the Royal Society in 1998.

He was elected a Fellow of the Royal Society (FRS) in 1999. His certificate of election to the Royal Society reads: [2]

Barry Marshall, together with Robin Warren, discovered spiral bacteria in the stomachs of almost all patients with active chronic gastritis, or duodenal or gastric ulcers, and proposed that the bacteria were an important factor in the aetiology of these diseases. In 1985, Marshall showed by self-administration that this bacterium, now called Helicobacter pylori, causes acute gastritis and suggested that chronic colonisation directly leads to peptic ulceration. These results were a major challenge to the prevailing view that gastric disorders had a physiological basis, rather than being infectious diseases. Marshall showed that antibiotic and bismuth salt regimens that killed H. pylori resulted in the cure of duodenal ulcers. The view that gastric disorders are infectious diseases is now firmly established and there is increasing evidence for a role of H. pylori infection in gastric cancers. The work of Marshall has produced one of the most radical and important changes in medical perception in the last 50 years. Barry Marshall was awarded the Albert Lasker Award for Clinical Science in 1995 and the Buchanan Medal in 1998.

Marshall was awarded the Benjamin Franklin Medal for Life Sciences in 1999; the Keio Medical Science Prize in 2002; and the Australian Centenary Medal and Macfarlane Burnet Medal and Lecture in 2003. [27] [28]

Marshall was appointed a Companion of the Order of Australia in 2007. [29] He was awarded an honorary Doctor of Science degree by the University of Oxford in 2009. [30]

Marshall was elected Fellow of the Australian Academy of Health and Medical Sciences (FAHMS) in 2015. [31]

Marshall was awarded the honour of Western Australian of the Year in 2006. [32]

Marshall was awarded The Companion in the General Division of the Order of Australia (AC) in 2007. [33]

Marshall was awarded The University of Oxford honorary Doctor of Science degree in 2009. [34]

Marshall is the Ambassador for Life Sciences for Western Australia.

See also

Related Research Articles

<span class="mw-page-title-main">Urea breath test</span> Medical test for a bacterial infection

The urea breath test is a rapid diagnostic procedure used to identify infections by Helicobacter pylori, a spiral bacterium implicated in gastritis, gastric ulcer, and peptic ulcer disease. It is based upon the ability of H. pylori to convert urea to ammonia and carbon dioxide. Urea breath tests are recommended in leading society guidelines as a preferred non-invasive choice for detecting H. pylori before and after treatment.

<span class="mw-page-title-main">Peptic ulcer disease</span> Ulcer of an area of the gastrointestinal tract

Peptic ulcer disease is a break in the inner lining of the stomach, the first part of the small intestine, or sometimes the lower esophagus. An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer. The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain, and upper abdominal pain that improves with eating. With a gastric ulcer, the pain may worsen with eating. The pain is often described as a burning or dull ache. Other symptoms include belching, vomiting, weight loss, or poor appetite. About a third of older people with peptic ulcers have no symptoms. Complications may include bleeding, perforation, and blockage of the stomach. Bleeding occurs in as many as 15% of cases.

<i>Helicobacter pylori</i> Species of bacteria

Helicobacter pylori, previously known as Campylobacter pylori, is a gram-negative, flagellated, helical bacterium. Mutants can have a rod or curved rod shape, that exhibit less virulence. Its helical body is thought to have evolved to penetrate the mucous lining of the stomach, helped by its flagella, and thereby establish infection. The bacterium was first identified as the causal agent of gastric ulcers in 1983 by the Australian doctors Barry Marshall and Robin Warren. In 2005 they were awarded the Nobel Prize in Physiology or Medicine for this discovery.

<i>Helicobacter</i> Genus of bacteria

Helicobacter is a genus of gram-negative bacteria possessing a characteristic helical shape. They were initially considered to be members of the genus Campylobacter, but in 1989, Goodwin et al. published sufficient reasons to justify the new genus name Helicobacter. The genus Helicobacter contains about 35 species.

<span class="mw-page-title-main">Gastritis</span> Inflammation of the stomach lining

Gastritis is the inflammation of the lining of the stomach. It may occur as a short episode or may be of a long duration. There may be no symptoms but, when symptoms are present, the most common is upper abdominal pain. Other possible symptoms include nausea and vomiting, bloating, loss of appetite and heartburn. Complications may include stomach bleeding, stomach ulcers, and stomach tumors. When due to autoimmune problems, low red blood cells due to not enough vitamin B12 may occur, a condition known as pernicious anemia.

<span class="mw-page-title-main">Achlorhydria</span> Lack of hydrochloric acid production in the digestive organs

Achlorhydria and hypochlorhydria refer to states where the production of hydrochloric acid in gastric secretions of the stomach and other digestive organs is absent or low, respectively. It is associated with various other medical problems.

<span class="mw-page-title-main">Robin Warren</span> Australian pathologist (1937–2024)

John Robin Warren was an Australian pathologist, Nobel laureate, and researcher who is credited with the 1979 re-discovery of the bacterium Helicobacter pylori, together with Barry Marshall. The duo proved to the medical community that the bacterium Helicobacter pylori is the cause of most peptic ulcers.

<span class="mw-page-title-main">Gastroenterostomy</span> Surgical procedure involving the creation of a connection between the stomach and the jejunum

A gastroenterostomy is the surgical creation of a connection between the stomach and the jejunum. The operation can sometimes be performed at the same time as a partial gastrectomy. Gastroenterostomy was in the past typically performed to treat peptic ulcers, but today it is usually carried out to enable food to pass directly to the middle section of the small intestine when it is necessary to bypass the first section because of duodenal damage. The procedure is still being used to treat gastroparesis that is refractory to other treatments, but it is now rarely used to treat peptic ulcers because most cases thereof are bacterial in nature and there are many new drugs available to treat the gastric reflux often experienced with peptic ulcer disease. Reported cure rates for H. pylori infection range from 70% to 90% after antibiotic treatment.

<span class="mw-page-title-main">Atrophic gastritis</span> Chronic inflammation and degradation of the stomach lining

Atrophic gastritis is a process of chronic inflammation of the gastric mucosa of the stomach, leading to a loss of gastric glandular cells and their eventual replacement by intestinal and fibrous tissues. As a result, the stomach's secretion of essential substances such as hydrochloric acid, pepsin, and intrinsic factor is impaired, leading to digestive problems. The most common are vitamin B12 deficiency possibly leading to pernicious anemia; and malabsorption of iron, leading to iron deficiency anaemia. It can be caused by persistent infection with Helicobacter pylori, or can be autoimmune in origin. Those with autoimmune atrophic gastritis (Type A gastritis) are statistically more likely to develop gastric carcinoma, Hashimoto's thyroiditis, and achlorhydria.

<span class="mw-page-title-main">Walery Jaworski</span> Polish gastroenterologist (1849–1924)

Walery Jaworski was a Polish physician and gastroenterologist. He is considered one of the pioneers of gastroenterology in Poland. He is also known for making one of the first observations of Helicobacter pylori in 1899.

John Lykoudis was a Greek physician and politician. He treated patients who had peptic ulcer disease with antibiotics long before it was commonly recognized that bacteria were a dominant cause for the disease. He became mayor of Missolonghi in 1951, serving until 1959.

<span class="mw-page-title-main">Martin J. Blaser</span> American academic

Martin J. Blaser is an American physician who is the director of the Center for Advanced Biotechnology and Medicine at Rutgers (NJ) Biomedical and Health Sciences and the Henry Rutgers Chair of the Human Microbiome and Professor of Medicine and Pathology and Laboratory Medicine at the Rutgers Robert Wood Johnson Medical School in New Jersey.

<span class="mw-page-title-main">Buchanan Medal</span>

The Buchanan Medal is awarded by the Royal Society "in recognition of distinguished contribution to the medical sciences generally". The award was created in 1897 from a fund to the memory of London physician Sir George Buchanan (1831–1895). It was to be awarded once every five years, but since 1990 the medal has been awarded every two years.

<span class="mw-page-title-main">Vagotomy</span> Surgical procedure

A vagotomy is a surgical procedure that involves removing part of the vagus nerve. It is performed in the abdomen.

Timeline of peptic ulcer disease and <i>Helicobacter pylori</i>

This is a timeline of the events relating to the discovery that peptic ulcer disease and some cancers are caused by H. pylori. In 2005, Barry Marshall and Robin Warren were awarded the Nobel Prize in Physiology or Medicine for their discovery that peptic ulcer disease (PUD) was primarily caused by Helicobacter pylori, a bacterium with affinity for acidic environments, such as the stomach. As a result, PUD that is associated with H. pylori is currently treated with antibiotics used to eradicate the infection. For decades prior to their discovery, it was widely believed that PUD was caused by excess acid in the stomach. During this time, acid control was the primary method of treatment for PUD, to only partial success. Among other effects, it is now known that acid suppression alters the stomach milieu to make it less amenable to H. pylori infection.

The Florey Medal, also known as the CSL Florey Medal and the Florey Medal for Lifetime Achievement, is an Australian award for biomedical research named in honour of Australian Nobel Laureate Howard Florey. The medal is awarded biennially and the recipient receives $50,000 in prize money.

Helicobacter pylori eradication protocols is a standard name for all treatment protocols for peptic ulcers and gastritis in the presence of Helicobacter pylori infection. The primary goal of the treatment is not only temporary relief of symptoms but also total elimination of H. pylori infection. Patients with active duodenal or gastric ulcers and those with a prior ulcer history should be tested for H. pylori. Appropriate therapy should be given for eradication. Patients with MALT lymphoma should also be tested and treated for H. pylori since eradication of this infection can induce remission in many patients when the tumor is limited to the stomach. Several consensus conferences, including the Maastricht Consensus Report, recommend testing and treating several other groups of patients but there is limited evidence of benefit. This includes patients diagnosed with gastric adenocarcinoma, patients found to have atrophic gastritis or intestinal metaplasia, as well as first-degree relatives of patients with gastric adenocarcinoma since the relatives themselves are at increased risk of gastric cancer partly due to the intrafamilial transmission of H. pylori. To date, it remains controversial whether to test and treat all patients with functional dyspepsia, gastroesophageal reflux disease, or other non-GI disorders as well as asymptomatic individuals.

<span class="mw-page-title-main">Stomach disease</span> Medical condition

Stomach diseases include gastritis, gastroparesis, Crohn's disease and various cancers.

Charles Saul Lieber was a Belgian-American clinical nutritionist who established that excess alcohol consumption can cause cirrhosis of the liver even in subjects who have an adequate diet, contradicting then-current scientific opinion.

Helicobacter heilmannii sensu lato refers to a group of bacterial species within the Helicobacter genus. The Helicobacter genus consists of at least 40 species of spiral-shaped flagellated, Gram-negative bacteria of which the by far most prominent and well-known species is Helicobacter pylori. H. pylori is associated with the development of gastrointestinal tract diseases such as stomach inflammation, stomach ulcers, duodenal ulcers, stomach cancers that are not lymphomas, and various subtypes of extranodal marginal zone lymphomas, e.g. those of the stomach, small intestines, large intestines, and rectum. H. pylori has also been associated with the development of bile duct cancer and has been associated with a wide range of other diseases although its role in the development of many of these other diseases requires further study.

References

  1. 1 2 3 4 5 "Marshall, Prof. Barry James" . Who's Who . Vol. 2015 (online Oxford University Press  ed.). A & C Black.(Subscription or UK public library membership required.) doi:10.1093/ww/9780199540884.013.U26713
  2. 1 2 "Certificate of Election EC/1999/24: Barry James Marshall". London: Royal Society. Archived from the original on 30 December 2017.
  3. 1 2 "U.Va. Top News Daily". Virginia.edu. 4 October 2005. Archived from the original on 4 April 2010. Retrieved 2 March 2010.
  4. ↑ "The Marshall Centre". The Marshall Centre. Archived from the original on 31 March 2021. Retrieved 3 May 2021.
  5. ↑ "The University of Western Australia". Archived from the original on 13 October 2008.
  6. ↑ Marshall BJ, Warren JR (June 1983). "Unidentified curved bacilli on gastric epithelium in active chronic gastritis". The Lancet . 321 (8336): 1273–5. doi:10.1016/S0140-6736(83)92719-8. PMID   6134060.
  7. ↑ Marshall BJ, Warren JR (June 1984). "Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration" . The Lancet. 323 (8390): 1311–5. doi:10.1016/S0140-6736(84)91816-6. PMID   6145023. S2CID   10066001.
  8. ↑ Sweet, Melissa (2 August 1997). "Smug as a bug". The Sydney Morning Herald. Archived from the original on 18 July 2014. Retrieved 28 January 2007.
  9. 1 2 Barry, Marshall (2005). "Autobiography". Nobel Foundation. Archived from the original on 18 February 2007. Retrieved 28 January 2007.
  10. ↑ In 1972 he was also a state yo-yo champion.
  11. ↑ "Sydney Morning Herald Features Barry Marshall Helicobacter pylori". Vianet.net.au. 2 August 1997. Archived from the original on 18 July 2014. Retrieved 2 March 2010.
  12. ↑ "Barry Marshall Interview, H. Pylori and the Making of a Myth". Academy of Achievement. 23 May 1998. Archived from the original on 24 June 2013. Retrieved 28 January 2007.
  13. ↑ Atwood, Kimball C. (November 2004). "Bacteria, Ulcers, and Ostracism?". Skeptical Inquirer . Archived from the original on 17 October 2013. Retrieved 17 July 2007.
  14. 1 2 Seeing What Others Don't, chapter 4, by Gary Klein
  15. ↑ "The Doctor Who Drank Infectious Broth, Gave Himself an Ulcer, and Solved a Medical Mystery". Discover Magazine. Archived from the original on 24 January 2018. Retrieved 23 January 2018.
  16. ↑ "Helicobacter Connections: Nobel Lecture, December 8, 2005" (PDF). Nobel Prize. Retrieved 20 January 2024.
  17. ↑ This story is related by Marshall in his Nobel acceptance lecture 8 December 2005, available for viewing on the Nobel website. "Barry J. Marshall – Biographical". Nobelprize.org . Nobel Media AB. Retrieved 1 August 2013.
  18. ↑ Marshall BJ, Armstrong JA, McGechie DB, Glancy RJ (1985). "Attempt to fulfil Koch's postulates for pyloric Campylobacter". Medical Journal of Australia. 142 (8): 436–9. doi:10.5694/j.1326-5377.1985.tb113443.x. PMID   3982345. S2CID   42243517.
  19. ↑ Van Der Weyden, Martin B; Armstrong, Ruth M; Gregory, Ann T (2005). "The 2005 Nobel Prize in Physiology or Medicine". Medical Journal of Australia. 183 (11/12): 612–4. PMID   16336147.
  20. ↑ "Professor Barry Marshall". University of Western Australia. 28 July 2006. Archived from the original on 17 February 2007. Retrieved 28 January 2007.
  21. ↑ Marshall, Barry (26 August 2002). "Helicobacter pylori Research Laboratory". University of Western Australia. Archived from the original on 28 January 2007. Retrieved 28 January 2007. Marshall's home page and various links can also be found there.
  22. ↑ "Nobel laureate Marshall joins Penn State faculty". Penn State Live. 6 September 2007. Archived from the original on 25 August 2011. Retrieved 6 September 2007.
  23. ↑ "Noisy Guts : Gut Health Research + Recipes + Products" . Retrieved 28 March 2023.
  24. ↑ BrainChip Holdings Ltd: June Quarter Update – August 2020 Archived 9 July 2021 at the Wayback Machine
  25. ↑ "The Nobel Prize in Physiology or Medicine 2005". Nobel Foundation. 2005. Archived from the original on 18 February 2007. Retrieved 28 January 2007.
  26. ↑ "Golden Plate Awardees of the American Academy of Achievement". www.achievement.org. American Academy of Achievement.
  27. ↑ "Curriculum Vitae". Nobel Foundation. 2005. Archived from the original on 14 February 2007. Retrieved 28 January 2007.
  28. ↑ "Macfarlane Burnet Medal and Lecture". Australian Academy of Science. Retrieved 22 February 2017.
  29. ↑ "It's an Honour". Government of Australia. 26 January 2007. Archived from the original on 2 October 2018. Retrieved 28 January 2007.
  30. ↑ "Encaenia 2009". University of Oxford. 24 June 2009. Archived from the original on 4 July 2009. Retrieved 9 September 2009.
  31. ↑ "Fellowship of the Australian Academy of Health & Medical Sciences – October 2015" (PDF). Australian Academy of Health & Medical Sciences. Archived from the original (PDF) on 28 November 2016. Retrieved 12 October 2018.
  32. ↑ "Hall of Fame 2006". Western Australian of the Year. Archived from the original on 18 March 2018. Retrieved 19 April 2021.
  33. ↑ "Australian Honours Lists". Department of the Prime Minister and Cabinet. Archived from the original on 2 October 2018. Retrieved 19 April 2021.
  34. ↑ "University of Oxford Annual Review 2008/2009" (PDF). Archived (PDF) from the original on 24 February 2018. Retrieved 4 May 2021.
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