Barry Marshall

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Barry James Marshall
Dr Barry Marshall - Nobel Laureate.jpg
Marshall in 2019 with Nobel Laureate pin
Born
Barry James Marshall

(1951-09-30) 30 September 1951 (age 67) [1]
Kalgoorlie, Western Australia
NationalityAustralian
CitizenshipAustralian
Alma mater University of Western Australia (MB BS) [1]
Known for Helicobacter pylori
Spouse(s)
Adrienne Joyce Feldman(m. 1972)
[1]
Children1 son, 3 daughters [1]
Awards
Scientific career
Fields
Institutions
Website www.hpylori.com.au

Barry James Marshall AC FRACP FRS FAA [1] [2] (born 30 September 1951) is an Australian physician, Nobel Prize Laureate in Physiology or Medicine, and Professor of Clinical Microbiology at the University of Western Australia. 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. [4] [5] [6]

Fellow of the Royal Australasian College of Physicians, abbreviated as the post-nominal initials FRACP, is a recognition of the completion of the prescribed postgraduate specialist training programme in internal adult or internal paediatric medicine of the Royal Australasian College of Physicians.

Fellow of the Royal Society Elected Fellow of the Royal Society, including Honorary, Foreign and Royal Fellows

Fellowship of the Royal Society is an award granted to individuals that the Royal Society of London judges to have made a 'substantial contribution to the improvement of natural knowledge, including mathematics, engineering science, and medical science'.

Microbiology Study of microscopic organisms

Microbiology is the study of microorganisms, those being unicellular, multicellular, or acellular. Microbiology encompasses numerous sub-disciplines including virology, parasitology, mycology and bacteriology.

Contents

Education and early life

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 Newman College 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. [7] [8] [9]

Carnarvon, Western Australia Town in Western Australia

Carnarvon is a coastal town situated approximately 900 kilometres (560 mi) north of Perth, Western Australia. It lies at the mouth of the Gascoyne River on the Indian Ocean. The popular Shark Bay world heritage area lies to the south of the town and the Ningaloo Reef and the popular tourist town of Exmouth lie to the north. Within Carnarvon is the Mungullah Aboriginal Community. Inland, Carnarvon has strong links with the town of Gascoyne Junction and the Burringurrah Community. At the 2016 census, Carnarvon had a population of 4,426.

Newman College, Perth

Newman College is a pre K–12 co-educational Catholic school which operates in the Marist tradition. It is currently a joint governed college with the governors being the Archbishop of Perth, Archbishop Barry Hickey, and the Provincial of the Marist Brothers of the Southern Province of Australia, Brother Paul Gilchrist. The College is a foundation member of the Association of Marist Schools of Australia (AMSA).

University of Western Australia School of Medicine

The University of Western Australia School of Medicine is the medical school of the University of Western Australia, located in Perth, Australia. Established in 1957, it is the oldest medical school in Western Australia, with over 6000 alumni. Well-known for its research and clinical teaching, the medical school is ranked 39th in the world by the 2018 Academic Ranking of World Universities in clinical medicine. The medical school is affiliated with various teaching hospitals in Perth such as Royal Perth Hospital and Sir Charles Gairdner Hospital. The medical school is also heavily affiliated with the Queen Elizabeth II Medical Centre and its various research institutes. The school has prominent researchers and clinicians amongst its faculty and alumni, including Nobel Prize laureates Barry Marshall and Robin Warren ; recipients of the Australian of the Year award Fiona Stanley and Fiona Wood; and cancer researcher Richard Pestell. The school has produced 11 Rhodes Scholars.

Career and research

In 1979, Marshall was appointed as a Registrar in Medicine at the Royal Perth Hospital. He met Robin Warren, a pathologist interested in gastritis, during internal medicine fellowship training at Royal Perth Hospital in 1981. Together, the pair studied the presence of spiral bacteria in association with gastritis. In 1982, they performed the initial culture of H. pylori and developed their hypothesis related to the bacterial cause of peptic ulcer and gastric cancer. [7] It has been claimed that the H. pylori theory was ridiculed by the establishment scientists and doctors, who did not believe that any bacteria could live in the acidic environment of the stomach. Marshall has been quoted as saying in 1998 that "(e)veryone was against me, but I knew I was right." [10] 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. [11]

Royal Perth Hospital Hospital in Western Australia, Australia

Royal Perth Hospital (RPH) is a 450-bed teaching hospital located on the northeastern edge of the central business district of Perth, Western Australia.

Robin Warren Australian microbiologist and Nobel Laureate

John Robin Warren AC is 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.

Gastritis stomach disease that is an inflammation of the lining of the stomach.

Gastritis is 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 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.

In 1982 Marshall and Warren got funding for one year 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 2 days. This was standard practice for throat swabs where other organisms in the mouth rendered cultures as not useful after 2 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 Monday. In this sample, they discovered the presence of H. pylori. It turns out that H. pylori grow more slowly than 2 days, and also that the stomach cultures are not contaminated by other organisms. [12]

In 1983 they submitted their findings so far to the Gastroenterological Society of Australia, but the reviewers turned their paper down, rating it in the bottom 10% of those they received in 1983. [12]

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. [13] 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 only by his mother. On days 5–8, he developed achlorydric (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. [14] 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 ulcer. This experiment was published in 1985 in the Medical Journal of Australia [15] and is among the most cited articles from the journal. [16]

Endoscopy medical procedure

An endoscopy is used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inserted directly into the organ.

Achlorhydria medical state where the production of hydrochloric acid in gastric secretions of the stomach and other digestive organs is absent or low

Achlorhydria, also known as hypochlorhydria, refers 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.

Bad breath, also known as halitosis, is a symptom in which a noticeably unpleasant breath odour is present. It can result in anxiety among those affected. It is also associated with depression and symptoms of obsessive compulsive disorder.

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 1998–2003. [17] Marshall continues research related to H. pylori and runs the H. pylori Research Laboratory at UWA. [18]

In 2007, Marshall accepted a part-time appointment at the Pennsylvania State University. [19]

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". [20]

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 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. [21] [22]

Marshall was appointed a Companion of the Order of Australia in 2007. [23] He was awarded an honorary Doctor of Science degree by the University of Oxford in 2009. [24]

Marshall was elected Fellow of the Australian Academy of Health and Medical Sciences (FAHMS) in 2015. [25]

See also

Related Research Articles

Gastroenterology branch of medicine focused on the digestive system and its disorders

Gastroenterology is the branch of medicine focused on the digestive system and its disorders.

Urea breath test The urea breath test is a rapid diagnostic procedure used to identify infections

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.

Peptic ulcer disease Ulcer of an area of the gastrointestinal tract

Peptic ulcer disease (PUD) is a break in the inner lining of the stomach, first part of the small intestine or sometimes the lower esophagus. An ulcer in the stomach is called a gastric ulcer, while that 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 or 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 have no symptoms. Complications may include bleeding, perforation and blockage of the stomach. Bleeding occurs in as many as 15% of people.

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

Helicobacter pylori, previously known as Campylobacter pylori, is a Gram-negative, microaerophilic bacterium usually found in the stomach. It was identified in 1982 by Australian scientists Barry Marshall and Robin Warren, who found that it was present in a person with chronic gastritis and gastric ulcers, conditions not previously believed to have a microbial cause. It is also linked to the development of duodenal ulcers and stomach cancer. However, over 80% of individuals infected with the bacterium are asymptomatic, and it may play an important role in the natural stomach ecology.

<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.

Atrophic gastritis Human disease

Atrophic gastritis (also known as type A or type B 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 which results in a megaloblastic 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 the autoimmune version of atrophic gastritis are statistically more likely to develop gastric carcinoma, Hashimoto's thyroiditis, and achlorhydria.

Walery Jaworski Polish physician

Walery Jaworski, was one of the pioneers of gastroenterology in Poland.

Martin J. Blaser American academic

Martin J. Blaser(born 1948) is the Muriel G. and George W. Singer Professor of Translational Medicine, Director of the NYU Human Microbiome Program, former Chair of the Department of Medicine, and Professor of Microbiology at New York University School of Medicine. In mid-January 2019, Blaser will become the next director of the Center for Advanced Biotechnology and Medicine (CABM) at Rutgers (NJ) Biomedical and Health Sciences (RBHS) and the Henry Rutgers Chair of the Human Microbiome and professor of medicine and microbiology at the Rutgers Robert Wood Johnson Medical School in New Jersey.

Buchanan Medal award

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. Since its creation, it has been awarded 28 times, and unlike other Royal Society medals such as the Royal Medal, it has never been awarded to the same individual multiple times. As a result of the criteria for the medal, most of the winners have been doctors or other medical professionals; an exception was Frederick Warner, an engineer who won the medal in 1982 "for his important role in reducing pollution of the River Thames and of his significant contributions to risk assessment".

Vagotomy surgical procedure

A vagotomy is a surgical procedure that involves removing part of the vagus nerve.

Thomas Borody is an Australian gastroenterologist based in Sydney who is noted for his innovative clinical work and research in complex gastrointestinal disorders.

Giulio Bizzozero Italian physician

Giulio Bizzozero was an Italian doctor and medical researcher.

Timeline of peptic ulcer disease and <i>Helicobacter pylori</i> timeline of the events relating to the discovery that peptic ulcer disease and some cancers are caused by H. pylori

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 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; the primary goal is not only temporary relief of symptoms, but also total elimination of Helicobacter 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.

Stomach disease gastrointestinal system disease that is located in the stomach.

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

Charles Saul Lieber was a 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.

Gastric folds

The gastric folds are coiled sections of tissue that exist in the mucosal and submucosal layers of the stomach. They provide elasticity by allowing the stomach to expand when a bolus enters it; these folds stretch outward through the action of mechanoreceptors which respond to the increase in pressure. This allows the stomach to expand, therefore increasing the volume of the stomach without increasing pressure. These folds provide the stomach with increased surface area for nutrient absorption during digestion. Gastric folds may be seen during esophagogastroduodenoscopy or in radiological studies.

References

  1. 1 2 3 4 5 6 Marshall, Prof. Barry James. ukwhoswho.com. Who's Who. 2015 (online Oxford University Press ed.). A & C Black, an imprint of Bloomsbury Publishing plc. Closed Access logo transparent.svg (subscription required) doi:10.1093/ww/9780199540884.013.U26713
  2. 1 2 3 "Certificate of Election EC/1999/24: Barry James Marshall". London: Royal Society. Archived from the original on 17 August 2015.
  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. 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.
  5. 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.
  6. Sweet, Melissa (2 August 1997). "Smug as a bug". The Sydney Morning Herald . Retrieved 28 January 2007.
  7. 1 2 Barry, Marshall (2005). "Autobiography". Nobel Foundation. Archived from the original on 18 February 2007. Retrieved 28 January 2007.
  8. In 1972 he was also a state yo-yo champion.
  9. "Sydney Morning Herald Features Barry Marshall Helicobacter pylori". Vianet.net.au. 2 August 1997. Retrieved 2 March 2010.
  10. "Barry Marshall Interview, H. Pylori and the Making of a Myth". Academy of Achievement. 23 May 1998. Retrieved 28 January 2007.
  11. Atwood, Kimball C. (November 2004). "Bacteria, Ulcers, and Ostracism?". Skeptical Inquirer . Retrieved 17 July 2007.
  12. 1 2 Seeing What Others Don't, chapter 4, by Gary Klein
  13. "The Doctor Who Drank Infectious Broth, Gave Himself an Ulcer, and Solved a Medical Mystery - DiscoverMagazine.com". Discover Magazine.
  14. 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.
  15. 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. PMID   3982345.
  16. 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.
  17. "Professor Barry Marshall". University of Western Australia. 28 July 2006. Archived from the original on 17 February 2007. Retrieved 28 January 2007.
  18. 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.
  19. "Nobel laureate Marshall joins Penn State faculty". Penn State Live. 6 September 2007. Retrieved 6 September 2007.
  20. "The Nobel Prize in Physiology or Medicine 2005". Nobel Foundation. 2005. Archived from the original on 18 February 2007. Retrieved 28 January 2007.
  21. "Curriculum Vitae". Nobel Foundation. 2005. Archived from the original on 14 February 2007. Retrieved 28 January 2007.
  22. "Macfarlane Burnet Medal and Lecture". Australian Academy of Science. Retrieved 22 February 2017.
  23. "It's an Honour". Government of Australia. 26 January 2007. Retrieved 28 January 2007.
  24. "Encaenia 2009". University of Oxford. 24 June 2009. Archived from the original on 4 July 2009. Retrieved 9 September 2009.
  25. "Fellowship of the Australian Academy of Health & Medical Sciences - October 2015" (PDF). Australian Academy of Health & Medical Sciences. Retrieved 12 October 2018.