Two British researchers who pioneered treatments which have helped millions of people with rheumatoid arthritis and other autoimmune diseases have been awarded the prestigious 2008 Dr. Paul Janssen Award for Biomedical Research, announced today.
Emeritus Professor Sir Ravinder Maini and Professor Marc Feldmann, who have been carrying out research together at Imperial College London since the 1980s, were selected for the $100K award by an international committee including Nobel Laureates and other world-renowned scientists.
Their research has led to the development of new drugs which tackle the inflammation and tissue destruction caused by rheumatoid arthritis and other diseases including ankylosing spondylitis, psoriatic arthritis, psoriasis, Crohn's disease and ulcerative colitis.
The treatments they developed, now used by millions of people across the world, have proved effective in most patients, even those resistant to all previous treatments. They also protect the joints from further destruction.
Previous treatment options for rheumatoid arthritis left almost half of all patients with symptoms of continuing disease, deterioration of physical function and progressive joint damage.
The breakthrough came for Professors Maini and Feldmann when they discovered how autoimmune diseases such as arthritis cause the immune system to fight itself. Their work showed that the key lay in molecules responsible for cell communication, known as cytokines.
Cytokines are normally released by immune cells, to alert the immune system to initiate a protective counter-response against infections. Professors Maini and Feldmann discovered that in autoimmune diseases, cytokines are over-produced, with highly increased cytokine levels around otherwise healthy cells. This leads to the signs and symptoms of disease and in rheumatoid arthritis it explains the body's aggressive reaction in areas of arthritic inflammation around patients' joints.
In 1991, the two Professors and their colleagues found that all the different cytokines causing inflammation could be stopped by blocking one kind, Tumor Necrosis Factor (TNF) alpha. In 1992, the first series of successful trials were run with rheumatoid arthritis patients at Charing Cross Hospital, now part of Imperial College Healthcare NHS Trust. The improvements in patients' health were so dramatic that the nurses could identify merely by observation, without access to blood tests, which patients had been given a placebo and which had received TNF alpha blockers.
The Professors' work stimulated the development of three anti-TNF drugs, infliximab, etanercept and adalimumab. Furthermore, a new branch of medicine known as anti-cytokine therapy is now emerging, which builds on their work. This research is looking at other cytokine messengers, in addition to TNF, to see how targeting these messengers might treat more conditions.
Professor Feldmann, Head of the Kennedy Institute of Rheumatology at Imperial College London, said: "Our findings were exciting because we discovered a new way of treating not just rheumatoid arthritis, but also a host of other chronic inflammatory conditions and perhaps acute ones too. It's great to see that through targeting other cytokine messenger molecules, as well as TNF, we now have the potential to tackle even more diseases and help even more patients. I believe Dr Janssen would have been intrigued as we explore the range of diseases which may be treatable by these anti-cytokines."