In modern medicine the idea of organ transplants is almost taken for granted, however, it was not so long ago that successful organ transplants were a dream or even part of science fiction. In historical records there are anecdotal stories about attempts to transplant organs centuries ago, but the first documented transplant of skin (the skin is considered an organ) was done in 1869. Many attempts to transplant organs were tried and failed, with the most common reason being the rejection of the organ by the host body. Transplants were usually considered successful for a matter of days, or weeks, at the most.
This began to change in 1969 when J. F. Borel, a microbiologist who worked for Sandoz Pharmaceuticals of Switzerland (now a division of Novartis) was attempting to discover new antifungal compounds. His company encouraged all employees to collect soil samples wherever they went. Borel, from Switzerland, was visiting rural southern Norway and he continued the practice. When he returned to Switzerland, Borel isolated a fungus, Tolypocladium inflatum. The fungus produced a chemical we now call cyclosporine (ciclosporin in Europe). The Sandoz company was mainly interested in new antimicrobials, and cyclosporine did not show a great effect in this area. However, Borel had experience studying how the immune system works in his doctoral studies, and he noticed that cyclosporine showed immunosuppressant effects. He tried to convince Sandoz to pursue cyclosporine, but the company decided against doing so because it was more interested in the pursuit of antibiotics.
The story continues in 1976 when Borel was presenting his findings at the British Society of Immunologists. Two of the attendees who heard his presentation, David White and Sir Roy Calne asked Borel for samples of cyclosporine to conduct organ transplantation in rats, and later wanted more of the drug to test in dogs. Borel was able to show his company the research by White and Calne, and then Sandoz was convinced there was merit in developing cyclosporine for the market. The drug was approved by the FDA in 1983 for use in organ transplants. It has proven to be the major factor for the success of transplantation. When used in conjunction with steroids (cortisone-like drugs) survival time is measured in years.
Cyclosporine is used in liver, kidney, heart, lung, pancreas, and bone marrow transplants, and is also approved for use in treating rheumatoid arthritis, psoriasis, and severe dry eyes.
Other immunosuppressant drugs that need mentioning are tacrolimus and sirolimus. Tacrolimus, isolated from a soil bacterium collected from Japan, was discovered in 1987 and approved in 1994. Sirolimus, also called rapamycin, was isolated from a soil bacterium collected from Easter Island and was approved in 1999.
These immunosuppressive drugs are unique in that they allow foreign organs to be accepted by the body and function, but still let the host body have a degree of disease fighting ability. This ability to allow foreign organs to be accepted by host bodies has been the one of the major keys for the advancement in organ transplantation and survival of organ recipients.
This story is another example of the wonders of science and the debt of gratitude owed to the researchers and scientists who investigate and search for new treatments.
Stay informed and stay healthy.
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