Monday, 17 September 2018

British vet wins top research award for breakthrough anaesthetic

John Glen given 2018 Lasker award for discovery of propofol, now used in 90 countries, enabling millions of surgical operations every year

A British veterinarian has won America’s top biomedical research prize for his discovery of a new way to knock people out.

John Glen, a researcher at ICI before the company became AstraZeneca through a series of mergers, spent 13 years developing propofol, a cloudy fluid dubbed the “milk of amnesia” that is now one of the most widely used anaesthetics in the world.

The compound’s rapid effects, coupled with patients’ fast and clear-headed recovery, helped to make propofol the anaesthetic of choice for many doctors who need to sedate patients for surgery. It is now administered more than 60m times per year in the US.

John Glen started his career as a vet, before
moving in to research full time. 
“I was most surprised,” said Glen, who must now decide what to do with the $250,000 (£193,000) that accompanies the Lasker award for clinical research. “We’re going to go on holiday and I suspect my wife would like a new car.”

The prize, backed by the Lasker Foundation, has previously been awarded for work on cancer-preventing vaccines, electrical brain stimulation to combat symptoms of Parkinson’s disease, and advanced hearing aids called cochlear implants.

Glen, who is known as Iain to avoid confusion with his father, another John, went into veterinary medicine after spending his childhood on a small farm on the Isle of Arran in the Firth of Clyde. Working in Glasgow he became a specialist on anaesthetics, knocking out cats and dogs, horses, sheep and pigs. On one occasion he was brought a pelican with a broken beak. He dealt with the patient by putting a plastic bag over its head and pumping in halothane, a general anaesthetic, until the bird fell unconscious. “We put a pin in its jaw and it came round fine,” he said.

The ability to send humans to sleep while they have surgical procedures is one of the most important advances in medical science, but side effects made some of the older anaesthetics complicated to use. In particular, patients woke up slowly and often felt nauseated and sick.

In the 1970s, Glen was hunting for better anaesthetics and found propofol among hundreds of compounds that ICI had synthesised over the years. Early tests on animals were encouraging. Mice went to sleep swiftly on propofol and when they woke up they aced a task that involved balancing on a narrow beam, suggesting they had regained consciousness with clear heads.

With earlier anaesthetics patients tended to wake up slowly, feeling nauseous and sick, but propofol changed all that. Photograph: Johnny Greig/Getty Images
But the drug very nearly failed. Before it could be injected into humans, propofol had to be mixed with another substance to make it soluble. The first mixture that went into trials produced life-threatening reactions in some people and the work was nearly abandoned.

It took more than a decade to develop a safe and effective formulation that was finally approved in Britain in 1986. Approval in the US followed three years later and today propofol is used in more than 90 countries. The speed at which people recover from the drug has had a profound impact on lives, allowing some patients to go home on the same day they have surgery.

“I think it’s a drug hunter’s hunger that keeps you going,” Glen told the Lasker Foundation. “If you see an outcome that is achievable you find ways around and over the barriers.”

Propofol has, however, figured in some controversies. It was cited in the 2009 overdose death of Michael Jackson and in 2012 was approved for use in the execution of prisoners in the US.

(Source: The Guardian)

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