Source: www.nature.com
Author: Alison Abbott

This year’s Nobel Prize in Physiology or Medicine honors three Europeans who discovered viruses that cause deadly diseases, and whose findings have led to major medical advances.

Harald zur Hausen, former director of the German Cancer Research Center (DKFZ) in Heidelberg, Germany, was honoured for his work on the human papilloma virus (HPV), which causes cervical cancer. A protective vaccine for this virus has now been developed and is in widespread use. Françoise Barré-Sinoussi and Luc Montagnier share the other half of the prize for their discovery of the human immunodeficiency virus (HIV-1), which causes AIDS.

Zur Hausen was the only one of the three who was at home when the famous call from Stockholm came. Montagnier, now director of the World Foundation for AIDS Research and Prevention, was working in the Côte d’Ivoire. Barré-Sinoussi, who is at the Pasteur Institute in Paris, was in Cambodia. The Nobel committee had been unable to contact either before the time of the announcement.
Search for the AIDS virus

Barré-Sinoussi — who, accompanied only by her mobile phone, found herself overwhelmed by the event — becomes the 36th woman to win a Nobel prize of any kind, compared with a list of 745 male laureates. She worked with Montagnier at the Pasteur Institute, from the beginning of the hunt for the virus causing AIDS in the early 1980s. The pair identified the virus, which they originally called LAV (lymphadenopathy associated virus), in 1983.

A bitter battle for credit soon began, with Robert Gallo of the US National Institutes of Health in Bethesda, Maryland, claiming to be the true discoverer. But in 1987, the heads of state of France and the United States brokered an agreement to share the benefits of the discovery, and the researchers had apparently buried the hatchet by 1990. Many believed that the Nobel prize could not be awarded for this field of research — despite its importance — while tempers were still high.

The Nobel committee has now made its position clear in an announcement that includes a list of who discovered what, and when. It says the discovery of Barré-Sinoussi and Montagnier “was accepted by the research community and resulted in an explosion of scientific breakthroughs”. It then refers to Gallo’s “detection of a novel … virus from a vast number of patients with AIDS or pre-AIDS in 1984 … [which] showed considerable similarities with LAV-1”.

The work of the French scientists has led to the development of diagnostic tools and blood screening agents that have helped to fight the spread of the disease, particularly in western countries. It has also allowed the development of drugs to fight the virus in different ways. Combinations of these drugs have dramatically increased life expectancy.
Elegant experiments

Zur Hausen is Germany’s 79th Nobel laureate in the sciences, and is widely considered a modest and gentle man who raised research standards at the DKFZ during his time there between 1983 and 2003.

In the early 1970s, the reigning hypothesis held that it was a herpes simplex virus that caused cervical cancer, a disease already believed to be largely sexually transmitted. But the young zur Hausen preferred to trust his own eyes — and he failed to find the herpes simplex virus in cervical cancer cells. He fixated instead on the papilloma virus, ignoring the scorn of many colleagues who believed the virus to be nothing more than a generator of skin warts.

“Virologists, and for sure all gynaecologists, thought his idea about the papilloma virus was very strange,” says virologist Herbert Pfister, a former colleague who is now at the University of Cologne. “But he carried through his theory in a determinedly logical way, not caring about the controversy he was raising.”

In a series of elegant experiments over the next decade — during which he moved between universities in Germany, settling in 1977 at the University of Freiburg — zur Hausen identified many different types of HPV, which he linked to different diseases. In 1983 he described HPV-16, which occurs in more than half of all human cervical cancers as well as other anogenital cancers. A year later came HPV-18, which accounts for a further 25% of cases.

“His work has directly influenced our daily lives — for years we have been able to identify women at high-risk of developing cervical cancer,” says Marion Kiechle-Bahat, head of the department of gynaecology at the Technical University of Munich, who studied under zur Hausen in Freiburg. “And now, as a direct result of his work, we have a vaccine to protect young girls, before they start to have sex.”

Roughly 500,000 women worldwide now receive the vaccine each year. The disease is fatal in around one-third of cases, and the vaccine is expected to significantly reduce these figures.