Curing or preventing a disease has to do, in most cases, with the thousands of hours of research behind a drug or technology; in others, with the clinical eye of the doctor; and more often than we think, with chance. Pharmacies sell many drugs created for one ailment that have been found to be effective on other unsuspected ones.
These surprises arise when observing the side effects in patients, or when someone receives a treatment for a disease that ends up healing from a different one. This is what happened with amantadine, an antiviral from the 1950s and 1960s. Joan Ramón Laporte, director of the Catalan Institute of Pharmacology and WHO advisor, indicates that “it was ineffective against the flu, but Parkinson’s patients who took it suffered less. tremors, and was investigated as an antiparkinsonian ”.
The two most common active ingredients to treat alopecia, finasteride and minoxidil – the first is taken in pills and the second is made of lotions – began to be used in benign prostatic hyperplasia and arterial hypertension, respectively. Many of the patients who tried them referred to an unexpected effect: it made their hair grow. It was just a fluff, but enough to pull the thread and do the tests that have led to current use.
Something similar happened with the first pill to treat premature ejaculation : Priligy. “Its development was accidental, after some patients taking antidepressants from the same family as dapoxetine, its active principle, found that the treatment delayed ejaculation,” recalls Miren Larrazábal, president of the Spanish Society of Sexology.
This remedy, promoted in 2009 as “the viagra against premature ejaculation” has been less useful than expected, but other drugs and techniques whose medical application has been discovered on the rebound have represented a milestone for medicine. This is the case of X-rays. On November 8, 1895, the German doctor Wilhelm Röntgen discovered, working with a cathode ray tube, that when it was connected, it emitted invisible rays that passed through materials such as wood or glass.
The discovery spread rapidly and aroused passions. Some skeptics said that X-rays would destroy the human species and the most enthusiastic attributed to them the ability to restore sight to the blind. Some dreamed of using them to “get diagrams directly into students’ brains,” he says in his book Pickover. The benefits of X-rays have been unquestionable, but they had their dark side. In 1926, the American biologist Hermann Muller showed that overexposure to this electromagnetic radiation can cause cell mutations.
Another scientific serendipity – though without any ill effects – was the discovery of an effective test to detect cervical cancer. For Santiago Domingo, head of Gynecological Oncology at Hospital La Fe in Valencia, “Pap smears are one of the cheapest medical tests that have saved the most women’s lives : it has allowed us to prevent and detect early stage cancer. cervix. Before spreading its use, the normal thing was to find already incurable tumors ”.
The doctor who gives the technique its name, Georgios Papanicolaou, developed it nearly a hundred years ago while researching the effect of alcohol on guinea pigs and their young. His task required the study of large numbers of eggs in the pre-ovulation phase, and at that time the only way to obtain them was by sacrificing many females. To avoid this, he decided to take advantage of the ovules of the periodic vaginal bleeding of the rodents. How? With a vaginal smear made with the help of a small speculum.
Looking at the samples under a microscope, he was fascinated by the variety of cell shapes that appeared, so he decided to test in humans. His wife, María, was the first in history to undergo a Pap smear. In 1924, Papanicolaou performed a cytology on a patient who had developed uterine cancer and found neoplastic cells that he had not seen in previous tests. He had discovered, without looking for it, a screening technique of enormous use in gynecology.
A century before this advance, in the 1820s, it had been defined how to perform with certain guarantees, although mortality was very high, cesarean section. The first time this surgery was performed successfully for the mother and baby was around 1500 ; Knowing the details of the case, modern gynecologists agree that the matter ended well in a fluke.
His executor was a Swiss pig farmer named Jacob Nufer. Desperate because his wife had been in labor for days, he got permission from the authorities for a reckless act. One of the knives he used in his trade was used to open his wife’s abdomen and remove the baby. Both survived, and the couple had five more children. According to specialists, everything went well because it happened that the pregnancy was ectopic; that is to say, that the creature had developed outside the womb . If it had been a normal pregnancy, the mother would have bled to death.
This success is an exception; the drugs and techniques whose effects have been found to rebound come mostly from researchers “who were caught by luck at work, often after a lifetime of effort. We are talking about people with an unusual scientific capacity ”, says Francisco Zaragozá, professor of Pharmacology at the University of Alcalá de Henares.
The English veterinarian Frank Schofield credited these qualities when he determined in 1921 the cause of the serious hemorrhages that killed numerous cows and sheep in Canada, where he worked. After ruling out an infectious agent, he observed which plants the cattle ate and concluded that the responsible of the deaths was sweet clover, a herbaceous species introduced by farmers in the diet of their animals to replace corn, affected by a plague.
Experimenting with calves, Schofield found that calves fed silos-fermented sweet clover suffered uncontrollable bleeding when castrated, which was not the case with those fed other vegetables. When analyzing the blood of the specimens, he noticed that the dead calves took longer than normal to clot , due to some substance that prevented it.
It was identified in 1939 by the researcher Harold Campbell, from the University of Wisconsin, who isolated it and called it dicoumarol. The finding was too important to be restricted to veterinary use; In 1941, the Mayo Clinic Proceedings magazine published the first reference to the use of the anticoagulant in humans. Today 3% of the population is treated with similar drugs.
Professor Zaragozá cites Alexander Fleming as the greatest example of a life devoted to research. In 1928, the Scottish scientist discovered penicillin while studying the flu virus. When he was going to dispose of the Petri dishes in which he had grown the Staphylococcus aureus bacteria, he saw that mold had settled on them and that the bacteria had stopped growing around it . He deduced that the mold secreted some substance that inhibited this growth. He carried out a culture of the pure mold and established that it was of the genus Penicillium .
But his finding received little attention until on the eve of World War II, chemists Ernst Boris Chain and Walter Florey resumed research and developed the first clinical applications of penicillin: the era of antibiotics had begun, which ended ancient evils. such as tuberculosis or syphilis and served to treat those wounded in battle. When he won the 1945 Nobel Prize in Medicine together with Florey and Chain, Fleming downplayed himself: “My only merit was not ignoring that suggestive layer of mold. Sometimes you find what you are not looking for ”.
