Three scientists have shared this year’s Nobel prize in physiology or medicine for discovering how the body responds to changes in oxygen levels, one of the most essential processes for life.
William Kaelin Jr at the Dana-Farber Cancer Institute and Harvard University in Massachusetts, Sir Peter Ratcliffe at Oxford University and the Francis Crick Institute in London, and Gregg Semenza at Johns Hopkins University in Baltimore, Maryland, worked out how cells sense falling oxygen levels and respond by making new blood cells and vessels.
The research that revealed the fundamental physiological process that enables animals to thrive in some of the highest-altitude regions on Earth has also given researchers new routes to treatments for anaemia, cancer, heart disease and other conditions.
The three laureates will share the 9m Swedish kronor (£740,000) prize equally, according to the Karolinska Institute in Stockholm. The trio had in 2016 won the prestigious Lasker prize for the work that spanned more than two decades. In this programme, the researchers teased apart different aspects of how cells in the body first sense and then respond to low oxygen levels. The crucial gas is used by tiny structures called mitochondria found in nearly all animal cells to convert food into useful energy.
The scientists showed that when oxygen is in short supply, a protein complex that currently known as hypoxia-inducible factor, or HIF, builds up in nearly all the cells in the body. The rise in HIF has a number of effects but most notably ramps up the activity of a gene used to produce erythropoietin (EPO), a hormone that in turn boosts the creation of oxygen-carrying red blood cells.
The work has led to the development of a number of drugs such as roxadustat and daprodustat, which treat anaemia by fooling the body into thinking it is at high altitude, making it churn out more red blood cells. Roxadustat is on the market in China and is being assessed by European regulators.
Similar drugs aim to help heart disease and lung cancer patients who struggle to get enough oxygen into their bloodstream. More experimental drugs based on the finding seek to prevent other cancers growing by blocking their ability to make new blood vessels.