Covid Plasma therapy controversy and the first Nobel prize in medicine!

The latest controversy in COVID 19 regarding the usefulness of plasma therapy after ICMR – WHO disowned it and the government of Delhi insisted on its use, has brought the issue back into focus.

It is a little known fact that the knowledge that antibodies present in the plasma of an infected patient can be used as a useful drug to combat and cure the disease, had brought the very first Nobel Prize in Physiology or Medicine in the year 1901.

This Nobel Prize went to Emil Von Behring who is regarded as the founder of Plasma Therapy.

Behring belonged to an era when modern scientific understanding of microbiology and immunology was nascent. He worked with all-time greats such as Louis Pasteur, Robert Koch, P. Ehrlich, Loeffler; the who’s who amongst the founding fathers of modern medical science in late nineteenth century. They together produced several research papers in the diverse field of Bacterial immunology. Behring specially worked towards curing the curse of Diphtheria, Tetanus and also controlling the menace of Tuberculosis in the later part of his life. These problems together were responsible for milllions of helpless deaths in those days.

Behring was born on 15th March 1854 in Hansdorf (West Prussia), now Poland, in a large family of 13 siblings. His father was a school teacher who had difficulty in supporting his family with meagre income. After studying medicine with full scholarship in military medical school Behring joined the armed forces so that he could start supporting his family. He spent most part of his active life in Germany and France where later on he would get the

chance to work at the famous ‘Pasteur Institute ‘and subsequently at Marburg where he became professor of infectious diseases.

In the year 1898 – 99, he demonstrated that Diphtheria culture, when separated from bacilli completely, still contained pure toxins and that these toxins were lethal. Such toxins, when injected into animals (initially guinea pigs and later on horses) produced copious antitoxins. When plasma containing such antitoxins was transfused into diseased animals, and later on in human beings, it controlled and cured the certain fatal disease.

This instantly brought Behring huge fame and recognition and consequently the very inaugural Nobel Prize was awarded to him in the year 1901 by Nobel foundation.

Later on, with F. Wernicke, he established that lasting immunity to diphtheria could be produced for prophylaxis by injecting the toxin-anti-toxin  mixture producing antibodies which could neutralise the lethal bacterial toxins and antigens, eventually leading to final banishment of diphtheria from the scourges of mankind.

I don’t think the last word on the usefulness of plasma therapy has been pronounced as yet. The fact that monoclonal antibodies based on the same basic principle, made of specific clones against COVID antigens recently produced by REGENERON and used for American President Trump’s successful treatment vindicates its basic premise!

The Author is Currently Professor of medicine at Manipal Tata Medical College and Formerly Professor and Head, Department of Medicine at Rajendra Institute of Medical Sciences, Ranchi, Jharkhand.

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