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Doctors who persisted continue to inspire

26 Feb 2023

How a chicken led to a head start against AIDS



By: Marc Sunday, DO, medical staff president

Greetings, colleagues!

Doctor’s Day will be celebrated March 27 to 31. Details to follow in the next edition of Common Ground.

But first, let’s briefly look back at some of medicine’s rock stars:

In 1911, Dr. Francis Peyton Rous was visited by a woman whose chicken had developed a mass, which he found to be a sarcoma. On a whim, he ground up the mass and injected it into healthy chickens, who all subsequently developed the same sarcoma. It was the first known incidence of a cancer that was transmissible, which didn’t make any sense at that time in medicine.

 

So Dr. Rous got to work and eventually concluded that the mass must have acted like a virus. His research was dismissed as purely a poultry phenomenon and he soon abandoned his research, but ultimately the tumor’s precursor came to be known as the Rous Sarcoma Virus.

 

Years later, in the 1950s, Dr. Howard Temin picked up Dr. Rous’ research and began looking for a mechanism that might allow the Rous Sarcoma Virus (which had been proven to be an RNA virus) to infect the host cells. What he observed was that the tumor cells, once they encountered a naive host’s cell, would alter the host cell’s appearance to look just like the tumor did. He found that the tumor was inserting its own DNA into the host’s DNA. At the time, this violated the Central Dogma published by Drs. Watson and Crick; it appeared the tumor was going backwards, from RNA to DNA. Dr. Temin called Dr. Crick and told them of his theory that the Central Dogma was wrong, and he was answered curtly that he was mistaken.

 

But Dr. Temin was undeterred. Ultimately, he and another researcher and friend, Dr. David Baltimore, discovered the enzyme that allowed the virus to violate the Central Dogma, allowing RNA to transcribe the DNA of the host and insert its own DNA into the host’s genetic code. In 1970, they published their findings on this enzyme, which they called Reverse Transcriptase, and named the virus it resided within a retrovirus. Five years later, they were awarded the Nobel Prize.

 

In 1979, Dr. Robert Gallo met Dr. Temin and after hearing about a man in Alabama who had leukemia of the T cells. Dr. Gallo isolated Reverse Transcriptase from the leukemic T cells and named it Human T-Cell Lymphotrophic Virus-1 (HTLV-1). But his article was rejected from publication from the Journal of Virology in 1980 — he was told a human retrovirus was a controversial myth.

 

That same year, a strange illness was killing thousands of young, healthy, homosexual men around the country. To Dr. Gallo, the illness seemed to act very much like the retrovirus he had seen with HTLV-1. Three years later, Dr. Gallo’s lab isolated the Human Immunodeficiency Virus and, only 10 years later, the first Protease Inhibitor was approved by the FDA. HIV was no longer a death sentence.

 

But if Dr. Rous hadn’t ground up tumor cells and injected them into healthy chickens, leading to the cascade of events that brought about the identification of the HIV virus, we wouldn’t have had the head start against AIDS that we did and we would have floundered about, facing an illness we had never before encountered in humans.

 

Because of the persistence of these doctors in the face of everything known at the time, approximately 600,000 lives were saved and continue to be saved.

 

The reason we share this bit of medical history leading up to the week of Doctor’s Day is to celebrate you, our physician colleagues, for all of your efforts in this chosen passion.

 

We thank you for having persistence, for caring about the humanity that enters our buildings, for having the clinical curiosity to investigate a diagnosis that eludes you. Because like Drs. Rous, Temin, Baltimore and Gallo, you have chosen to serve humanity in a noble venture that is never easy — it’s not easy to become a physician and it’s not easy to practice as one. But you persist, driven by your inner core values that all physicians share: To know and to heal.

 

So thank you all, for everything you have done and everything you will do. The patients you heal and those you aid in dying with comfort and dignity thank you. Our patients come to you, holding not chickens but themselves, saying, “Something’s not right.”

And you get to work.

 

With gratitude,

Dr. Marc Sunday, medical staff president