Nobel Prize Winner Sir James W. Black (1924-2010)

Whether you know it or not, you have benefited greatly by the work of this man who passed away this week.

It is extraordinary to create a new drug that is the first of its kind; Sir James W. Black, MD did it not once but twice. If you have ever taken a beta-blocker (like atenolol, propranolol, or carvedilol) or an over-the-counter heartburn remedy (such as Zantac or Pepcid) you are indebted to Dr. Black. If you have never required either class of drugs, you still owe a great deal of gratitude to this scientist.

I have interviewed several Nobel Prize winners through the years, with the first being Dr. Black. What a place to start! His work helped take medicine to a new place that continues to produce life-saving drugs.


A Whole New World
Early drug development was based on chemical modification of natural substances. For example, early Greeks used willow bark as a fever fighter. Today we know it as aspirin. Another mainstay of medicine came from a beautiful country garden flower called foxglove; in 1775, an old woman’s home cure was first recognized as containing a powerful heart medication called digitalis.

Sir James W. Black, MD was one of the pioneers who introduced a more rational approach to drug development based on understanding basic biochemical and physiological processes. Instead of synthesizing drugs from naturally-occurring compounds, Dr. Black and others looked to purposefully build drug molecules that would directly interact with cells and cellular processes throughout the body.

Here’s just one example of how this works. Epinephrine and norepinephrine have opposing effects in the body. In 1948, American scientist Dr. Raymond Ahlqvist suggested these opposing effects were mediated by different receptors in the target organs. He called these different receptors alpha- and beta-receptors, suggesting that substances could selectively stimulate these receptors (agonists) or inhibit these receptors (antagonists). It was this theory that inspired Dr. Black and his colleagues.


A Nobel Life
Like many Nobel Laureates, Dr. Black’s personal story was colorful. In describing his education, this Scottish doctor admitted he “coasted, daydreaming, through most of my school years.” At 15, a math teacher “more or less man-handled me into sitting the competitive entrance examination for St Andrews University.” The fourth of five children from a staunch Baptist family, there was no money to send another kid to university, but that did not matter when his test scores led him to a full scholarship.

After earning his doctorate, he decided against a career as a medical practitioner due to what he perceived as the insensitive treatment of patients at the time. (To understand just how uninspiring medicine was back then, read my posting on the $14 Billion Heart Attack here: http://bit.ly/5PEh2j.) Instead, he joined the University of Glasgow in their veterinary school, eventually establishing the school’s physiology department.

He developed an interest in the way adrenaline affects the human heart, particularly those suffering from the often crippling chest pain known as angina. He had a theory to annul the effects of adrenaline, so he joined ICI Pharmaceuticals in 1958, where he created the first beta-blocker, propranolol. The discovery of this drug was hailed as the greatest breakthrough in the treatment of heart disease since the discovery of digitalis two centuries earlier.

He saw that the general idea might be applied to treat stomach ulcers, but his employers weren’t interested. So, Dr. Black left ICI in 1964 and joined Smith, Kline and French. (After numerous acquisitions and mergers, the company is known today as GlaxoSmithKline.) There, in 1975, he developed cimetidine (sold as Tagamet) which became the best-selling drug in the world. The drug that Tagamet knocked out of the #1 slot for worldwide sales: propranolol.

Based on this pivotal research, Dr. Black shared the 1988 Nobel Prize in Physiology or Medicine with Gertrude B. Elion and George H. Hitchings for their discoveries of “important principles in drug treatment.”

Of all the things Dr. Black and I discussed 10 years ago, this stands out:

He met his wife, Hilary, when they were both students at St. Andrews University. Upon graduation, Dr. Black stayed there as a teacher while his wife completed her degree in biochemistry. Dr. Black called his wife “the best student I ever had.” Her eclectic pursuit of knowledge led her to study law and later poetry.

Calling her "the mainspring of my life" until she died in 1986, he said, “Intellectually, she was the most exciting person I have ever known.”

Dr. Black, many could say the same about you.