David Julius and Ardem Patapoutian win Medicine Nobel Prize

David Julius and Ardem Patapoutian have been awarded this year's Nobel Prize in Physiology or Medicine.

The Nobel Committee's Thomas Perlmann said Julius and Patapoutian had "unlocked one of the secrets of nature," and that is how we sense and feel our way around in the world. Our sense of touch, how we sense depth, reach out for things, and also how we experience pain.

In a year when many may have expected the prize to go to at least one of the makers of a COVID-19 vaccine, Perlmann said this was deemed the most important discovery in Physiology or Medicine in 2021. He said he couldn't say more without "breaking confidentiality." 

This is basic research, which the committee says will have benefits for future drug development.  

As for the developments in coronavirus research over the past year and a half, the committee would only say that it worked on the basis of discoveries that had been nominated. 

They wouldn't say whether drug and vaccine discoveries against SARS-CoV-2 had been nominated.  

Red hot chili receptors 

We move about in the world as though it were second nature — and, indeed, it is.  

But until this novel research into proprioception, the Nobel Committee says we had yet to work out how temperature and mechanical stimuli get converted into electrical impulses in the human nervous system.  

That is how we sense and perceive temperature, and even pain, and why those senses and perceptions are different for many people.  

Some of us feel the cold more than others. Some of us can walk over burning coals, and others simply can't stand the heat.   

And it's the way that the nervous system interprets those electrical impulses that determines how we react and feel. 

Perhaps that's why David Julius landed on capsaicin as a basis for his research. 

Capsaicin is a chemical found in chili peppers. It's what makes chilis burn the nerve endings on our tongues or our eyes if we touch them after cutting up a chili. 

Julius used that chemical irritant and the burning sensation it creates "to identify a sensor in the nerve endings of the skin that responds to heat."  

His work led to the discovery of TRPV1, an ion channel that is activated by painful heat. Ion channels are proteins that allow ions, such as sodium, potassium, calcium, to pass through the cell membrane. They are vital for the nervous system, the contraction of the heart and skeletal muscle and other physiological functions. 

And this particular one allows us to understand pain just a little bit better.  

And novel receptors 

Ardem Patapoutian, meanwhile, used "pressure-sensitive cells to discover a novel class of sensors that respond to mechanical stimuli in the skin and internal organs," the committee writes. 

What did Patapoutian's team do? They switched 72 individual genes in a cell off and on, one by one, and poked that cell with a small pipette (a micropipette) to observe how the genes within the cell reacted.

They first found a gene that appeared to be responsible for pain, because when they "silenced" that gene, the cell was "rendered insensitive" when the researchers poked it.

Then they found a second, similar gene.

The two genes were named Piezo1 and Piezo2. "Further studies firmly established that Piezo1 and Piezo2 are ion channels that are directly activated" when pressure is exerted on cell membranes, writes the Nobel Committee.

Their work together 

It's now said that TRP and Piezo channels influence a range of physiological functions that depend on how we sense temperature or "mechanical stimuli" — that could be the prick of a vaccine needle — and how we adapt to those sensations. 

Placed together, the discoveries have been influential for our understanding about core body temperature, inflammatory pain, protective reflexes, respiration, blood pressure, and urination. 

"This knowledge," says the Nobel Committee, "is being used to develop treatments for a wide range of disease conditions, including chronic pain."     

Who are the winners? 

David Julius is a biochemist and professor of physiology at the University of California, San Francisco. In 2020, Julius was awarded the Kavli Prize in Neuroscience for this same body of research. It was cited as having created new approaches for the development of safe and targeted painkillers that may have lower addictive properties than opioids. 

Ardem Patapoutian, a professor of neuroscience at Scripps Research, an institute in California in the US, shared that 2020 Kavli Prize with Julius. It wasn't the first time: In 2019, they shared the Rosenstiel Award for Distinguished Work in Basic Medical Research. And now they share a Nobel Prize.  

Prize-heavy week

Medicine is always the first in a week of Nobel Prizes. Tuesday is traditionally the day for the Physics prize and Wednesday it's Chemistry. 

Later in the week, there will be Nobel Prizes for Literature and Peace, and then Economic Sciences.

Pomp and ceremony in December

In 2020, the Medicine prize was won by Harvey J. Alter, Michael Houghton und Charles M. Rice for the discovery of the Hepatitis C virus.

The Nobel Prize for Physiology or Medicine has been awarded 111 since the prize's first year in 1901. It's gone to 222 scientists, including two married couples, but only 12 women. 

This year's winners receive cash prize of 10 million Swedish Krona (about €980,000), a Nobel Medal and a range of other trinkets.

But they will have to wait until December 10, because tradition also has it that the prizes is handed out at a gala dinner in Stockholm.