Making British Cortisone: Glaxo and the development of Corticosteroids in Britain in the 1950s–1960s

Quirke, Viviane

doi:10.1016/j.shpsc.2005.09.001

Cited by 18 publications

(6 citation statements)

References 20 publications

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“…This reliance on external supply meant shortages and high prices, with its use in clinical practice very restricted. Distribution was managed centrally through the NHS and Medical Research Council (MRC) (Cantor 1993; Quirke 2005). By the mid-1950s, when the drug became more widely available, clinical trials, that had also been run by the MRC, showed that its benefits were limited and side effect common.…”

mentioning

confidence: 99%

Special issue—before translational medicine: laboratory clinic relations lost in translation? Cortisone and the treatment of rheumatoid arthritis in Britain, 1950–1960

Worboys

Toon

2019

HPLS

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Cortisone, initially known as ‘compound E’ was the medical sensation of the late 1940s and early 1950s. As early as April 1949, only a week after Philip Hench and colleagues first described the potential of ‘compound E’ at a Mayo Clinic seminar, the New York Times reported the drug’s promise as a ‘modern miracle’ in the treatment of rheumatoid arthritis (RA). Given its high profile, it is unsurprising that historians of medicine have been attracted to study the innovation of cortisone. It arrived at the end of a decade of ‘therapeutic revolutions’, kicked off by penicillin transforming the treatment of bacterial infections and ending with hopes of a revolution in the treatment of non-infectious, chronic inflammatory diseases. Despite these studies of cortisone’s introduction, few historians have taken the story forward and considered how cortisone was adopted and adapted into clinical practice. This article tells the longer of how the drug and its derivatives were taken from research laboratories and integrated into clinical practice; what has in recent decades become known as translational medicine (TM). In exploring cortisone’s first decade in Britain, we focus specifically on its role in the treatment of RA. Our approach is always to consider cortisone’s use in the context of other treatments available to clinicians, and at local and national institutional settings. We do not discuss the many other therapeutic uses of cortisone, which ranged for topical applications for skin diseases to the management of cancers, especially childhood leukaemia, nor do we discuss its close analogue ACTH—AdenoCorticoTropic Hormone. We think there are lessons in our study for TM policies today.

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confidence: 99%

Special issue—before translational medicine: laboratory clinic relations lost in translation? Cortisone and the treatment of rheumatoid arthritis in Britain, 1950–1960

Worboys

Toon

2019

HPLS

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“…80 Corticosteroids had been discovered in 1949 to be effective in the treatment of rheumatoid arthritis but the dollar shortage had forced Britain to find a way to manufacture its own cortisone rather than rely upon imports from the US. 81 When it came to the research prosecuted in British universities, a relationship with industrial development was more assumed than overseen. The CPRC's Director of Research, Simonsen, made direct contact with Cadbury's, ICI, Unilever, Trinidad Leaseholds, Glaxo and Boots during the 1940s in order to publicise the results of the council's work.…”

Section: Andmentioning

confidence: 99%

Scientific research and colonial development after 1940

Clarke¹

2018

Science at the End of Empire

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In 1941 the Colonial Office made a commitment to fund scientific research into the chemistry of sugar. If sugar cane could be used to make plastics, building materials, drugs and other synthetic products, then it was hoped the British West Indies would find themselves in the fortunate position of being producers of a lucrative raw material for the chemical industry rather than a low-value foodstuff. This was a vision that endowed laboratory research with the power to transform the economic and social life of the British West Indies. But how exactly was knowledge expected to move from the laboratory and spur development? This chapter will examine the relationship between scientific investigation and colonial development that was embodied in the new arrangements for colonial research that were created in fields such as sugar chemistry during the first half of the 1940s. The late colonial period saw an unprecedented expansion in scientific research across the Colonial Empire and in British universities, funded through the Research Fund of the 1940 CDW Act and its successors. The new research fund formed part of the Colonial Office response to the crisis that affected the Colonial Empire in the late 1930s, of which riots in the Caribbean were only a part. Research became a priority at a point at which Britain needed a meaningful gesture to ward off domestic and international criticism of the management of its colonies. Scientific research was described as a practical tool that would provide the basic information that underpinned development and so would serve to guarantee the efficacy of Colonial Office interventions in the future. The Colonial Office engaged a group of high-powered scientific advisors drawn from Britain's research councils to oversee spending

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“…The impetus to develop synthetic methods for adrenocorticosteroids came from the US entry into WWII in 1941, initially fuelled by a rumour that Luftwaffe pilots were taking adrenal extracts to increase their resistance to oxygen deprivation at high altitudes. Although this rumour was unfounded, it is said to have kickstarted the all-out quest for a large-scale synthetic route to the active adrenal hormone, which at the time was given higher strategic priority than penicillin and anti-malarials (Quirke 2005). Of the six biologically active steroids that had been isolated from adrenal glands, Kendall's compound A (11-dehydrocorticosterone) was initially targeted for synthesis because it possessed the simplest structure (Kendall 1964).…”

Section: Kendall's Compoundsmentioning

confidence: 99%

Diamonds are forever: the cortisone legacy

Hillier

2007

Journal of Endocrinology

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The year 1946 was not only the year that the Society for Endocrinology was founded, but also the year that Edward Kendall's compound E (cortisone) was first synthesised by Louis Sarett. By 1948, sufficient quantities of compound E were available for the rheumatologist Philip Hench to test it successfully for the first time in a patient with rheumatoid arthritis. It was immediately hailed as a 'wonder drug' and was shown to be effective in a number of inflammation-associated conditions, most notably rheumatoid arthritis. The subsequent development of endocrinology as a discipline is inextricably linked to the chemistry, biology and medicine of anti-inflammatory glucocorticoids. Sixty years after the first chemical synthesis of cortisone, corticosteroids remain among the top ten most commonly used prescription and over the counter drugs. Basic and clinical studies of glucocorticoid biosynthesis, metabolism and action have trail-blazed developments in endocrinology ever since. This article surveys the extraordinary cortisone timeline, from first synthesis until now. The concluding scientific message is that intracrine metabolism of cortisone to cortisol via 11bhydroxysteroid dehydrogenase type 1 likely sustains local amplification of glucocorticoid action at sites of inflammation throughout the body. The broader message is that the discovery of compound E by Kendall (basic scientist), its large-scale synthesis by Sarett (industrial chemist) and its therapeutic application by Hench (rheumatologist) serves as a paradigm for modern translational medicine. It is concluded that endocrinology will remain a force in health and disease if it continues to evolve sans frontières at the basic/applied/clinical science interface. A challenge for the Society for Endocrinology is to ensure this happens.

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Making British Cortisone: Glaxo and the development of Corticosteroids in Britain in the 1950s–1960s

Cited by 18 publications

References 20 publications

Special issue—before translational medicine: laboratory clinic relations lost in translation? Cortisone and the treatment of rheumatoid arthritis in Britain, 1950–1960

Special issue—before translational medicine: laboratory clinic relations lost in translation? Cortisone and the treatment of rheumatoid arthritis in Britain, 1950–1960

Scientific research and colonial development after 1940

Diamonds are forever: the cortisone legacy

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