张亭栋、王振义与白血病的药物治疗|赛先生
9月6日,2020年未来科学大奖揭晓,“生命科学奖” 颁发给哈尔滨医科大学第一附属医院教授张亭栋和上海交通大学瑞金医院教授王振义,以表彰“他们发现三氧化二砷和全反式维甲酸对急性早期幼粒细胞白血病的治疗作用”。
撰文 | 饶毅 黎润红 张大庆
摘要
在三氧化二砷(arsenic trioxide,ATO)被视为“对急性早幼粒白血病(APL)病人最为有效的单体”(Sanz et al., 2009; Tallman and Altman, 2009)的情况下,令人惊讶的是:最重要的发现者鲜为人知、其原始论文迄今未被一篇英文研究论文所引用。
该发现产生于文化大革命时期,当时大多数中国科学家和医生处于国家领导错误造成的困难时期。始于乡村中医针对性含糊的复方,张亭栋与同事于1970年代提出复方中单一的化学分子起作用、其最敏感对象为APL(张亭栋等,1973;张亭栋和荣福祥,1979)。张亭栋和同事二十多年的工作扫除了“能否”和“如何”有效使用ATO的困惑。此后中国和西方的其他研究者跟随张亭栋等的先驱工作。
张亭栋小组回顾性分析自己的资料证明APL确实为ATO最敏感的对象(张亭栋和李元善,1984;孙鸿德等,1991)。张亭栋所在医院另一研究组将原本微量的氯化亚汞从配方中完全去除证明ATO单独可以治疗APL(张鹏等,1996)。1998年西方研究者发表重复和证明中国发现的论文导致ATO疗法被广泛接受(Soignet et al., 1998)。不过, ATO相关英文论文的西方或中国作者皆未引用张亭栋等1970年代的文章。
本文集中介绍张亭栋等早期文献,但也提示进一步研究和验证中国报道ATO对其他肿瘤的作用,认为中国刊物发表的一些发现可能对病人有相当价值、其他国家的医生可能得益于有最大病人群落的中国医生之临床经验。
本文关键词:白血病;砒霜;三氧化二砷;张亭栋
ATO发现的文化环境和非典型历史
ATO治疗APL的原始发现: 1973至1979
张亭栋研究组1980至1990年代的进一步工作
中国对APL治疗的贡献
缺乏认可
注意中文发表的工作之意义
间接推断中药成分的严格科学研究还可能有更多发现。例如,一些医院自己试用的药物、和一些中药企业缺乏严格测试就猛力推进市场的药物。而可能在严格检验和研究后,会更为有效和有针对性,而更获得国际接受,最终帮助更多病人,挽救更多生命。
(上文为饶毅,黎润红,张大庆《化毒为药:三氧化二砷对急性早幼粒白血病治疗作用的发现》,2013年发表于《中国科学 生命科学》 43:700-707,英文发表于2013年《中国科学 生命科学》Science China Life Sciences 56:1-8。英文版原文见下。)
A drug from poison: how the therapeutic effect of arsenic trioxide (ATO) on acute promyelocytic leukemia (APL) was discovered
Yi Rao, Runhong Li and Daqing Zhang
01
Cultural Milieu and Historical Peculiarities of the Discovery
02
Original Discovery of the Effective Treatment of APL by ATO: 1973 to 1979
03
Further Studies by the Zhang Group from the 1980s to the 1990s
04
Chinese Contributions to APL Treatment
05
Lack of Recognition
ATO has now been well accepted (and generally used) nationally and internationally, saving lives in China and other countries. However, the discoverer remains largely unknown in academic and medical communities, although there was a 2001 story about him in the
New York Times (Rosenthal, 2001). It is more striking that, while the discovery of the effect of ATRA on APL has led to both national and international awards to Zhen-Yi Wang, not a single national or international award has been given to Tingdong Zhang or any of his Harbin colleagues for the discovery of the therapeutic effect of ATO on APL, although ATO was discovered more than a decade before ATRA and is recognized as “the most biologically active single drug in APL” by International Leukemia Experts for the European LeukemiaNet (Sanz
et al., 2009).
06
Implications of Paying Attention to Work Published in Chinese
致谢:作者之一(YR)感谢中医研究院李连达告知两篇文章(Guan 1958, and Chaoyang People’s Hospital, 1972),以及周霭祥和顾德馨的工作。
参考文献:
Notes:
Articles published in Chinese are listed in their original titles followed by a translation. Because several Chinese journals did not have regular volume numbers in the 1970s and 1980s, the year of publication and the issue within that year are listed. PDF files of the major Chinese papers can be accessed at the blog of YR: http://blog.sciencenet.cn/blog-2237-658474.html .
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文章来源:
饶毅,黎润红,张大庆(2013)化毒为药:三氧化二砷对急性早幼粒白血病治疗作用的发现. 中国科学 生命科学 43:700-707.
英文发表于2013年《中国科学 生命科学》英文版
Rao Y, Li RH, Zhang DQ (2013). A drug from poison: how the therapeutic effect of arsenic trioxide (ATO) on acute promyelocytic leukemia (APL) was discovered. Science China Life Sciences 56:1-8.
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