Behind the nobel prize: sulfa

Sulfonamide, also known as Prontosil was one of the miracle cures of the 19th century. Back then it was actually a non-bacterial synthetic drug that consisted of a sulfonamide-group that linked on a different molecule. If you happened to have read ‘The demon under the microscope’ by Thomas Hager you might recall that the discovery of this drug was definitely not a one-mans show. The discovery came from the hands of a trio: Gerard Domagk (physician and researcher), Joseph Klarer (chemist) and Friedrich Mietzsch (chemist). All three worked together for Farben industries, one of the biggest dye companies in the world, to synthethize a drug that could kill bacteria.

Both Klarer and Mietzsch were responsible for the production of different chemical molecules. Domagk would then take these structures and test them out on animals. They’d then take the results back and try to make the molecules more specific. They would add chemical groups or take groups away to increase the drug specificity. A technique that is still used today!

Eventually they found a molecule that somehow worked, it was named Prontosil rubor, because of the red color. Gerhard Domagk was responsible to test it out on the animals and he saw that it had great results, so he repeated the experiment on viral infections to see if it would work, however he came to the conclusion that only bacterial infections were susceptible to the drug. Even though the drug worked on the lab animals it took them a while to consider testing it on human beings. In fact, they only knew that it was effective in humans because Gerhard Domagk’s daughter had been infected with strep, she was going downhill very quickly and he saw no other option but to dose her with Prontosil and by doing so he proved it’s effectiveness in humans.
Two years after the discovery of Prontosil rubor, they published their results. Up until that moment Prontosil had only been available nationally, for own use. Something that was considered somewhat irresponsible as many women and neonatals were dying of the consequences of a puerpural infection. These bacterial infections could have been prevented with the use of this new drug.
Even though the drug had positive effects on patients, they still didn’t exactly know what it did in the body nor what effects and side effects were.

There are still a lot of old Prontosil ampoules sold online. A picture of an old package of Prontosil can be found above here.. It contained red ampoules with Prontosil in it.

That discovery belongs to French researchers who were able to identify that Prontosil became active in the body after it was cleaved in the nitrogen-nitrogen double bond. They also discovered that sulfanilamide was equally potent as Prontosil. The only difference was that sulfanilamide was available in most households, in fact it was cheap and easily available.
This ment that Prontosil which by that time had been patented had lost its value and that Farben Ig couldn’t benefit from their patent anymore.

Nevertheless Gerhard Domagk received the nobel prize for the discovery of Prontosil the first antibacterial drug. Because he won the prize during world war, and the germans thought that the nobel prize was heavily influenced by jews, he was unable to claim his prize at the time and received it years later. Klarer and Mietzsch never received a price for aiding in the discovery. Sulfanilamide is still available in a lot of different medications and is often given in one pill that also contains other drugs.

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Lots of love
-A doctor in spe

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