Peter Kolchinsky Profile picture
Managing Partner, RA Capital Management. We build & invest in biotech companies. Scientist. Author, The Great American Drug Deal. https://t.co/ARVLrrTQU4

Aug 30, 2020, 8 tweets

No viruses in this one but it’s still fun. In the spirit of the enemy of my enemy, there was once a time when MALARIA was a dangerous friend worth having in the fight against a deadlier pathogen: SYPHILIS. Like Godzilla vs Mothra, doctors would infect patients dying...

...from syphilis w/ malaria to cause them to spike a raging fever. Syphilis is a really nasty bacteria that for millennia was considered incurable, though patients could recover if their had a high enough fever... esp on Saturdays.

Malaria was hardly a walk in the park & one might not consider trading malaria for syphilis to be medically ethical, except that there was a drug, quinine, for malaria. So idea was to cure syphilis w/ malaria & cure malaria w/ quinine. Fun fact: quinine glows in black light:

Quinine comes from bark of a special tree that was known to help treat malaria for centuries; quinine itself was purified from the bark in early 1800. It took an Austrian psychiatrist in 1917 to connect the dots to come up w/ “malariotherapy” for syphilis.

Syphilis is an STD, so why a psychiatrist? B/c although infection shows up initially as lesion on genitals or cervix (sometimes also a rash elsewhere on body), it goes quiet for years, decades even, & then can reawaken in the brain (don’t look below). So called “neurosyphilis”...

...would sometimes have psychiatric symptoms, such as mania or dementia, making it logical that a psychiatrist would give thought to use it to induce fever to treat syphilis. Julius Wagner-Jauregg’s discovery of malariatherapy in 1917 won him Nobel Prize for it in 1927.

In 1943, penicillin was approved and was a way better cure, so we don’t need Godzilla anymore. That’s good because malariotherapy killed 15% of patients... kind of like Godzilla destroys at least 15% of any city it saves.

Of course, there are antibiotic-resistant strains of syphilis on the rise at a time when Congress is talking up price controls on biomedical innovation, making it even harder than before to justify investing in antibiotic companies. Oh well... at least we have malaria.

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