Penicillin during World War II
Humans and bacteria have co-existed for thousands of years. Many people have fallen to bacterial infections secondary to penetrating wounds or from being in proximity to those who are sick. Since ancient times, people have used honey, wine or vinegar on wound dressings, and used heavy metals such as silver or copper for vases to hold water to prevent bacterial growth (Greener, 2012). Also, our bodies naturally develop defenses against the deadly effects of bacteria, but it never seems like it is enough. Faced with this threat, humans have recently developed counter measures to reduce susceptibility to bacterial infections such as better infection control methods, improved sanitation and by widening the range of antibiotics. During World War II, the accidental discovery of penicillin was instantly gratifying and had a profound impact by saving countless lives. But now, we are entering an era of super bugs resistant to antibiotics so it is our duty to protect the efficacy of these miracle drugs (Greener, 2012).
Since the beginning of mankind, humans have struggled with hunger, violence and disease. As evidence shows in Neolithic skeletons of humans found in a cave near a settlement in the Eastern Mediterranean. Scientists detected changes in the bone structure and were able to isolate the DNA of Mycobacterium tuberculosis found inside the bone marrow (Greener, 2012). Ancient people would think disease was a punishment from the Gods and had a spiritual approach to disease. Until people started to think disease maybe was caused by natural causes. However, early medicine was limited and was rarely effective. A trip to the doctor could most times be worse than the actual disease.
An example of this, brings us back to the Civil War times, when the battle field doctors would clean their surgical instruments on the side of their boot after going horseback riding and walking on manure. Their blades were infected with thousands of different species of bacteria, some carrying virulence genes. An amputated toe, could easily become infected and poison the blood. Then the amputated toe, would become an amputated leg. Until there was nothing else to amputate and the patient would eventually die. Keep in mind, this was happening before the use of morphine or anesthesia. Nowadays, improved methods of sterilization of surgical equipment and improved sanitation has helped reduce illnesses. But to put things into perspective, our current arsenal of medicinal practices is limited against the enemy of fast changing, ever evolving bacteria.
The evolution of bacteria occurs much faster compared to human evolution. Bacteria reproduces at an extraordinary rate, during this process, point errors in DNA and lateral gene transfers by plasmids may lead to beneficial mutations that create antibiotic resistant bacteria. Like words in a sentence, the DNA sequence of a gene determines the amino acid sequence for the protein it encodes. In the protein-coding region of a gene, the DNA sequence is interpreted in groups of three nucleotide bases, called codons. Each codon specifies a single amino acid in a protein(APA format: Genetic Science Learning Center. (2016, March 1) How do Cells Read Genes?. Retrieved March 08, 2018, from http://learn.genetics.utah.edu/content/basics/dnacodes/). Bacteria may employ alternative metabolic pathways to bypass the disruption caused by an antibiotic. They do this by secreting enzymes that destroy antibiotics or altering cell wall composition (Greener, 2012). Those bacteria that survive, get to reproduce, a good example of natural selection. Our bodies also go through natural selection, but not even close to the rate of bacteria.
Today we take antibiotics for granted. If we get chills or a fever, we immediately go to the doctor who prescribes a few hard to swallow pills. If we do not feel better after a few days, we get irritated and frustrated. But the people that lived through World War II, lived in different world. A world where even a minor injury, such as a splinter, could easily get infected and poison the blood leading to possible death. In those days, the treatment of choice for infected wounds, was to drain them. No antibiotics. In Asia, moldy soy beans were being used for curing some skin infections. In other parts of the world, arsenic was also used for infections, but were disastrous for body cells. Then sulfa drugs were introduced by the Germans, who at that time were the leaders in pharmaceuticals. But most drugs on the market were highly toxic and in most cases prohibited the full recovery of a sick individual or killed them.
After penicillin, once deadly diseases such as syphilis, meningitis and pneumonia were now treatable. Penicillin is an antibiotic that destroys the cells walls of infectious bacteria. Bacteria constantly destroy and rebuild their peptidoglycan cell walls as they grow and divide. The B-lactam ring inhibits the formation of peptidoglycan cross links by binding to the transpeptidase enzyme. The transpeptidase enzyme cannot catalyze the formation of the cell wall cross links. Penicillin weakens bacterial cell walls and eventually burst due to osmotic pressure- cytolysis.
The miracle of penicillin was a complete accident. Sir Alexander Flemming after coming back to his laboratory from vacation, noticed Penicillium notatum growing on a petri dish with a culture of bacteria. A halo was formed around the mold where the bacteria was killed off. Sir Flemming decided to make an experiment with penicillium extract. He proceeded to inject six laboratory mice with virulent staphylococcus aureus and injected only three with penicillium extract. The following morning, the three mice injected with penicillium extract, survived. Sir Flemming was unsuccessful in purifying penicillium for human use, so for years his mold sat on a shelf untouched. The real work began with Sir Howard Florey, an Australian pharmacologist, and Ernst Chain, a German Jewish refugee at Oxford University. In 1940, they published their results of experiments done on mice, showing penicilium was non-toxic and was effective against a variety of pathogenic bacteria. At the time of their publishing, war was raging in Europe and over the skies of Britain. To protect their findings, they rubbed Penicillium notatum spores on their jackets in case they had to evacuate and start all over in America. Again in 1941, they published more evidence of the healing powers of penicillin including detailed manufacturing instructions (Connif, 2013).
Their operation was at a small scale so they decided to travel to the United States in search of help. Researchers there recognized the importance of such endeavor, to save lives. Through good luck, Sir Florey and Mr. Chain met Mr. Percy Wells, a U.S Department of Agriculture administrator with interest in mass commercial fermentation of mold. Wells, suggested using corn steep liquor, a waste product of turning corn into cornstarch. The operation was a success with the joint effort of Canada, Britain and the United States. The centralized production of penicillin, reduced duplicate efforts, many Allied businesses and governments were pouring in millions of dollars and working around the clock to get penicillin ready before D-Day. Germany caught news of this endeavor but was fighting at too many fronts to give the attention penicillin deserved. On D-Day, Allied troops went into Normandy with penicillin saving thousands of lives.