Addison’s disease is no walk in the park. The disorder occurs when a person’s adrenal glands don’t make enough cortisol. This hormone plays a key role in multiple bodily functions, including metabolism and immune response. People with Addison’s disease can feel fatigued or nauseous, suffer from chronic pain, and lose unhealthy amounts of weight. If untreated, the condition can be fatal.
However, since 1930, Addison’s disease has been easily treatable. Moreover, the breakthrough behind that treatment led to the creation of two of the most commonly prescribed medicines we have today. And it all started here at Cold Spring Harbor Laboratory (CSHL).
In 1929, Wilbur W. Swingle and Joseph J. Pfiffner were working between CSHL and Princeton University when they isolated adrenocorticotropic hormone (ACTH) from the adrenal glands of slaughtered cows. At the time, ACTH was described as a “cortical hormone.” As it would turn out, ACTH is actually another kind of hormone that stimulates the adrenal gland to produce cortical hormones.
Swingle and Pfiffner first tested their adrenal extract in animal models. “The interesting point is that all healthy double operated animals survive and remain in normal condition when treated with the extract,” they wrote in a March 21, 1930, article for Science.
Following this success, they made enough of their extract for clinical trials at the Mayo Clinic. But at least one patient couldn’t wait for a trial. In 1930, a farmer with Addison’s disease was brought to the Mayo Clinic at the point of collapse. His outlook was dire until a telegram was dispatched to Swingle and Pfiffner asking for an emergency dosage of ACTH via airmail. It worked. Within a few days, the farmer recovered.
Picking up where Swingle and Pfiffner left off, Edward Kendall, another Princeton scientist, isolated the actual cortical hormones. You’ve probably already heard of cortisol and cortisone.
Cortisol treatment has helped countless people with Addison’s disease manage their symptoms, including President John F. Kennedy. Additionally, cortisol and cortisone have become some of the most common medicines available. They’re delivered via pills, creams, and injections. They’re regularly used to treat asthma, allergies, eczema, and arthritis. And they are routine in cancer care, either as part of treatment—as in some leukemias, lymphomas, and multiple myelomas—or to help manage side effects of radiation and chemotherapy, such as nausea and vomiting.
While the name of the farmer who was treated with that airmailed emergency ACTH has been lost to history, he inadvertently played a key role in the creation of medicines that many of us take for granted. His life was saved. And his story appeared in a November 7, 1930, Science article, just eight months after Swingle and Pfiffner published their results. The article, fittingly titled “The Treatment of Patients with Addison’s Disease with the ‘Cortical Hormone’ of Swingle and Pfiffner,” showed the world the potential of these treatments. And it did so with flair.
“Within thirty-six hours a marked effect on appetite and strength was apparent,” the doctors Leonard G. Rowntree and Carl H. Greene wrote. “The patient, who had been so nauseated as to retain water with difficulty, now asked for wieners and sauer-kraut and in lieu of the latter ate a double order of beef-steak with relish.”
Written by: Jen A. Miller | publicaffairs@cshl.edu | 516-367-8455