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The 2011 Nobel Prize in Physiology or Medicine
What if you awarded a Nobel Prize and one of the laureates had died? That is exactly what happened this morning. The Nobel committee announced this morning that Bruce A. Beutler, Jules A. Hoffmann and Ralph M. Steinman had been awarded the 2011 Nobel Prize in Physiology or Medicine for their pioneering work in understanding how the immune system functions. A few hours later, it was announced that Professor Steinman lost his battle with cancer last Friday. It is the practice of the Nobel Committee not to award prizes posthumously. Perhaps the most well-publicized instance of this practice occurred when Rosalind Franklin died before the Nobel Prize was awarded to Watson, Crick, and Wilkins for their elucidation of the double-helical structure of DNA. Her x-ray data of DNA were critical to the determination of the double helix. The committee decided after today's announcement to allow Steinman to retain the honor.

The events that have occurred are unique and, to the best of our knowledge, are unprecedented in the history of the Nobel Prize. In light of this, the Board of the Nobel Foundation has held a meeting this afternoon.
According to the statutes of the Nobel Foundation, work produced by a person since deceased shall not be given an award. However, the statutes specify that if a person has been awarded a prize and has died before receiving it, the prize may be presented.

An interpretation of the purpose of this rule leads to the conclusion that Ralph Steinman shall be awarded the 2011 Nobel Prize in Physiology or Medicine. The purpose of the above-mentioned rule is to make it clear that the Nobel Prize shall not deliberately be awarded posthumously. However, the decision to award the Nobel Prize to Ralph Steinman was made in good faith, based on the assumption that the Nobel Laureate was alive. This was true – though not at the time of the decision – only a day or so previously. The Nobel Foundation thus believes that what has occurred is more reminiscent of the example in the statutes concerning a person who has been named as a Nobel Laureate and has died before the actual Nobel Prize Award Ceremony.

The decision made by the Nobel Assembly at Karolinska Institutet thus remains unchanged.

Professors Beutler and Hoffmann were awarded their share of half the prize for their work in how innate immunity works. Innate immunity is the body's natural reaction to general challenges from microbes. This initial reaction is non-specific, i.e. the immune system reacts to the foreign invader regardless of whether this particular invader has been recognized previously. For this to work properly, there must be some general characteristics of pathogenic microbes that the immune system must recognize. This turns out to be the case and Beutler and Hoffmann identified receptors on cells that are responsible for recognizing these characteristics. These receptors are known as Toll-like receptors and are found in both vertebrates and invertebrates as well as plants suggesting that they are some of the most ancient components of the immune system. Recognition of a pathogenic invasion via the Toll-like receptors triggers an inflammatory response as the first defense in fighting the infection. It is for their discovery of the role of Toll-like receptors in this response that Beutler and Hoffmann were recognized with the Nobel Prize.

Professor Steinman was honored for his work in the second part of the immune response, adaptive immunity. Anyone who has received a vaccination is familiar with the concept of adaptive immunity. Your system is challenged by a modified pathogen which triggers a response that allows your body to fight off a recurring attack by that same pathogen. In the early 70s, Steinman discovered a new type of cell, the dendritic cell. Steinman proposed that these cells played a role in the activation of the immune response by activating T-cells. He later showed this to be the case and demonstrated that this activation could be triggered by signals from the initial innate immune reaction. It is this process that is key to the "self or enemy" paradigm and under normal conditions protects the immune system from turning on the body.

These studies have laid the ground work for fundamental applications in immunity related to vaccinations against dangerous infections as well as to the promising area of vaccines against cancer. In fact, Professor Steinman was being treated for a very deadly form of pancreatic cancer using some experimental treatments of his own devising. Whether this treatment was effective is probably up for debate but he lived 4 years post-diagnosis with a cancer with a 4% survival rate at 5 years.

Congratulations to Professors Beutler, Hoffmann and Steinman and a special kudos to the Nobel Committee for allowing the continued awarding of the prize to Professor Steinman.

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Wow. That's a very poignant bit of timing. I'm very sorry that *$%#ing cancer took him.

It was definitely a conundrum for the committee. I suspect the prize money will be used to start an endowment to continue his research at the university.

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