He Should Have Won the Nobel Prize!

In 1913, a Russ­ian pathol­o­gist named Niko­lai Anitschkow fig­ured out the cause of ath­er­o­scle­ro­sis, which is the under­ly­ing cause of near­ly all heart attacks and most strokes. He even pub­lished his find­ings in the major inter­na­tion­al med­ical jour­nals of his day. He should have won the Nobel Prize. If peo­ple had rec­og­nized the impor­tance of his work, mil­lions of pre­ma­ture deaths could have been avoid­ed.

By the late 19th cen­tu­ry, pathol­o­gists knew that peo­ple who had died of heart attacks and strokes tend­ed to have a lot of softy, fat­ty mate­r­i­al stuck to the inner walls of their arter­ies. This mate­r­i­al even­tu­al­ly hard­ens with the buildup of scar tis­sue and cal­ci­um deposits. The pres­ence of this mate­r­i­al is called ath­er­o­scle­ro­sis, which means hard­en­ing of the arter­ies. The mate­r­i­al itself is called plaque.

In its ear­ly stages, ath­er­o­scle­rot­ic plaque looks and feels like cheese­cake. In 1910, a Ger­man chemist named Adolf Win­daus showed that like real cheese­cake, ath­er­o­scle­rot­ic plaque is rich in cho­les­terol. Because of his work on the chem­istry of sterols, Win­daus won the Nobel Prize in chem­istry in 1928.

As soon as Win­daus pub­lished his find­ings about the cho­les­terol in plaque, Niko­lai Anitschkow start­ed an impor­tant series of exper­i­ments at the Mil­i­tary Med­ical Acad­e­my in St. Peters­burg. Anitschkow dis­solved some puri­fied cho­les­terol in sun­flower oil and fed it to some rab­bits. Con­trol rab­bits got some sun­flower oil with­out added cho­les­terol. The rab­bits that got cho­les­terol in their sun­flower oil got ath­er­o­scle­rot­ic plaque, but the con­trol rab­bits did not. To the naked eye and under a micro­scope, the plaque from rab­bit arter­ies looked a lot like the plaque from human arter­ies.

Anitschkow and his cowork­ers dis­cov­ered a lot of impor­tant things about ath­er­o­scle­ro­sis in those ear­ly exper­i­ments. As cho­les­terol researcher Jon Gof­man argued,

If the full sig­nif­i­cance of his find­ings had been appre­ci­at­ed at the time, we might have saved more than 30 years in the long strug­gle to set­tle the ‘cho­les­terol con­tro­ver­sy’ and Anitschkow might have won a Nobel Prize. Instead, his find­ings were large­ly reject­ed or at least not fol­lowed up. Seri­ous research on the role of cho­les­terol in human ath­er­o­scle­ro­sis did not real­ly get under­way until the 1940s.

Why were Anitschkow’s find­ings ignored? Because they couldn’t be repeat­ed in dogs. As a result, many sci­en­tists assumed that the find­ings wouldn’t apply to human beings, either. That’s an idi­ot­ic assump­tion, because ath­er­o­scle­ro­sis is rare in dogs, which are nat­ur­al car­ni­vores. Anitschkow guessed cor­rect­ly that dogs and oth­er car­ni­vores are good at excret­ing excess cho­les­terol. Human beings and rab­bits are not. Trag­i­cal­ly, no one lis­tened, prob­a­bly because they’d rather eat meat than rab­bit food.