Ireland has a long and distinguished record in medical research and innovation, despite the minuscule amounts of money made available here to enable research to be undertaken. The names of Irish surgeons and physicians are known around the world because of diseases or syndromes they were the first to describe, or surgical procedures they were the first to develop. Research remains a requirement here for doctors and other medical scientists seeking preferment in their careers, even if very little of that research ever makes headline news or dramatic improvement in patient care or treatment.
Yesterday's edition of the distinguished medical journal, The Lancet, carried a report of a significant new Irish research project which could well lead to the worldwide saving of the lives of patients who have had the misfortune to contract a mercifully uncommon form of bacterial infection known as fulminant meningococcal septicaemia. This hitherto rapidly fatal condition can occur as a complication of infections caused by Neisseria meningitidis, the cause of an estimated 19 per cent of cases of bacterial (as opposed to viral) meningitis, and it complicates only a small number of this minority of meningitis cases. But when it does occur, it can kill the patient with an alarming and most distressing rapidity.
It has been noted in recent years that a little understood naturally-occurring protein in the body - known as protein C - declines sharply in patients with fulminant meningococcal septicaemia, and the report in The Lancet covers 12 cases, including both children and adults, who were treated with protein C in addition to antibiotics, anticoagulants, intensive life-support and blood dialysis in an effort to overcome the effects of lethal bacterial toxins on the cells and organs of the body. The research was conducted in the National Children's Hospital, Harcourt Street, St James's Hospital, James's Street, and Our Lady's Hospital for Sick Children in Crumlin, Dublin. While three patients suffered significant subsequent disability, all survived when the expected death toll, without the use of protein C, was between 57 percent and 80 percent.
This is, by any standards, a remarkable result and the researchers, Dr Owen Smith of the National Children's Hospital and his colleagues in that and the other two hospitals involved, deserve great credit for their work. They are understandably pleased with their results, some of the immediate human effects of which can be found in the Weekend supplement today. They point out themselves, however, that a much wider research programme is now required in various clinical centres here and elsewhere to substantiate their findings and to ascertain with some degree of certainty exactly what the biochemical role of protein C might be in these cases.
This kind of multi-centre research programme will require more resources than are usually available for medical research projects in this country. But Dr Smith and his colleagues have already demonstrated that, in conjunction with the generally agreed treatment now provided intensively for these very serious cases, protein C seems to defeat death and save life. If their hypothesis is correct, the most basic principles of scientific research now require that their results can be confirmed by doctors working in other centres. The case for this further research is irresistible and the resources simply must be forthcoming if more lives are to be saved.