Discoveries on Temperature and Touch Win Nobel in Medicine

The 2021 Nobel Prize in Physiology or Medicine went to 2 scientists who answered essential questions about how humans feel heat or sense pain, which members of the Nobel Assembly said are key to basic survival and could be applied to find treatments for chronic pain.

David Julius, PhD, an American who is a professor at the University of California at San Francisco, and Ardem Patapoutian, PhD, an Armenian-American born in Beirut and now a professor at Scripps Research in La Jolla, California, share this year’s Nobel Prize, which was announced this morning shortly after the winners were contacted. They will each receive a gold medal and split a prize worth approximately $1.14 million, according to Forbes.

“This year's Nobel Prize has to do with our ability to feel temperature and touch, a sense which is called somatosensation,” said Professor Thomas Perlmann, secretary-general of the Nobel Assembly at Karolinska Institutet. “Imagine that you're walking barefoot across a field on a summer's morning. You can feel the warmth of the sun. The coolness of the morning or a caressing summer breeze, and the fine texture of blades of grass underneath your feet. These impressions of temperature, touch, and movement are feelings relying on some other sensation. So, motor sensation is what gives us the ability to feel our body surface and internal organs. It monitors temperature, pain, touch, and the location and movement of our body called proprioception.

“Such information continuously flows from the skin and other deep tissues and connects us with the external and the internal world,” Perlmann continued. “It is also essential for tasks that we perform effortlessly and without much thought.”

The winners of Monday’s Nobel Prize in Physiology or Medicine made a series of discoveries to reveal the cellular mechanics of how these sensations occur, according to the citation from the committee. Their work has implications in everything from pain management to regulation of blood pressure to bladder control.

Julius was cited for work published between 1997 and 2002, which used the compound capsaicin found in chili peppers to identify the sensor in nerve endings that responds to heat and causes pain. He found the gene involved and traced its role in the capsaicin receptor, which was named TRPV1.

Patapoutian’s key papers appeared from 2002 to 2015, as both he and Julius pursued questions raised by the discovery of TRPV1. If there was a sensor triggered by heat, there would one activated by cold as well—and they each used the chemical substance menthol to identify the receptor TRPM8.

Then Patapoutian continued work to understand how humans respond to mechanical stimuli. In painstaking steps, he and collaborators used a cell line that had shown sensitivity to touch and went through 72 possible genes until they discovered which ones were responsible for the cells’ response. After finding 2, the new channels were named Piezo1 and Piezo2, for the Greek word for pressure. The cellular processes identified in this work govern physiological processes that keep the body running, such as the sensations that regulate the bladder, control respiration, and help stabilize the walls of the blood vessels that maintain blood pressure.

Despite the far-reaching implications of the basic science highlighted in Monday’s award, there had been considerable speculation that the Nobel might go to a winner associated with the development of coronavirus vaccines. First on the list was Katalin Karikó, PhD, the Hungarian-born biochemist who worked in obscurity for decades at the University of Pennsylvania until her basic research on messenger RNA formed the foundation for both the Pfizer-BioNTech and Moderna vaccines.

But as longtime Nobel watchers know, and as Perlmann stated in response to a reporter, “That may be a relevant question, but it's not really how we work.”

Indeed, it took more than 20 years from the 1996 publication of work on the potential harnessing of anti–CTLA-4 responses, and 7 years after FDA approval of ipilimumab, for Jim Allison, PhD, to win a share of the 2018 Nobel for his work in immunotherapy. Last year’s Nobel in Chemistry to Jennifer Doudna, PhD, and Emmanuelle Charpentier, PhD, for their work in CRISPR Cas-9 genome editing technology was for a 2012 paper—breakneck speed by Nobel standards. Some note that Karikó could perhaps win this week’s Chemistry prize.

“We perform our work originating from nominations,” Perlmann said. “And always, when we get a nomination that is new to us, we do a very thorough investigation. But I mean, of course, big breakthroughs in medicine, they usually reach us. I'm not able to say more than that, in this particular case, anymore.”