
Emmanuel Mignot
Stanford University School of Medicine

Masashi Yanagisawa
University of Tsukuba
For identification of orexin, a brain peptide that maintains wakefulness, and the discovery that orexin deficiency causes uncontrolled sleep in narcolepsy—revealing a key insight into the nature of sleep
The 2026 Albert Lasker Basic Medical Research Award honors two physician scientists for the identification of orexin, a brain peptide that maintains wakefulness, and for discovering that orexin deficiency causes uncontrolled sleep in narcolepsy. Through an astounding experimental intersection, Emmanuel Mignot (Stanford University School of Medicine) and Masashi Yanagisawa (University of Tsukuba) revealed a key insight into the nature of sleep. Yanagisawa began with an intriguing cellular protein of unknown function. Through an ambitious biochemical approach, he unearthed peptides that animate it and demonstrated that the resulting signaling system keeps animals awake. Mignot started, in contrast, with clear physiology—the disease narcolepsy. Individuals with this neurological disorder succumb to bouts of sleepiness, and the most common form prompts sudden loss of muscle tone and even collapse. In a heroic feat of genetic sleuthing, Mignot tracked the source of inherited narcolepsy in dogs. His venture led to the same protein that Yanagisawa was studying. Their work has cracked open a molecular dissection of sleep regulation, reinforced the immune system’s involvement in human narcolepsy, and pointed toward new treatments for this illness and other sleep disturbances. In the United States, narcolepsy affects at least 1 in 2000 people. Experts believe that many cases are never diagnosed.
Rousing revelations
In the late 1990s, Gregor Sutcliffe (Scripps Research Institute, La Jolla) was looking for genes that operate in specific parts of the brain. In 1998, postdoctoral fellow Luis de Lecea showed that one of them—from a region called the hypothalamus—encodes a precursor of two peptides that resemble each other. A synthetic version of one of the peptides, which he named hypocretins, elicited an excitatory response in neurons grown in the lab. These observations suggested that the hypocretins are secreted neurotransmitters, made by a particular group of hypothalamic neurons.
The physiological role of the hypocretins would crystallize in the lab of Yanagisawa, then at the University of Texas Southwestern Medical Center. Simultaneously and independently, a different topic had captured him. A family of cell-surface proteins called G protein-coupled receptors (GPCRs) translate a vast array of environmental cues into appropriate responses by sparking intracellular signaling pathways. GPCRs had already proven themselves useful as targets for drugs that, collectively, treat myriad disorders.
Genomic studies had revealed many potential human GPCRs with unknown jobs. To explore the undeciphered biology that these so-called “orphan” receptors enable and expose new therapeutic possibilities, Yanagisawa sought molecules that stimulate them.
Toward that end, he undertook a search for peptides in the brain that would selectively goad particular GPCRs. He and postdoctoral fellow Takeshi Sakurai ground up rat brain and subjected the material to chromatography that sorted its components based on their chemical and physical properties. They applied the resulting portions individually to cultured human cells, each of which was engineered to produce a distinct orphan GPCR. Then they monitored for the calcium spikes that reflect receptor signaling.
Award Presentation: Jeffrey Friedman
Marcel Proust’s classic novel Swann’s Way begins with a meditation on the porous boundary between wakefulness and sleep. The narrator describes a midnight world where thoughts bleed into hallucinations, and the mind struggles to move cleanly between consciousness and sleep. For most of us, that blurring is occasional. For patients with a disease known as narcolepsy, it is ever-present: they fall asleep hundreds of times a day, begin dreaming almost as soon as they doze off, sometimes even while still awake, and can collapse, fully immobile, when they feel a sudden rush of emotion. It is a disorder that can make an ordinary day—driving, holding a job, even laughing at a joke—dangerous.
The cause of this often-devastating disorder was unknown until the discoveries of this year’s Lasker Award winners for Basic Medical Research: Emmanuel Mignot and Masashi Yanagisawa. Working independently, they found that orexin, a brain peptide, keeps us awake, and that its loss causes the uncontrolled sleep of narcolepsy—a finding that has reshaped our understanding of what controls when we sleep, when we wake, and when we dream.
Narcolepsy affects roughly one in two thousand people and was coined by Jean-Baptiste-Édouard Gélineau in 1880 from the Greek words for “stupor” and “attack.” Its full features stayed a mystery until the 1950s when scientists described the ordered phases of sleep, culminating in REM sleep, the vivid dreaming stage marked by rapid eye movements, and a brain that is fully active despite an immobile body.
William Dement, at Stanford, helped establish this architecture, and discovered that in narcolepsy, the boundaries between sleep and wakefulness collapse. After a presentation in San Francisco, a veterinarian told him of a dog that collapsed whenever excited—a condition known as cataplexy. Dement went looking for similar dogs and built a colony of narcoleptic dogs at Stanford. When one Doberman passed the condition to her puppies, it became clear that canine narcolepsy could be caused by a mutation in a single gene.
Acceptance remarks
Acceptance Remarks: Emmanuel Mignot
What an audience! Thank you for being here today. Never did I dream of being recognized by a group like this. It is beyond anything one dares to imagine. Dr. Goldstein, I owe you an apology. Everyone fears their LDL far more than their orexin levels. So I have used your and Mike Brown’s names, many times, to explain to my friends how incredible this award is.
Like many of you, I have always been fascinated by science. My reason is simple. It works. Nature calls upon us to explore the reality of our universe. What better calling is there? In philosophy, I was a fan of Spinoza. And of Pascal, who separated the geometrical mind from the intuitive, subtle mind. Nothing beats pulling knowledge out of the world around us. We are explorers.
So I have tried to live with wonder and curiosity. And with Camus, the sense that none of it should be taken too seriously. Early on, I chose a human disease: narcolepsy. The reasons were simple. A human tragedy. A clear phenotype. A tractable question. And a hunch that finding its cause could open the door to the nature of sleep itself.
I have let my discoveries guide my steps, more than any technique. That took me from pharmacology to genetics, even to zebrafish, and lately to immunology and deep learning of sleep signals. I even love the HLA complex, which terrifies most scientists! Through it all, understanding the disease stayed my compass. Even today, I wake up chasing the elusive T cell clones that kill orexin cells in narcolepsy.
With AI, we are living a transition as profound as the industrial revolution. That revolution automated production. It also brought wars of escalating scale and stunning atrocity. It was stopped, against all predictions, by the building of the atomic bomb. I am afraid this revolution may also prove massive, and possibly destructive. It will automate knowledge. Perhaps even scientific discovery, the very thing we celebrate today.
For me, though, AI is still just a new tool in the service of our goals. More science. More diseases understood. I have never had so much fun working with my students! But we must stay vigilant, so that our future, and the future of this award, does not become an assembly of AI agents. Let us continue international science together, with the goal of reducing human suffering through medical discovery. This was Albert and Mary Lasker’s intention.
Acceptance Remarks: Masashi Yanagisawa
For as long as I can remember, I wanted to be a scientist. When I was finishing high school, my father, who was an engineer-turned-surgeon, told me, “This is the age of biology; if you are interested in biology, go to medical school to do basic research.” It is because of those thoughtful words that I am who I am today.
After my MD degree, I obtained a PhD in pharmacology at Tsukuba, Japan. There I was lucky in my PhD dissertation study to discover endothelin—a potent vasoconstrictor peptide. Then I was again lucky enough to be recruited by Joe Goldstein and Mike Brown to UT Southwestern as an HHMI investigator—without even having done a postdoctoral fellowship.
One of my neighbor scientists on the HHMI floor was the late David Mangelsdorf. Davo Mango used to always bother me by boasting about his exciting research on orphan nuclear receptors—those “lock” molecules in the cell without a known “key” molecule. One day, I snapped back at Davo, saying, “There are only 40 genes in the human genome encoding nuclear receptors; but there are several hundred orphan GPCR genes”—the class of cell-surface receptors I was studying. “Mine is bigger than yours!” That exchange of jokes made me seriously think about “de-orphanizing” orphan GPCRs, which eventually led to our purification of Orexins, new brain peptides, together with Takeshi Sakurai, then a research fellow in the lab.
So, the project was a “fishing expedition” without setting specific goals.
We initially thought orexin regulated appetite—a tremendously important field in medicine—so we were very disappointed when we saw “no phenotype” in orexin-deficient mice generated by Rick Chemelli, a physician-scientist in our lab. Then I found an advertisement by SONY for their brand-new product NightShot —an inexpensive infrared camcorder. So, I asked Rick to start observing the mice during their active nighttime, when they roam around their cage and eat their food. That led to our completely unexpected, serendipitous discovery that orexin-deficient mice suffer from the sleep disorder narcolepsy.
Again, the key was an open-minded scrutiny of very boring mouse videos, without setting a specific hypothesis.
So, our orexin story was “entirely untargeted, open-ended discovery science. This type of science, which is currently under threat, has repeatedly led to enormously important avenues for treating patients”—as phrased by my collaborator, Clif Saper, for his JCI article on this Award. With this invaluable lesson, I would like to conclude. Thank you!
2026 Basic Award video



