For advancing the concept of alpha and beta adrenergic receptors, which opened the door to the development of propranolol.
Dr. Ahlquist conceived the theory that there must be two types of receiving mechanisms, or sites, in the cardiovascular system—one type prevailing in the heart, and the other in the blood vessels. These receptors, which receive “messages” from the sympathetic nervous system, were classified and named by him, alpha and beta. Because they are receptors for adrenaline and adrenaline-like substances, they are known as “adrenergic” receptors.
Dr. Ahlquist further postulated that the predominant adrenergic receptors in the heart are of the beta type, and affect its contraction, its rate and its rhythm.
These theoretical concepts were later confirmed by Dr. Ahlquist and other investigators. The drug, propranolol, based on Dr. Ahlquist’s original hypotheses, was later developed by Dr. J.W. Black, and is now widely used here and abroad for the treatment of severe high blood pressure, cardiac arrhythmias, and the agonizing pain of angina pectoris.
Propranolol works by blocking the beta-adrenergic receptors, thus preventing noradrenaline from reaching them. As a result of this blocking process, the heart is not compelled to work as hard nor as fast as it would have, had the noradrenaline reached its receptors, and thus the symptoms of angina pectoris are alleviated. Blocking the beta receptors also brings cardiac arrhythmias and severe high blood pressure under control, although the means by which this functions in the latter condition are not yet clearly established.
For the incisive scientific reasoning which led Dr. Ahlquist to formulate the dual adrenergic receptor theory, which made possible the later development of clinically useful drugs, especially propranolol, this 1976 Albert Lasker Clinical Medical Research Award is given.
For the development of propranolol as a major treatment of heart disease.
Dr. Black, whose research in beta blockers began in 1958, acknowledges that this work would not have started, but for the existence of the Ahlquist concept of the adrenergic receptor mechanisms—a theory which had been ignored by others for a decade.
Although science had envisioned the possibility of a pharmaceutical beta blocker, no practical application of this concept was achieved until Dr. Black, in 1962, validated this theory by the creation of such an agent, which led, in 1964, to his invention of propranolol.
His design of a drug able to attach itself to the specific beta-adrenergic receptors in the heart, and thus block potentially harmful nonadrenaline in various heart diseases and in severe high blood pressure, now makes it possible to prevent the symptoms and agonizing pain of angina pectoris; reduce excessively rapid heart rates; regulate or normalize life-threatening arrhythmias; reduce the cardiac work load; and lower severe high blood pressure—all with consequent saving of thousands of lives.
Since disorders and diseases of the cardiovascular system are the number one cause of death in the United States today, Dr. Black’s creation of propranolol represents a milestone advance toward the treatment and conquest of these diseases and of severe high blood pressure.
For this tremendous achievement, by which clinical medicine has gained another therapeutic milestone, this 1976 Albert Lasker Medical Research Award is given.