BOOK REVIEW

Interferon: The Science and Selling of a Miracle Drug Pieters T ISBN: 0-415-34246-5(hbk) Taylor & Francis, Basingstoke (London & New York: Routledge) 2005 63 € GBP clothbound, 264 pages Toine Pieters, Professor of the History of Pharmacy at the Groningen University and Senior Lecturer at the Amsterdam Medical School, has written a most interesting and profound book on the historical perspective of the development of interferons – antiviral drugs that have been in registered use in clinical medicine for almost 20 years and which still are being developed for the treatment of additional diseases.

From their discovery in 1957 by the English virologist Alick Isaacs and his Swiss collaborator Jean Lindenmann it took almost 30 years for their registration as medical drugs. The various biological roles played by these intriguing molecules are still under investigation and over a period of almost 50 years their function, possibilities, influence and general medical, theoretical and clinical impact have affected the medical community and also the general society to an extent which is very unusual to be the case for a biological family of molecules. Accordingly their development has been the subject of a whole series of previous books covering various phases of interferon development both medically and socially.

What is so exciting about this book is that it covers a large part of the whole history of interferons including also the non-medical aspects which played a not insignificant role during the development of the interferon story. The author has based his information on scientific and other papers including the media outburst but a particularly important effort was to interview 24 members of the pharmaceutical industry (representing 6 companies), 39 scientists from the academic area and 6 representatives of the government institutions and regulatory bodies. All of these people were (and some are) involved in the development of this area. As being one of the dramatis personae ( a term used by the author; see also [1]) it has been intriguing and somewhat strange to view everything from the outside in a historical perspective. Of all the other books dealing with the interferon story the one written by Kari Cantell [2], a key dramatis personae, probably comes closest to the present one but with the distinction that his excellent book was written by someone very much personally involved. References to all these other books and reviews can be found in the extensive reference list of the book of Pieters. Having stressed that the author has done a meticulous job by collecting a fantastic body of information, also off record, it must definitely be stated that he has been successful in producing a most interesting story. It begins with the background and the discovery of interferon as an antiviral substance, how it was going public, how it almost disappeared from the scene, how it was saved as a research topic, how it was difficult to purify and how this fact caused reluctance of basic medicine to accept the whole concept, how it was shown to have antitumour activity, how it was produced on a large scale to allow the treatment of a few patients and how it was considered to be a miracle drug. The new phase consisted of drawbacks and it was even considered to be a flop.

This latter period was later compensated by the development of the interferons as a family of substances and their individual production as recombinant molecules. It lead to the concepts of biological response modifiers and cytokines. For a while interferons were considered as drugs looking for a disease. During the last 20 years, though, interferons have found a place in clinical medicine and they are used for the treatment of various diseases from multiple sclerosis to hepatitis to cancer. It is probably this width of the interferon concept and all the various functions of interferons that has made their story so intriguing. It is interesting to follow how the author compares the interferon story with the development of cortisone, streptomycin and penicillin. One difference, according to the author, is that the “interferon was rocketed to Elysian heights by a pounding cocktail of modern mass media”, although all four compounds “were breathing new life into the critically ill body”. And all this was achieved by a “natural substance”!

It is also of relevance to read the book from a medical-political standpoint and much can be learned about the response of the society to new drugs and how the public enthusiasm always was dangerously close to cause an uncontrollable situation despite the involvement of extremely serious and non-profit searching investigators. Another area which is extremely fascinating to follow is the bench and clinical bedside acting up to each other. There is a lot of translational research going on over a period of almost 50 years!

Pieters ends his book by summarising the role played by the interferons in retrospect and prospect. The final outlook is one of optimism concerning a developing area which is probably only in its beginning phase!

The book is very well written and through all the various topics the historical thread is never lost. The author has certainly become part of the interferon story! This fascinating ook can be strongly recommended.