Erik Jorpes

Erik Jorpes (1894-1973) was a pioneer of clinical chemistry who worked for many years at the Karolinska Institute, and became Professor of Medicinal Chemistry from 1947-1963. His speciality was the rapidly developing field of protein chemistry, and he is best remembered for his ground-breaking work on the structure and function of heparin and other factors involved in coagulation. He also made important contributions to our knowledge of the gastrointestinal hormones. His small but crucial contribution to insulin therapy has largely been forgotten: he discovered that insulin allergy could be cured by the use of recrystallized insulin, and thus paved the way to the virtual elimination of this problem by the introduction of highly purified insulins in the 1970s.

J Erik Jorpes, born in Aland in 1894, belonged to the minority of Swedish-speaking Finns. After qualifying in medicine he joined Einar Hammarsten at the Karolinska Institute in 1928 and spent the rest of his working life there. Here he became interested in heparin which, as the name implies, was originally extracted from the liver by Jay Maclean, a medical student at Johns Hopkins. Heparin is a complex sugar, and Jorpes played a major role in elucidating its chemistry[1]. Jorpes worked for twenty years or so on the development of heparin into an effective medical therapy. He also worked on the extraction of von Willebrand's factor and wrote on the history of coagulation[2] and other aspects of medical history.

His other major research interest was the gastrointestinal hormones, and he published many studies concerning the chemistry and action of secretin, pancreozymin and cholecystokinin.

He entered the history of diabetes by accident. Early preparations of insulin were thought to be pure because they could be crystallised, as shown by John Jacob Abel in 1926. In reality these insulin preparations contained glucagon, named 30 years in advance of its isolation by Murlin, and also referred to as the hyperglycemic-glycogenolytic factor; this was not identified and eliminated from commercial insulin preparations until the 1950s.

Other impurities were responsible for the localized allergic reactions that resulted in egg-sized red lumps at the site of injection, and caused distress for many users of insulin. These were thought to be triggered by the insulin itself, since crystallization was considered to guarantee its purity.

Insulin supplies were restricted in wartime Sweden, and all users were on a national registry. A woman reduced to misery by this problem came to consult Jorpes, who happened to have a preparation of thrice-purified insulin intended for laboratory use on his desk. On impulse, he prepared some for her, and her problem resolved. He quickly demonstrated that other patients enjoyed similar benefits, and ensured that highly purified insulin was available for them to use[3].

The message was not lost upon the insulin manufacturers, and the result was the introduction of highly purified (also called monocomponent or single peak) insulins in the 1970s. Jorgen Schlichtkrull of Novo, whose daughter suffered from unstable insulin-dependent diabetes, was to play an important role in this development.

Erik Jorpes is honoured in Sweden, and his role in wartime insulin production is also remembered, but the importance of his observation for the future of insulin therapy does not get a mention in the Swedish dictionary of national biography. http://www.nad.riksarkivet.se/sbl/Presentation.aspx?id=12209

References

  1. ^ Jorpes E. Heparin in the treatment of thrombosis. An account of its chemistry, physiology and application in medicine. 2nd Edition, New York, Oxford Univeristy Press, 1946

  2. ^ Jorpes JE. One hundred years of research into blood coagulation, leading to the present-day anticoagulant therapy of thrombosis. In Koller T, Merz WR (Eds), Thrombosis and Embolism. Basel, Benno Schwabe, 1955

  3. ^ Jorpes JE. Recrystallized insulin for diabetic patients with insulin allergy. Arch Intern Med 1949;83(4):363-71

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