The story of a scientific discovery. "In the early 1980s, I was starting my training as a surgeon when I found myself treating several patients with venous ulcers", explains professor Paolo Zamboni, director of the Centre for Vascular Diseases of Ferrara University.
"I continued to study ulcers during my time in the US, then in Sassari, and then back in Ferrara. The first discovery was that the appearance of an ulcer was preceded by visible signs of iron deposits, brownish marks which appear on the site where the ulcer will subsequently emerge." So the iron could also be at the origin of the ulcer.
"We observed that these patients lacked a protein that could control the very negative capacity of iron to produce free radicals. The genetic route - which had caused the absence of this protein - might be the right path. It was crucial to understand which genetic lines were most affected, in what type of population the ulcer mainly occurred. I discovered that there were three times as many patients suffering from venous ulcers in Dublin as here. There were also many cases in Normandy, Scandinavia and Minnesota."
The geographical map of the ulcer was also the map of the areas conquered and colonised by the Vikings or their descendents. The mutation therefore affected the Vikings, and if they had survived it means that it must have had fundamentally beneficial effects. What might these be? "We discovered that the absence of this protein prevented anaemia. The Vikings could go for months without eating meat, and retain reserves of iron that enabled them to make it through to the spring in good health. Average life expectancy for the Vikings was 35, so the negative effect of the absence of the protein, such as the venous ulcers, would not have been felt until a time when they would have already been long dead."
This led Zamboni's research group to conclude that the defect in metabolising iron is the most widespread cause of venous ulcers.
In February 2005 this discovery was rewarded with the "American Venous Forum" prize for the discovery of the year in vascular medicine.
