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Imagine an internist without a stethoscope, or an orthopedist without an x-ray machine. Technologies like those completely changed medical practice. Thirty-five years ago another technology did. Two Swedish scientists invented the ELISA test. NPR's Joe Palca has this look at ELISA's origins, and how it revolutionized medicine.
JOE PALCA reporting:
In the bowels of the UCLA Medical Center, there is a small windowless room. Inside, there is a large machine that resembles nothing so much as a sophisticated photocopier. This is a clinical testing lab, and Anthony Butch is in charge. He says the machine is a wonder. It can test whether you have been infected by the flu virus, whether you have prostate cancer, or whether your thyroid is working properly.
Mr. ANTHONY BUTCH (Lab Technician, UCLA Medical Center): It does 170 tests an hour, and you can load many, many different tests on it; and it is fully automated. You just simply put the sample on the end there. It automatically [unintelligible], runs the test for you and puts the result on the computer terminal there.
PALCA: This machine is doing a modern version of the ELISA test. ELISA uses antibodies to seek out the presence of hormones or viruses. In the past, testing for these was cumbersome and time consuming. ELISA tests can be done in a matter of hours, sometimes minutes. Butch says in the future ELISA won't be done on large machines, but on tiny silicon chips.
Mr. BUTCH: Where you could put 15 different tests on there and do it in very, very small quantities. Right now, we're down to on the order of 10 or 12 microlitres.
PALCA: Butch says ELISA, and the similar tests it spawned, will be critical part of medical care for many, many years.
Thirty-five years ago, Eva Engvall wasn't trying to revolutionize medicine. She was just trying to find a simple way to detect specific proteins in blood samples. Then Engvall was a young graduate student at the University of Stockholm. Now, she is a professor at the Burnham Institute in La Jolla, although she spends most of her time at her home office - an 1100-acre ranch in the Santa Ynez Valley, where she breeds whippets.
Professor EVA ENGVALL (Burnham Institute): (Unintelligible) are you coming in? Come. Come, come.
PALCA: Engvall is a compact woman with a gentle manner. She doesn't take all of the credit for ELISA.
Prof. ENGVALL: It wasn't my invention. It was my mentor's, Peter Perlman's.
PALCA: Perlman died last year. Antibodies had been used in the past to zero in on viruses or cancer cells. Perlman's innovation was to use an enzyme to make it easy to see whether those antibodies found their targets. Engvall does take full credit for one thing; technically, she was trying to make an enzyme-linked immunosorbent assay. But that was a mouthful. So she came up with the acronym ELISA.
Prof. ENGVALL: That was actually the first thing that I did, before I did any experiment.
PALCA: And Engvall says finding the right name turned out to be very important.
Prof. ENGVALL: That's why we have been so much more recognized than anyone else who did similar things, just because it was an name?
PALCA: Before Engvall proved it did work, many scientists weren't convinced ELISA would work. Engvall says working in a fairly remote location like Stockholm was an advantage.
Prof. ENGVALL: I had no idea there was so many doubts out there in the world - that this wouldn't work, it wouldn't be useful.
PALCA: Although, even today, there are some doubters.
Prof. ENGVALL: This lady came up to me and said, are you Eva Engvall; and I said yes. Are you the Eva Engvall for the ELISA? Yes, I said. It doesn't work, she said; it doesn't work. Of course it works, I said.
PALCA: Engvall says this lady turned out to be a scientist. After a brief conversation, Engvall was able to figure out what she was doing wrong. I asked Engvall what was the most gratifying thing about her invention?
Prof. ENGVALL: I have always been mostly impressed with the use of ELISA for tests that couldn't really be done any other way.
PALCA: You don't need electricity, so you can do ELISA's in small villages in Africa. One of the first uses of ELISA was to test for malaria. And you don't need special expertise. ELISA's are used in home pregnancy tests. The 35th anniversary of ELISA has brought a new round of attention to Engvall's invention. She can stand a little adulation, but she is realistic.
Prof. ENGVALL: There's never a discoverer of any thing. There are the people who had the bits and the pieces and so on, but may have not followed up the way we did.
PALCA: You did do the name?
Ms. ENGVALL: I did the name, yes.
PALCA: And of course, as any marketer will tell you, the right name is crucial, Joe Palca, NPR News.
INSKEEP: Find out the connection between the test of that name and the Hollywood stunt man's escapade with a herd of horses by going to our website at npr.org.
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