Beyond the classroom lecture: Liang Wang’s personal war on tuberculosis in China

Abstract

Tuberculosis, historically one of the deadliest and most prevalent infectious diseases, is caused by the bacterium Mycobacterium tuberculosis. It is estimated that one-third of the world’s population is infected by this agent (Zumla et al., 2014), and tuberculosis is therefore a major topic for medical students. M. tuberculosis is a small aerobic bacillus, with a remarkably high lipid-content cell wall that plays a critical role in its pathogenicity. Although the efficacy of the Bacillus Calmette-Guérin (BCG) vaccine for preventing tuberculosis continues to be debated (Villarreal-Ramos, 2009), live attenuated BCG has been the only approved vaccine against M. tuberculosis infection since its introduction in 1921, and is still administered routinely around the world, particularly in developing countries. In China, BCG has been included in the national vaccination program for newborns and children under 15 since the mid-1970s. After decades of intensive effort, remarkable progress has been made in the fight against tuberculosis in China. This great achievement was made possible by Liang Wang, a physician who pioneered the introduction of the BCG vaccine to China in the early 1930s and spearheaded China’s fight against tuberculosis (Yan, 2003; Dai et al., 2014). Although his accomplishments are frequently discussed in the medical school classroom, most students are unfamiliar with Liang Wang’s personal story and the significant challenges he faced in his battle against tuberculosis. Liang Wang was born on May 5, 1891 in Chengdu in the Sichuan Province. He lost his father at very young age. After graduating from the Hanoi Medical School in Vietnam in 1913, he entered private practice in the Yunnan and Sichuan regions of China. In the early 20th century, tuberculosis was the leading cause of death. Because there was no known cure, the severe health threat posed by tuberculosis was considered to be as serious as that posed by cancer today. Wang’s older brother and younger sister both died of tuberculosis. As a young doctor, Liang Wang determined to devote himself completely to the fight against tuberculosis. In 1924, Albert Calmette and Camille Guérin from the Pasteur Institute in France published their research results on the BCG vaccine, demonstrating its efficacy in the prevention of tuberculosis. One year later, Liang Wang learned about BCG and began fundraising to support a trip to France. With the help of France’s foreign ministry, Wang was able to visit the Pasteur Institute in 1931, where he began his research career under the personal guidance of Guérin. Wang’s modesty and eagerness to learn were quickly appreciated. During his two years at the Pasteur, Wang completed four research papers, three of which focused on BCG and the culture of M. tuberculosis. In the summer 1933, Liang Wang returned to China with the BCG seed strain and lab equipment. He established a microbiology laboratory while working as a physician in a private hospital in Chongqing. He committed much of his spare time to BCG culture preparation and developed the first batch of BCG vaccine in China. Beginning October 1933 through August 1935, 248 infants were inoculated with the BCG vaccine manufactured by Liang Wang. No adverse reactions were observed. Crucially, BCG vaccination conferred significant protection against the development of tuberculosis, and also offered some degree of immunity against other common infectious diseases. However, just as Liang Wang was planning to expand and promote BCG vaccination, the Japanese invaded China in 1937, beginning the Anti-Japanese War, also known as the Second Sino-Japanese War. Wang’s lab was forced to close, and the development of the vaccination project halted for more than a decade until the Japanese were defeated and the People’s Republic of China was established. The new Department of Health, opened by the Southwest Military Administrative Committee in Chongqing, provided Liang Wang with the opportunity continuing his work. He was invited to participate in the first national health working conference in 1950, and was authorized by the central government to found the Southwest Chinese BCG

DOI: 10.1007/s13238-016-0304-3

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@inproceedings{Li2016BeyondTC, title={Beyond the classroom lecture: Liang Wang’s personal war on tuberculosis in China}, author={Ming Li and Xiaomei Hu and Fuquan Hu and Xiancai Rao}, booktitle={Protein & Cell}, year={2016} }