Downton Abbey is a popular British historical period drama that takes place in the 1920’s post-Edwardian era. Set in a fictional Yorkshire estate known as Downton Abbey, the series follows the lives of the mansions inhabitants – the aristocratic Crawley family and their domestic servants – as they experience great events in history that change their lives and the British social hierarchy. The Crawleys – Robert and Cora – are the Earl and Countess of Grantham and the show’s main protagonists.

During the show’s fifth season, Robert Crawley – Lord Grantham – visits the doctor to determine the cause of mysterious chest pains and discovers that he has a stomach ulcer. The doctor recommends that he follow a special diet and, to Lord Grantham’s disappointment, limit his alcohol consumption. As the show moves into its sixth season, he continues to experience stomach pain which he dismisses as indigestion. Events come to a dramatic head in the fifth episode when Lord Grantham stands up during a dinner and projectile vomits blood all over the table and diners.

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Lord Grantham’s burst ulcer – click for animated .gif (courtesy mars_colonizer)

Lord Grantham’s stomach ulcer has burst and he is rushed to the hospital for emergency surgery. As luck would have it, he survives; fortunately today such incidents are prevented thanks to modern advances in treatment for ulcers that are made possible through lifesaving animal research.

Lord Grantham’s condition – known as a peptic ulcer – is today well understood and effectively treated thanks to biomedical research. We now know that the advice given to Lord Grantham by his doctor was half incorrect; diet does not play an important role in either causing or preventing ulcers. Stopping alcohol consumption will help with ulcers along with taking medications to decrease stomach acid.

A widely-used type of medication for decreasing acid is called a proton pump inhibitor. One such drug, Nexium, is the top-selling drug in the United States. Like most every drug, Nexium relied on animal models for development and testing – specifically mice, rats, rabbits and dogs. Another path to reducing stomach acids comes from a line of drugs known as H2 blockers, which block the action of histamine in the stomach and decrease acid. The most prescribed H2 blocker is Tagamet, known generically as cimetidine. Tagamet was developed with the help of mice, rats, rabbits and monkeys.

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Nexium (courtesy Wikipedia)                       Helicobacter pylori (courtesy AJC/Flickr)

The stomach-dwelling bacteria Helicobacter pylori can also be responsible for stomach ulcers. More than 50% of the world’s population is infected with H. pylori in their upper gastrointestinal tract. With a helical shape, H. pylori has evolved to penetrate the mucosal lining of the stomach. Treatment of helicobacter is accomplished with a combination of amoxicillin and clarithromycin – drugs which were both developed and tested using mice, rats, rabbits and monkeys.

In recent years, the Mongolian gerbil has been established as the best animal model of gastric inflammation. It has an equivalent susceptibility to H. pylori infection as humans and develops ulcers in a similar manner. Scientists have used animal models to study the mucosal blood flow, acid/base balance, mucosal pH, hormones, mucosal resistance, the protective properties of mucus, ultrastructure, microvasculature, biochemical changes, oxygen-derived free radicals, the influence of the nervous system, and the ability to resist luminal noxious agents under different conditions.

 

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Mongolian gerbil (courtesy Wikipedia)

Even the life-saving surgery that Lord Grantham underwent after his ulcer burst was refined in recent years using animal models. Surgeons have used rabbits and pigs to develop hemostatic techniques that increase the success rate of surgery while lowering the risk of complications.

Lord Grantham was lucky to survive his burst ulcer – surgery and medicine in 1925 were nowhere near today’s standards. Someone who finds themselves with an ulcer today lives in a world with a far better understanding of the condition and a range of treatment options – made possible by research with animals.