The tale of the doctor in the Bronx and the Gila monster

Have you heard the story about the scientific gold in Gila monster venom?

With what's happening in Washington these days, it's a tale worth telling.

The best starting point for this decades-long drama is the late 1980s at the VA Hospital in the Bronx. That's where young endocrinologist John Eng, who was treating veterans with diabetes and whose research specialty was peptide hormones, was seeking to identify new hormones whose benefits for human health had yet to be tested. After studying guinea pigs and chinchillas, he began casting about for different animals.

That's when he happened upon studies from researchers at the National Institutes of Health who had found that some snake and lizard venoms caused inflammation of the pancreas, which makes insulin. They were particularly interested in the venom of the Gila monster, a fortuitous focus with a major health care payoff. 

 Gila monsters live in the southwestern U.S. and northwestern Mexico. Heavy and slow-moving, they live underground for nearly 95% of their lives. They have spectacular bands of geometrically intricate colors from head to tail and a bite that is ferocious and difficult to dislodge but not usually fatal to humans. When a Colorado man who had one as a pet died from its four-minute-long bite in 2024, it was believed to be the first human fatality from a Gila monster bite in nearly a century.

The Gila monster was not an obvious candidate to be at the center of an amazing and impactful discovery. But that's science for you.

Eng set about studying the Gila monster's venom and discovered a compound that had never been identified, one he dubbed exendin-4. It seemed similar to a human gut hormone called GLP-1, which was being studied by researchers in Massachusetts for the way it stimulated insulin secretion only when blood sugar is high, not when it's at normal levels, an obvious boon in treating patients with diabetes. But GLP-1 degrades quickly, meaning injections would be needed almost every hour. Eng's substance, exendin-4, didn't degrade for hours, which made it much more promising as a drug.

Years of development and more serendipity awaited, but the synthetic version of Eng's discovery, called extenatide, was approved by the Food and Drug Administration in 2005 to treat type 2 diabetes. It's still in use. But its greatest significance is its influence in developing other GLP-1s — like semaglutide, the synthetic substance at the heart of blockbuster anti-obesity drugs like Ozempic and Wegovy.

Which means it's not at all hyperbolic to say that at the root of one of the biggest health care advancements of this century is the poisonous venom of the Gila monster.

That's worth noting, especially at the end of a week that saw the nation's vice president and one of its top legislative leaders snicker as our president used part of his congressional address to read off a list of supposedly silly scientific studies that never would produce anything useful for humans. A week when one U.S. senator at a confirmation hearing for the NIH director nominee sneered at "frivolous studies." At a time when so much research whose promise is not concrete or easily understood seems doomed to the chopping block in the ongoing campaign to slash government spending.

Pruning must be done with care. Public investment in science is critical. The work is hard and often long, sometimes spanning decades, and serendipity can be essential but unpredictable. Private investment has no interest in such a time frame. Too much runway with no guarantee of liftoff. And yet, we need to be on the runway to keep moving forward.

Valium evolved from failures in trying to make fabric dyes. And weight-loss drugs stemmed from a doctor in the Bronx who wanted to study the Gila monster.

Often, the roads worth going down are the ones where we can't yet see the end.

Columnist Michael Dobie's opinions are his own.

By Michael Dobie

michael.dobie@newsday.commwdobie

Michael Dobie is a member of the Newsday editorial board.