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As we reported before, Dr. Péter Hegyi, Professor and Head of the Institute for Translational Medicine at the University of Pécs Medical School, Head of the Centre for Translational Medicine at Semmelweis University, Doctor of the Hungarian Academy of Sciences, member of the Academy of Europe and Head of its clinical unit since 2021, received the prestigious Robert F. Pitts Lecture Award at the World Congress 2025 of the International Union of Physiological Sciences (IUPS). The award that he received has been presented every four years since 1978 to the outstanding members of the global physiology community. This was the first time that a Hungarian researcher received the award for his 25 years of research work on ion transport mechanisms of pancreatic ducts. Professor Dr. Péter Hegyi spoke about the main stages of his research and his future plans, as well.

Written by Rita Schweier

„Receiving this award is like winning the Olympic gold medal in sports, I can also call it a lifetime achievement award. Receiving it really surprised me, because I was always dissatisfied with the progress I had been making. I thought that the results were not good enough.  I never summarized what I had done in the past 25 years, I rather focused on finding answers to new questions that arose during the research. But in connection with the recognition, I was forced to think over the achievements. I believe that I managed to fully map the research topic in detail regarding the physiological, pathophysiological and pharmacological aspects. My career path is similar to the path of the American kidney researcher Robert F. Pitts, the award was also named after him, who first described that the acid-base balance of the kidney’s epithelial cells is extremely important for the body. He managed to understand its physiological regulation in the mid-1900s, examined how it changes due to diseases, and he also took part in pharmacological research" - said Professor Dr. Péter Hegyi, who began to dive into the research of the ion transport mechanisms of pancreatic ducts around 2000 in Newcastle because of a successful application.”

The road to specific therapy

Around the millennium, all that was known about pancreatic duct cells was that they produce large amounts of bicarbonate, which is needed to neutralize the acid in the intestines flowing from the stomach, so that digestion can begin. Dr. Péter Hegyi and his colleagues discovered that the physiological role of bicarbonate does not begin in the intestines, but in the pancreatic ducts, where the bicarbonate concentration, because of its alkaline content, is able to keep the digestive enzymes inactive. Their other discovery was in connection with the regulation of bicarbonate secretion. They described that this regulation does not only consist of being turned on or stimulated during eating, but also of having a precise inhibitory-regulatory mechanism, as it switches off. These two important physiological observations were also included in physiology textbooks. Their research results were significant, because specific therapy for treating pancreatitis does not exist yet.

„We did not fully understand how the disease develops. We knew that enzyme activation was very important, and that bicarbonate helps prevent this enzyme from being activated in the pancreas. I connected the two: if bicarbonate secretion is damaged, then this might be one of the reasons why pancreatitis develops. We also looked at all the factors that can trigger inflammation: gall, alcohol, smoking, fat. We experienced that the cells of the pancreatic duct almost completely turn off bicarbonate secretion because of these factors. Then we found the cystic fibrosis channel which is responsible for turning it off. So, the inhibition of bicarbonate secretion starts there, which is also the case regarding children having cystic fibrosis. This has a genetic cause regarding children, as for adults it is caused by different chemical substances” - he explained.

They were aware of the fact that CFTR gene abnormalities caused disease, but they did not know that environmental damage to the pancreas could also cause disease. This was also confirmed by Dr. Péter Hegyi. The publication on this realisation was published in 2015 in journals with the impact factor of over 20. He said that their task had been easier with the pharmacological field, as they knew that CFTR modulators had been already developed that could restore the function of the cystic fibrosis channel. Their task was to prove that the medicine was also good for diseases caused by chemicals, not just for those caused by genetics. Their publication in connection with this was published in The Journal of Physiology in 2024 and was chosen as the best publication of the month by the editor-in-chief.

„It took us 25 years to complete our physiological, pathophysiological and pharmacological experiments and to fully explore this field. We were lucky that CFTR modulators already existed before, otherwise the research would have taken much longer. From now on, we are only dealing with the clinical area” - he emphasized, adding that these medicines are currently under patent protection, which is why they are still very expensive. A one-year-long therapy for a patient costs 300 000 dollars, which is more than 100 000 000 forints. At least twenty patients need to receive this therapy to prove their effectiveness, which is why these tests cannot be initiated by researchers, only by the pharmaceutical company, Vertex. There are five thousand patients with acute pancreatitis every year only in Hungary.

Internal medicine and gastroenterology instead of surgery or obstetrics

At the beginning Professor Hegyi was interested in surgery and obstetrics, but during his fourth year at the University of Szeged, he met Dr. Tamás Takács, who became his mentor, and a determining factor in his career.

„I remember the time we met, Professor Takács was still a senior lecturer at the clinic in Szeged. He started to treat patients at 8 am, but he had arrieved at 6 am to show me how to operate on small animals. In the 1990s, “in vivo” experiments were conducted requiring very good manual skills, which fortunately I had. I used to play the cello as a child and the fact that my fingers are able to move independently might have played a role in this. Professor Takács was an incredible mentor, we were successful, and the results came, so I started to like this field” - he said.

Dr. Péter Hegyi has worked with many people over the past 25 years. The first five years were connected to colleagues in Newcastle, the next fifteen years were spent with colleagues in Szeged, and the remaining five with colleagues in Pécs. His own team consists of approximately sixty people, but joint publications include nearly 1500 colleagues. Hundreds of people from many centres around the world worked on his project.

„90% of my work consisted of basic research and only 10% clinical work 15 years ago, but now clinical work accounts for 90-95% of my work. Currently, we are asking questions at hospital beds. We were on the cover of the Journal of Gastroenterology two years ago with a project completely originating from Pécs in order to confirm the risk of death after pancreatitis. Our new article will be soon published in this journal presenting why 70-80 percent of patients will have sugar metabolism disorder four years after pancreatitis, why the disease returns in one-third of the patients, and what can be done about it” - he said.

His driving force is dissatisfaction

Dr. Péter Hegyi plans his schedule scientifically, lives and works accordingly, he has enough time for everything: he is the head of two institutes, practices, teaches and does research, while he is also present in the world. He plays sports every day, meets his three grandchildren and his mother every week. He does not give up on his hobbies, including folk dancing, performances, and the membership in the UEFA Referees Committee.

„I feel good about myself, it has been this way for the past 53 years, but being satisfied is completely out of the question. I can only see those 98 problems and tasks every single day that I was not able to solve, so I do not focus on those two that I handled successfully. Dissatisfaction is also my driving force, and it will remain that way” - he added.

Photo:

mta.hu