Focus Rheums| Dr. Jekyll or Mr. Hyde? (video)

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Metrics in Rheumatology: Focus on Harold E. (Hal) Paulus, MD

  |  Issue: November 2010  |  

1956 – Completes an internship at the Hospital of the University of Pennsylvania

1956 – Serves as Captain, M.C., in the U.S. Army Medical Corps

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1958 – Goes into private general practice at the Austin Clinic in Austin, Minn.

1967 – Completes an internal medicine residency at VA Wadsworth Medical Center

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1968 – Completes a rheumatology fellowship at VA Wadsworth Medical Center

1969 – Completes a rheumatology fellowship at UCLA Medical Center

1969 – Becomes assistant professor of medicine in residence at UCLA School of Medicine

1969 – Completes a clinical pharmacology fellowship at Cedars-Sinai Medical Center in Los Angeles

1972 – Becomes associate director of the Institute of Rehabilitation and Chronic Diseases, UCLA

1973 – Becomes associate professor of medicine at UCLA School of Medicine

1977 – Becomes associate director of the Division of Rheumatology, UCLA School of Medicine

1978 – Becomes professor of medicine at UCLA School of Medicine

1981 – Becomes acing director of the Division of Rheumatology, UCLA School of Medicine

1999 – Becomes emeritus professor of medicine at UCLA School of Medicine

New Concept of Autoimmunity

As a medical student, Dr. Paulus had been intrigued by lectures on the then–relatively new concept of autoimmunity and had taken an elective in rheumatology. That fascination took hold as he learned the basics of inflammation and immunity from Michael Whitehouse, PhD, an experimental pharmacologist Dr. Pearson had also recruited to UCLA. Dr. Pearson had developed a rat model of adjuvant arthritis, which Dr. Whitehouse had transferred by infusing animals with lymphocytes from diseased rats and then studying the effects of potential drugs on various types of induced inflammation. Dr. Paulus became interested in studying the effects of nonsteroidal antiinflammatory drugs on several types of induced inflammation in patients with RA.

Those mechanistic studies led Dr. Paulus in the early 1970s to investigate the involvement of lymphocytes in RA, systemic lupus erythematosus (SLE), dermatomyositis, and scleroderma, first in a case report of thoracic duct lymphocyte drainage (TDD) published in 1973.1 In a 1977 study, he and his coinvestigators documented significant improvement in grip strength, ring size, duration of morning stiffness, and number of tender joints in their RA study participants who underwent TDD.2 Reinfusion of unlabeled or 51Cr-labeled lymphocytes resulted in transient exacerbation of disease activity in three of the study subjects. These studies validated the hypothesis that these lymphocytes played a critical role in the chronic inflammatory disease process and helped form the basis for subsequent basic research.

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