Dr. Fauci received the 2005 National Medal of Science Award in ceremonies at the White House earlier this year. President Bush recognized a total of 30 winners of both the 2005 and 2006 National Medal of Science at this event. “It was an extraordinary honor … to receive this award from the president,” says Dr. Fauci, director of the National Institute for Allergy and Infectious Disease (NIAID) at the National Institutes of Health in Bethesda, Md. He was chosen for the award by a committee of 13 scientists following a two-year selection process “for pioneering the understanding of mechanisms whereby the human immune system is regulated, and for his work on dissecting the mechanisms of pathogenesis of human immunodeficiency virus (HIV) that has served as the underpinning for current strategies for the treatment of HIV disease,” according to a National Science Foundation award announcement.
Dr. Fauci is known worldwide for his pioneering work on the pathogenic mechanisms of HIV disease, but he says his early work as a research physician was centered on diseases linked to rheumatology. He completed his medical training at Cornell Medical School in New York City and an internship and residency at New York Hospital-Cornell Medical Center.
Dr. Fauci trained in two subspecialities, clinical immunology and allergy, and is board certified in infectious diseases. As a fellow in the late 1960s, he began to study the mechanisms of the immune system, “a hallmark of rheumatologic disease,” he notes. In the 1960s and 1970s Dr. Fauci studied immune regulation and its effect on systemic lupus and RA. When the first cases of HIV were reported in 1981, he changed the primary direction of his basic and clinical research.
Dr. Fauci began his career at the NIAID in 1968 with work on the human immune system, particularly on conditions that cause the immune system to malfunction. His seminal work on HIV/AIDS is the foundation for the current treatment and prevention strategies for the disease. Dr. Fauci says he applied his basic training in immunology and rheumatology to research on HIV/AIDS. This work has now won him the prestigious national honor that has been given to only 441 other scientists since Congress established the National Medal of Science in 1959.
Dr. Maini: Anti-TNF Visionary
In the United States, selection for the National Medal of Science is the highest award for scientific achievement; in the United Kingdom, it is being chosen by the Royal Society of England. The Fellowship of the Royal Society in England was founded in 1660 and is the world’s oldest scientific academy in continuous existence, with a membership of more than 1,300 distinguished scientists. Each year, the Royal Society recognizes fellows and foreign members for their scientific achievements. In 2007, Dr. Maini, emeritus professor of rheumatology at the Kennedy Institute of Rheumatology of the Imperial College of London, was elected a fellow of the Royal Society. His name is now placed along side that of highly respected past awardees including Isaac Newton, Albert Einstein, Charles Darwin, and Steven Hawking—and 21 Nobel Prize winners.
Dr. Maini says that he is “delighted to be chosen as a fellow, particularly because it is an unusual selection for a clinical researcher like myself to be chosen.” The award is primarily given to basic scientists. “When two fellows of the society asked me for my curriculum vitae, I guessed that I might be in the running,” he says.
The lifelong rheumatologist and ACR member was given this distinction because of his pioneering work on the use of anti–tumor necrosis factor (TNF) monoclonal antibodies for the treatment of RA.
In London in the early 1980s, Dr. Maini and his colleague, immunologist Marc Feldmann, MD, first tested the theory that cytokines lead to autoimmune disease. They decided to study this theory by testing the tissue of patients with RA because it gave them the opportunity to study the tissue when it was highly inflamed. The tissue could be accessed during the synovium in RA. They found a direct association, but no antibody-based therapy existed at the time.
In 1992, the two researchers began the first clinical trial of anti-TNF in patients with RA. Early success among patients who had not responded to other therapy led to a multi-center, double-blind, placebo trial in Europe in 1993. Dr. Maini’s clinical research on anti-TNF has proven that antibodies can be used long term in patients and that immunogenicity issues are “real but nevertheless manageable,” he says.
Dr. Salmon: Lupus Leader
The former chair of ACR’s Committee on Research, Dr. Salmon was named the co-winner of the Carol Nachman Prize for 2007. This award is the most prestigious international award for rheumatology research. Dr. Salmon received the award, which includes a monetary prize that allows her to further her work, for her innovative research into the pathogenesis of organ damage in systemic lupus erythematosus and other disorders of the immune system. Most recently, Dr. Salmon and her colleagues at the Hospital for Special Surgery in New York City have explored the reasons for high incidence of pregnancy loss in women with lupus. This is particularly the case in women who have antiphospholipid syndrome, says Dr. Salmon.
“I was thrilled when I was notified of the award,” says Dr. Salmon. It was particularly gratifying because the award is based in Germany. “My parents were German refugees after World War II,” she explains. “This award is recognition that things have changed since then.” Dr. Salmon invited her mother to join her at the awards ceremony in Wiesbaden, Germany. Dr. Salmon is also proud of this achievement because few other women have received the Nachman Award since it was established in 1972.
Dr. Salmon trained in medicine at Columbia University College of Physicians and Surgeons in New York City and was the first woman chosen for the Medical Scientist Training Program in 1978. She completed a fellowship in rheumatic diseases at New York Hospital and the Hospital for Special Surgery. She is now the co-director of the Mary Kirkland Center for Lupus Research at the Hospital for Special Surgery.
Her two decades of rheumatology research—and lupus research in particular—have included basic, translational, and clinical research. She contradicted accepted thinking about antiphospholipid syndrome and was convinced that inflammation, not thrombosis, is the event that leads to pregnancy loss in patients with the disorder. Her research to prove this hypothesis is considered one of the seminal achievements of recent research in rheumatology.
Dr. Smolen: RA Revolutionary
Dr. Salmon shares the 2007 Nachman Award with Dr. Smolen, chair of rheumatology at the Medical University of Vienna (Austria). Dr. Smolen was chosen for the award for his work identifying crucial steps in the pathogenesis of generalized and local bone dismantling in chronic inflammatory rheumatic illnesses.
Dr. Smolen, a longtime colleague of Dr. Maini, has also done extensive research into preventing the destruction of joint tissue in patients with RA. He began his career in the late 1970s as a postdoctoral fellow at the Institute of Immunology at the University of Vienna. He met Dr. Maini in the late 1980s and became one of the first investigators for the clinical trial of the effects of cytokines and anti-TNF. His research found that the TNF therapy also resulted in a much lower progression of joint destruction. His further work in this area focused on dosing and the used of combination therapy using anti-TNF and methotrexate.
“I was overwhelmed by learning that I was to receive this highly prestigious award,” Dr. Smolen says, “and at the same time very grateful—grateful to the jury that had assigned the prize to my work and thus gave it public recognition, and grateful to my collaborators in my own department and internationally. Without their input, support, and important activities, the research … for which the prize was awarded would not have come so far.”
Terry Hartnett is a frequent contributor to The Rheumatologist.
