Albert Lasker
Clinical Medical Research Award

Acceptance Remarks by Sir Ravinder Maini

Dr. Goldstein, Madam President, Chairman, Ladies and Gentlemen.

I feel greatly privileged to be a co-recipient of the Clinical Medical Lasker Award, and especially happy that I am to share this honour with Marc, my friend and close colleague for the past 20 years.

As an undergraduate at Cambridge University, and later at Guy's Hospital in London, I was truly inspired by my teachers and mentors, especially Dr. Charles Baker, a cardiologist, and Professor John Butterfield, the Head of Medicine. Here I was introduced to the scientific basis of medicine, learned the art of practicing bedside medicine, and developed a critical and questioning approach to medical dogma. More importantly, I began to appreciate the importance of clinical measurement. This experience was responsible for a brief foray into measuring pressures and performing angiography by cardiac catheterisation in acquired and congenital diseases of the heart.

I rapidly tired of this mechanical approach and instead became fascinated and excited by the immunological concepts underpinning the emerging field of modern rheumatology. In the late 1960s and early 1970s as a Fellow at The Kennedy Institute of Rheumatology in London, I began to examine the biological activity of soluble factors termed lymphokines or cytokines, elaborated by the interaction of lymphocytes with antigens. I was greatly encouraged at this formative stage to have a paper accepted for publication in Nature, and by an invitation from Barry Bloom to present my work at the First International Congress of Immunology in 1971 in Washington, DC. Next, with Dumonde and based on the ideas and work of Jerry Lawrence at NYU, I embarked on a small placebo-controlled trial of lymphocyte extractable Transfer Factor in rheumatoid arthritis patients. Needless to say, no significant benefit was observed by this naïve approach using poorly characterised materials.

However the dye was cast and I began work on the immune pathogenesis and biological therapy of rheumatoid arthritis, a disease which I realised wreaks havoc with patients' lives. By the mid-1980s, the field was transformed by molecular and biochemical characterisation of an increasing number of cytokines which we could explore in arthritic tissues. How this path then led to Marc Feldmann's door and our work on the identification of TNF as a key regulator of chronic inflammation has brought us to your attention today.

The benefit that treatment of patients with rheumatoid arthritis have derived from anti-TNF therapy and the expanding indications for treatment of other immune inflammatory diseases has given me immense satisfaction. The single-minded and dogged pursuit of research that I have followed has, however, exacted a price from my family who have consequently lived with my absences. I am particularly indebted to all of them for their tolerance and to my wife, Geraldine, who for the past 20 years has been my muse and inspiration.

Ladies and Gentlemen, the Lasker Award, with which you have honoured us, will draw attention to the plight of patients with chronic diseases that destroy the quality of life, and will give a signal that scientific discovery can and does alter their future prospects.