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Deborah Doniach, a Pioneer in the Field of Autoimmunity

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Deborah Doniach, a Pioneer in the Field of Autoimmunity RESEARCH HIGHLIGHTS WOMEN IN IMMUNOLOGY primary biliary cirrhosis and clarified how autoantibodies to gastric parietal cells play a role in pernicious anaemia. Deborah Doniach, a pioneer Deborah’s research team were also among the first to show that auto- antibodies specific for pancreatic in the field of autoimmunity islet cell antigens were present in the Deborah Doniach (1912–2004) As a clinician, Deborah recog- sera of patients with type 1 diabetes was a clinician and immunologist nized the need for a clinical diagno- mellitus. Although the formal proof who made the ground-breaking stic service to monitor patient the ground- that type 1 diabetes mellitus was an observation of the autoimmune autoantibodies and pushed for the breaking autoimmune disease was to come basis of Hashimoto disease, which establishment of a clinical immuno- later, these early studies provided damages the thyroid gland. This logy service in the Depart ment observation an indication that there might be an paved the way for the subsequent of Immunology at the Middlesex of the auto- autoimmune aetiology. identification of other organ-specific Hospital. As well as forming a immune basis Deborah had a wonderfully autoimmune diseases. blueprint for the diagnostic and of Hashimoto inquisitive mind that embraced Deborah was born in Geneva, monitoring facilities now routinely new ideas and technologies. studied medicine at the Sorbonne available, this service also greatly disease … This stood her in good stead in Paris and completed her medical assisted the development of many paved the way throughout her academic career. degree at the Royal Free Hospital clinical research programmes. for the sub- Deborah was a remarkable woman Medical School in London. After The Department of Immunology sequent identi- who was undaunted by adversity graduation, she worked as a research at the Middlesex Hospital was a and had a great love of science. assistant at the Royal Free Hospital vibrant research community not least fication of other Her enthusiasm was infectious and then as an assistant lecturer in because of Deborah’s enthusiasm for organ-specific and her interest in people coupled chemical pathology at the Middlesex new ideas and thirst for knowledge. autoimmune with her warm, generous nature Hospital, London. This was followed In addition to her longstanding enabled those young clinician by an endocrinology post at the collaboration with Ivan Roitt, Deborah diseases scientists working with her to Middlesex Hospital and afterwards established very productive collab- achieve their potential. The fact a position, initially as Honorary orations with many scientists and that she spoke several languages Consultant Immunopathologist clinicians, including Dame Sheila fluently, that she had wide-ranging and subsequently as Professor of Sherlock, Noel Ling, Gianfranco interests and that she was immensely Clinical Immunology, in the new Bottazzo, Hemmo Drexhage, Ricardo hospitable ensured that any new Department of Immunology at the Pujol-Borrell and Rita Mirakian. arrival to the Department of Middlesex Hospital. She and her colleagues identified Immunology was rapidly put at ease. Whilst diagnosing and treating the thyroid antigens recognized Deborah received many awards patients with thyroid disease, by the immune system in Hashimoto in recognition of her studies in she noted that following thyroid disease, established a role for anti- autoimmunity, including the resection the previously elevated mitochondrial autoantibodies in Van Meter Award of the American plasma immunoglobulin levels seen Goitre Association, jointly with in Hashimoto disease fell to normal Ivan Roitt (1957), the Canada levels. Deborah was aware that Gairdner International Award, jointly patients with Hashimoto disease with Ivan Roitt (1964), the Prize of had plasma cell infiltration of their the British Postgraduate Federation thyroid glands and she made the (1967), and she was elected ‘Woman conceptual leap that these cells Scientist of the Year’ in 1984 by the were recognizing thyroid antigens. Association of American Women Together with Ivan Roitt and Peter Scientists. Campbell, she tested the hypothesis Anne Cooke that plasma cells in the patients The author declares no competing interests. produced immunoglobulins that ORIGINAL ARTICLES Roitt, I. M. et al. Auto- recognized thyroid antigens. antibodies in Hashimoto’s disease (lymphadenoid They demonstrated that sera from goitre). Lancet 271, 820–821 (1956) | Berg, P. A., the patients contained antibodies Doniach, D. & Roitt, I. M. Mitochondrial antibodies in primary biliary cirrhosis. I. Localization of against thyroid antigens, indicating the antigen to mitochondrial membranes. J. Exp. an autoimmune basis for Hashimoto Med. 126, 277–290 (1967) | Bottazzo, G. F., disease. Deborah retained a fruitful Florin-Christensen, A. & Doniach, D. Islet-cell antibodies in diabetes mellitus with autoimmune collaboration with Ivan Roitt, polyendocrine deficiencies. Lancet 304, 1279–1283 and the Department of Immuno logy (1974) | Mirakian, R. et al. Autoimmunity to anterior pituitary cells and the pathogenesis of insulin- at the Middlesex Hospital became dependent diabetes mellitus. Lancet 319, 755–759 an internationally renowned (1982) | Berg, P. A. et al. Clinical significance of centre for the study of autoimmune mitochondrial antibodies in relation to liver disease. Lancet 318, 804 (1981) disease. Doniach Tabitha of courtesy Image Credit: 354 | JUNE 2020 | VOLUME 20 www.nature.com/nri.
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