Phenotypes and Biomarkers of Diabetic Retinopathy. Personalized Medicine for Diabetic Retinopathy: The Weisenfeld Award
2014; Cadmus Press; Volume: 55; Issue: 8 Linguagem: Inglês
10.1167/iovs.14-14884
ISSN1552-5783
Autores Tópico(s)Retinopathy of Prematurity Studies
ResumoI have not yet found the right words to express my gratitude to the persons involved in my nomination for this Award and to the ones who finally made me this year’s choice. It is great to hear someone telling you that your life work has been worthwhile. The Award is named after Mildred Weisenfeld, a person who suffered from a disease that caused her to lose vision progressively. Mildred Weisenfeld dedicated her life to promote and establish eye research, and her commitment was so relevant that she was highly instrumental in the inception of the National Eye Institute (Bethesda, MD, USA). The National Eye Institute has now a unique place in supporting eye research in the United States and worldwide. When I returned to Europe in 1986 after my stay in the United States, where I realized the unique value of the National Eye Institute, the development of an European Vision Institute following on the steps of the USA National Eye Institute has been always a permanent goal for me. The Weisenfeld Award is one of the main Awards of the Association for Research in Vision and Ophthalmology (ARVO), and ARVO means, to me, Eye Research. Since working under the mentorship of Norman Ashton, in London, I realized that eye research was my calling. Finding new solutions and adding to present knowledge to help human beings who lost vision or are at risk of losing vision clearly was a useful and rewarding challenge. At ARVO I feel at home, and it is a special feeling to be recognized by my peers. My links to ARVO were initiated a long time ago and became emotional for a variety of reasons. My first ARVO meeting took place in 1977 in Sarasota, Florida. I was invited to lecture at Johns Hopkins (Baltimore, MD, USA) by Arnall Patz just before the ARVO meeting, and one of my mentors, David Maurice, insisted that I should take the opportunity to participate in the ARVO meeting. He booked me, at the last minute, a room at the Around the World Motel and shepherded me there. At this same ARVO meeting, Mark Tso and Morton Goldberg invited me to the Illinois Eye and Ear Infirmary Party, which was followed by an invitation to come to Chicago. Therefore, ARVO 1977 was a turning point in my life and career. Now, in 2014, a few years later, I am here receiving the Weisenfeld Award for Excellence in Ophthalmology. Why am I here? I am here for many reasons, for which I will try to mention just a few. On reviewing my life, two words come to my mind, luck and fun. Fun, because I enjoyed very much doing what I have been paid to do. Luck, because of the persons who opened the way for me and supported my first steps. First, my father, an ophthalmologist who wanted me to become a better ophthalmologist than himself and advised me to learn eye pathology for my medical practice to be based on the best available scientific knowledge. I then was extremely lucky to have as mentors two of the best minds in the Institute of Ophthalmology in London, UK, where I stayed between 1963 and 1966: Norman Ashton, an ARVO Proctor Awardee, who welcomed me into his Department on March 8, 1963, and David Maurice, an ARVO Friedenwald Awardee, 1 year later. These very different personalities helped me learn to enjoy working in eye research. Finally, and probably more important of all, I was lucky enough to find the right girl, who has since supported me all the way. In 1963, when initiating my stay in London, Norman Ashton challenged me to work in diabetic retinopathy (DR), a major cause of blindness, and to focus my research on the retina and retinal vascular disease, a challenge that I accepted and has now brought me here today. At that time, the work of Majno et al. appeared in the literature, suggesting that the venous side of the capillary circulation was the most susceptible site for alterations of vascular permeability. Considering that this finding could explain the initial changes occurring in DR, we repeated their experiments in the retina and we found, to our great surprise, that the retinal vessels behaved differently from other vessels in other regions of the body or even from other vessels of the eye. These observations led us to the discovery of tight junctions between the endothelial cells of the retinal vessels, making the retinal endothelium function as an epithelial-like barrier (Fig. 1), an observation that later was confirmed also to occur in the brain. A specific blood–retinal barrier then could be demonstrated, in the rabbit, to be mainly located in the endothelial layer of the retinal vessels (Fig. 2). After establishing the morphologic basis of the blood–retinal barrier, the next challenge was to calculate its restricted permeability, and it was then that I started to work also with David Maurice. We were able to measure the permeability of the retinal vessels and to identify, for the first time, the
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