Milestones in European Thyroidology (MET)
Deborah Doniach (1912-2004)
Deborah Doniach was a remarkable person who made outstanding contributions to medical research. She was a pioneer in the establishment of new paradigms in immunology which have provided the stimulus for far reaching studies into disorders now recognized to be a damaging consequence of reaction of the patient’s immune system with their own tissues – so-called autoimmune disease.
She was born on April 6, 1912 in Geneva Switzerland, the oldest of three daughters. Her father, Arieh Abileah, was a distinguished concert pianist and accompanist of Josef Szigetti, the noted violinist. He later emigrated to Palestine where he was a Professor at the Jerusalem conservatory of music for many years. Her mother was Fee Helles, born Fea Geller in Poltava, Ukraine and inspired by Isadora Duncan, she created a novel School of Dance and Movement in Paris.
Deborah had a checkered childhood during the World War I period, and eventually moved to Paris where she was educated at Lycée Molière, and later became a medical student at the Sorbonne. She interrupted her studies to marry Sonny (Israel) Doniach with whom she moved to London to begin a long and happy marriage. Eventually she enrolled in the Royal Free Medical School. After graduation she worked as an assistant lecturer in chemical pathology at the Middlesex Hospital, London and as a research assistant first at the Royal Free Hospital and then crucially, at the Middlesex as an endocrinologist with the eminent thyroid surgeon, Rupert Vaughan-Hudson. Afterwards she joined the newly-formed Department of Immunology where she soon became an Honorary Consultant Immunopathologist and Professor of Clinical Immunology.
In 1956, in the course of her research on patients with the thyroid inflammatory disorder, Hashimoto’s disease, she noted that the serum protein fraction containing the body’s general store of antibodies which protect against infection fell from elevated to normal levels after removal of the thyroid. Also aware that the patient’s thyroid contained many plasma cells, normally known to produce antibodies to foreign moieties such as microbes, she astutely formed the idea that they were responding to a stimulus within the gland itself. As chance would have it, Ivan Roitt and Peter Campbell working in the same Medical School (later to merge with University College London), were examining the possibility that autoimmune reactions to milk proteins might help to restrain the growth of certain breast cancers, so it was perhaps inevitable that interaction between Doniach, Roitt & Campbell would generate the hypothesis that the plasma cells in the Hashimoto gland might be reacting against normal thyroid components. It was rapidly confirmed that the serum of these patients did in fact react with normal thyroid extracts, and such was the import of these observations and the percipience of the then current editors of The Lancet, that the preliminary communication was published within a week of receipt!
Thus began an extremely fruitful partnership between Doniach and Roitt with collaboration from many gifted postdoctoral scientists and clinicians including, amongst others, Keith Taylor, Giorgio Torrigiani, Noel Ling, David El-Kabir, Geoffrey Walker, Dame Sheila Sherlock, Gianfranco Bottazzo, Alex Florin-Christensen, Hemmo Drexhage, Rita Mirakian, Maurizio Rizetto and Ricardo Pujol-Borel, with loyal technical support from Marlene and Granville Swana. They elucidated the nature of the thyroid components evoking autoantibodies in Hashimoto’s disease, revealed the involvement of the acid-producing parietal cells in the gastric autoimmunity of pernicious anaemia, and formulated the concept of a spectrum of autoimmune disorders ranging from organ-specific or restricted diseases such as Hashimoto thyroiditis and pernicious anaemia at one pole, with the rheumatological disorders involving antibodies to widely distributed body components such as DNA, at the other. Later, intensive studies revealed the central role of mitochondrial autoimmunity in the liver disease, primary biliary cirrhosis. After a period of 13 years or so, Deborah pursued a wonderfully productive independent pathway which uncovered the critical evidence for autoimmunity in insulin-dependent diabetes mellitus, and the existence of thyroid growth-promoting and -inhibitory antibodies. The care she had for the patients in her Thyroid Clinic and her awareness of the diagnostic value of the antibodies in these autoimmune diseases were driving forces behind the initial establishment of a diagnostic Clinical Immunology Routine Service, now provided by virtually all major pathology laboratories. She received numerous awards including the 1957 Van Meter Prize of the American Goitre Association, the 1964 Gairdner Award Toronto (both jointly) and in 1967 the Prize of the British Postgraduate Federation; she was elected ‘Woman Scientist of the Year’ in 1984 by the Association of American Women Scientists.
Deborah retired in her mid-70’s but never lost her enthusiasm for reading about science. Indeed, she was enthusiastic not just about science but also, as a true scholar, the pursuit of knowledge for its own sake. She would take subjects like the works of Shakespeare, Byron, Freud, Molière and at the end, Spinoza and delve deeply into each of them with an academic relish that it would behoove many of us and our students to emulate. Her many talents included fluency in several languages and an accomplished soprano voice. She loved the arts but could not abide sports, and found her delightful husband’s interest in football on TV utterly incomprehensible. Deborah was a warm and friendly person, open always to new ideas and always willing to help young research workers and clinicians. Her extraordinary zest for life was inspiring and guaranteed that never a dull moment would be had in her company. As the saying goes, she will be a hard act to follow.
Tragically, her daughter died at the age of 20 and she sorely missed her husband who passed away in 2001. She is survived by her two sisters, Miriam Bendor and Maia Helles, her son, Sebastian, a Professor of Physics at Stanford University, California, five grandchildren and seven great-grandchildren.
Professor Ivan M. Roitt, FRS
University College London