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Tales from a career in medical research | Higher Education Network

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Category: Education
Published on Wednesday, 11 April 2012 Written by Super User
lincolnshire

Stephen Holgate's story begins in a small village in Lincolnshire. Photograph: John Leslie/Alamy

A few weeks ago I received an email notifying me that I was now the oldest clinical academic in the Faculty of Medicine in Southampton. This came as a surprise because, arriving at this new institution two years after its beginning 40 years ago seems like yesterday. Having been trained at Charing Cross Hospital Medical School and completing my early postgraduate career in London, going to a newly established medical school seemed an exciting option. At my interview at Charing Cross, I was asked if anyone in my family was a doctor. My mother told me that we did have a distant relative, Christopher Addison. Neither my mother nor I knew much about him except that he was the middle child of a large family from Hogsthorpe in Lincolnshire. I subsequently found out that Dr Addison was an anatomy lecturer at Charing Cross Medical School in 1901 then, after entering politics to became the first minister of health under Lloyd George in 1919, helped establish the Medical Research Committee (renamed Council, MRC) in 1913. I am sure, however that none of this had anything to do with my being accepted to study medicine at Charing Cross! Like many of my peers I received my medical education in what was then the standard curriculum – two years of anatomy, physiology and biochemistry followed by three year of clinical attachments to medical 'firms' as an apprentice. This worked well for a small medical school of only 40 to 50 students per year.

Since the historical epicentre for medicine was London, why did I move to Southampton? A particularly attractive feature was the opportunity of starting some research while finishing my general medical training in Salisbury, and continuing this in a new medical school. Southampton was one of three new medical schools established in 1971 along with Nottingham and Leicester. My first recollections were at my registrar interview which took place on a cold foggy November day and I had influenza: not the best conditions for answering challenging questions. When one of the consultants from Salisbury asked me if I was mentally stable, I thought I was doomed. But this was not so. My early days at Southampton were at the 'Western', an old infectious disease and TB hospital. From there, I moved to the main Southampton General Hospital, then a 19th Century hospital with long Nightingale-style wards. However change was happening rapidly. The first new ward block was opened in 1974 and we moved in with a great sense of optimism.

I was a university clinical lecturer working for the Foundation Professor of Medicine, Jack Howell who also had a major interest in asthma. The medical curriculum in was unique being modelled on that at McMaster University in Canada. Students were taught medicine in 'Systems Courses' where different disciplines were taught in the context of disease and, importantly had early patient contact. Such a curriculum was considered by many in the medical establishment as highly experimental, but its successes were soon built into new GMC guidance on medical education. My role was to organise and teach the respiratory systems course which was a most stimulating experience, as well as forcing me to understand how the lungs worked since I never really understood this as a student.

My research interests in asthma were encouraged and, with an MRC Fellowship, I moved to Boston, USA, to acquire new research skills at Harvard Medical School where K Frank Austen and colleagues were discovering new mechanisms of allergy and asthma. This was a totally liberating experience. My return to Southampton in 1980 was the real start of a lifetime in research. We set about uncovering asthma mechanisms and new ways of treating the disease. Funding was hard to come by but we did win some grant support from the MRC enabling me to eventually secure four year MRC programme support.

A key to enabling me to build a successful research career was the tremendous facilitatory atmosphere created by this new medical school; the pervading atmosphere was one of encouragement and excitement. The ability to recruit bright young researchers from both the UK and from over 30 different countries was hugely catalytic each one contributing something unique to our research endeavour. The award of an MRC Clinical Professorship in 1987 enabled me to concentrate on research and to receive continuous MRC grant support.

However, there were times when grant support was hard to find. Such an occasion occurred when my research was moving away from studying asthmatic inflammation towards understanding how asthma begins and why sudden severe attacks occur. With help of a local research charity that I established (AAIR), and the newly formed British Lung Foundation involving a visit by Diana, the Princess of Wales, we developed new diagnostic technology to show that attacks of asthma were mostly triggered by the common cold virus (rhinovirus). This turned out to be a real breakthrough because, up until this time, asthma had only been regarded as an allergic disorder. After uncovering the mechanisms involved in 2003, we established a university spin out company, Synairgen, to develop new treatments for viral-induced asthma and are soon to hear the results of our first clinical trial!

Another high I recall is coming in one Monday to find that over the weekend one of my overseas research fellows had safely obtained asthmatic biopsies using the newly developed fibre optic bronchoscope and for the first time showed that even mild asthma was caused by inflammation. The discovery of the first novel asthma gene (ADAM33) in 2001, in collaboration with US colleagues, was another thrilling moment. We now know that this gene contributes to the characteristic structural abnormalities in chronic asthma.

I can honestly say that there were very few "lows". What are the factors that have helped me on this exciting research and academic journey? Undoubtedly the ability of being able to do research in Southampton with patients at the centre of discovery, the pleasure of working with so many talented and committed bright individuals from all over the world and the enormous encouragement I have always been given by colleagues. The University of Southampton's Faculty of Medicine is now up there with the best in the country and it has been a privilege to help create some of the foundations for this.

Professor Stephen Holgate is the MRC Professor of Immunopharmacology at the University of Southampton and honorary consultant physician at Southampton University Hospitals Trust.

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