Anthony Fauci: Unfinished business  pg. 3

Fauci, class of 1958 and captain of the Regis High School basketball team, dribbles in for a basket against Brooklyn archrival St. Francis Xavier High.
Photo courtesy of the Fauci family
Wolff, who directed the Laboratory of Clinical Investigation at the NIAID, was studying the molecular underpinnings of fever. Some of his patients with persistent or chronic, intermittent fevers had immune deficiencies, while others had vasculitis—blood vessel inflammation caused by a misguided attack by the body’s immune system. Wolff encouraged his fellows to study a group of patients and find a way to treat them.

Fauci chose Wegener’s granulomatosis, a severe form of vasculitis that was nearly always fatal. He recall’s Wolff’s reaction: “Let’s sit down and try to figure out a protocol.”

Upstairs, on the 12th floor of the Clinical Center, Vincent DeVita, M.D., who later became director of the National Cancer Institute, was testing drugs such as prednisone and cyclophosphamide—which suppress the immune system—to treat lymphomas and leukemias.

“We looked at the literature and came up with the idea: What happens if you treat these lethal inflammatory vasculitides with a low dose of these immunosuppressive drugs, not enough to wipe out the bone marrow but enough to suppress the aberrant immune response?” Fauci recalls. “And we did it in the first few patients and, lo and behold, they had a totally dramatic remission in their disease, which was just absolutely extraordinary.

“So then we started admitting a lot more patients, and a lot more, and before you know, we had ended up curing a very, very lethal, albeit uncommon disease.” Fauci went back to Cornell to complete his chief residency in medicine in 1971-72, and after returning to Wolff’s lab the next year, they reported their findings in 18 patients in the journal Medicine.

Wolff, who later became chairman of medicine at Tufts University before his death in 1994, put Fauci in charge of the lab’s vasculitis program. “He launched me in my career,” Fauci says. “I could not possibly have gotten to where I am right now had I not been put into an environment on this campus through the vision of people like Shelly Wolff who used the formula: ‘Give me some smart people who are well trained and cut ’em loose.’”

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