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Geltrude Mingrone: an insatiable curiosity
In Focus
Profile Geltrude Mingrone: an insatiable curiosity It was the week before Christmas when The Lancet Diabetes & Endocrinology caught up with Geltrude Mingrone, but while everyone else seemed to be getting ready for the holidays, for Mingrone the next few weeks would be business as usual. As Head of the Division of Obesity and Metabolic Disorders at Rome’s Catholic University in Italy, Mingrone has been at the “forefront of research into bariatric surgery, insulin resistance, insulin secretion and study of glucose metabolism in humans”, says Jose Manuel Fernandez-Real at the University of Girona in Spain, and to say she’s had to work hard to get where she is would be a spectacular understatement. Born in the tiny town of Rossano near Italy’s Calabrian coast, her family moved to nearby Crotone when she was 2 years old, and she spent the rest of her childhood there. She still brims with the characteristic warmth of the country’s south. An only child, her father was a classics teacher at the local high school, and he wasted no time imparting his encyclopaedic knowledge to his daughter. For her part, Mingrone was child prodigy material: a lightning quick study, she was able to translate from latin to greek and vice versa well before she left for university at just 16 years old. She was always happiest when she was figuring out how the world works, and dreamed of studying physics. Her parents, however, had other ideas, and made it clear that the only subject they could countenance her leaving home for was medicine. Rome appealed to Mingrone’s sense of adventure, and so it was that the entire family upped sticks to the eternal city so that Mingrone could enrol at the Catholic University there. Predictably, she excelled in her studies. “I liked so much to learn new things, and I completed all the exams in 5 years, but I was forced to wait 1 year to complete the 6-year course”, she recalls. At the age of 22 she was the youngest medical graduate in Italy that year. It was 1978, a time of political upheaval in Italy, with the country rocked by regular outbursts of violence from paramilitary groups such as the Prima Linea and Red Brigades. Political turmoil might have seemed a remote concern to a young graduate, but after struggling to find a job that paid the bills at her university, Mingrone came face-to-face with Italy’s revolutionary element after taking a job as a physician in Rome’s jail, working in the wing that housed prisoners linked with political terror groups. It was dangerous work. “A colleague of mine was shot in the head”, she recalls, but it was interesting despite the risks, and it paid well enough to enable her to carry on with her work as a research scientist at the Catholic University. After 3 years of mixing research with prison work she won a National Council of Research competition to train as a researcher in Pisa for 2 years, before returning to Rome and the Catholic University in the mid-1980s as an assistant professor. 110
By this stage Mingrone was board certified in three different specialities. Gastroenterology had been a default choice after she completed her undergraduate training in that department, but it was endocrinology and metabolic diseases in particular that captured her imagination (she also picked up a certification in forensic medicine during her time working in jail). And she wasn’t finished there. Her seemingly insatiable drive for knowledge led to a PhD in clinical pharmacology at the University of Ghent in Belgium, where she thought she could put her French language studies to good use (it turned out that everyone spoke Flemish). She returned to the Catholic University in 1994 as an assistant professor in the Division of Metabolic Disease, and it was there that she began to make serious waves in diabetology. “Mingrone is a member of a stellar group of scientists which includes Francesco Rubino, Phil Schauer, and John Dixon in investigating the mechanisms involved in the almost immediate dramatic remission of type 2 diabetes following surgery to bypass the proximal small intestine”, says Paul Zimmet, of the Baker IDI Heart and Diabetes Institute in Melbourne, Australia. Mingrone’s group has shown that some kinds of bariatric surgery, and biliary pancreatic diversion in particular, probably prevent the secretion of an as-yet unidentified hormone responsible for insulin resistance, and that the remission of type 2 diabetes after surgery is most likely caused by this hormonal mechanism rather than being the result of weight loss. “Now we’ve done proteomics and secretomics in patients before and after bariatric surgery, and we have found at least seven uncharacterised proteins which could be new hormones”, says Mingrone. Characterising those proteins in muscle cells and hepatocytes will be complicated, painstaking work, and Mingrone bemoans the fact that she might have retired by the time it is finished, but that love of figuring out how things work still shines through undimmed by decades at the coalface of research. “One of the most amazing things about working with Geltrude is seeing how such an accomplished physician-scientist with many studies and publications under her belt can still jump in excitement at the slightest hint of a new finding, or spread a contagious enthusiasm for a new paper that gets accepted for publication”, notes Francesco Rubino of Kings’ College London in the UK, and a long-time collaborator with Mingrone. “It is the same energy and genuine passion you would expect from a junior researcher at the first step in his or her career, and that’s quite instructive about what drives her”, he says.
David Holmes www.thelancet.com/diabetes-endocrinology Vol 2 February 2014
Profile Geltrude Mingrone: an insatiable curiosity It was the week before Christmas when The Lancet Diabetes & Endocrinology caught up with Geltrude Mingrone, but while everyone else seemed to be getting ready for the holidays, for Mingrone the next few weeks would be business as usual. As Head of the Division of Obesity and Metabolic Disorders at Rome’s Catholic University in Italy, Mingrone has been at the “forefront of research into bariatric surgery, insulin resistance, insulin secretion and study of glucose metabolism in humans”, says Jose Manuel Fernandez-Real at the University of Girona in Spain, and to say she’s had to work hard to get where she is would be a spectacular understatement. Born in the tiny town of Rossano near Italy’s Calabrian coast, her family moved to nearby Crotone when she was 2 years old, and she spent the rest of her childhood there. She still brims with the characteristic warmth of the country’s south. An only child, her father was a classics teacher at the local high school, and he wasted no time imparting his encyclopaedic knowledge to his daughter. For her part, Mingrone was child prodigy material: a lightning quick study, she was able to translate from latin to greek and vice versa well before she left for university at just 16 years old. She was always happiest when she was figuring out how the world works, and dreamed of studying physics. Her parents, however, had other ideas, and made it clear that the only subject they could countenance her leaving home for was medicine. Rome appealed to Mingrone’s sense of adventure, and so it was that the entire family upped sticks to the eternal city so that Mingrone could enrol at the Catholic University there. Predictably, she excelled in her studies. “I liked so much to learn new things, and I completed all the exams in 5 years, but I was forced to wait 1 year to complete the 6-year course”, she recalls. At the age of 22 she was the youngest medical graduate in Italy that year. It was 1978, a time of political upheaval in Italy, with the country rocked by regular outbursts of violence from paramilitary groups such as the Prima Linea and Red Brigades. Political turmoil might have seemed a remote concern to a young graduate, but after struggling to find a job that paid the bills at her university, Mingrone came face-to-face with Italy’s revolutionary element after taking a job as a physician in Rome’s jail, working in the wing that housed prisoners linked with political terror groups. It was dangerous work. “A colleague of mine was shot in the head”, she recalls, but it was interesting despite the risks, and it paid well enough to enable her to carry on with her work as a research scientist at the Catholic University. After 3 years of mixing research with prison work she won a National Council of Research competition to train as a researcher in Pisa for 2 years, before returning to Rome and the Catholic University in the mid-1980s as an assistant professor. 110
By this stage Mingrone was board certified in three different specialities. Gastroenterology had been a default choice after she completed her undergraduate training in that department, but it was endocrinology and metabolic diseases in particular that captured her imagination (she also picked up a certification in forensic medicine during her time working in jail). And she wasn’t finished there. Her seemingly insatiable drive for knowledge led to a PhD in clinical pharmacology at the University of Ghent in Belgium, where she thought she could put her French language studies to good use (it turned out that everyone spoke Flemish). She returned to the Catholic University in 1994 as an assistant professor in the Division of Metabolic Disease, and it was there that she began to make serious waves in diabetology. “Mingrone is a member of a stellar group of scientists which includes Francesco Rubino, Phil Schauer, and John Dixon in investigating the mechanisms involved in the almost immediate dramatic remission of type 2 diabetes following surgery to bypass the proximal small intestine”, says Paul Zimmet, of the Baker IDI Heart and Diabetes Institute in Melbourne, Australia. Mingrone’s group has shown that some kinds of bariatric surgery, and biliary pancreatic diversion in particular, probably prevent the secretion of an as-yet unidentified hormone responsible for insulin resistance, and that the remission of type 2 diabetes after surgery is most likely caused by this hormonal mechanism rather than being the result of weight loss. “Now we’ve done proteomics and secretomics in patients before and after bariatric surgery, and we have found at least seven uncharacterised proteins which could be new hormones”, says Mingrone. Characterising those proteins in muscle cells and hepatocytes will be complicated, painstaking work, and Mingrone bemoans the fact that she might have retired by the time it is finished, but that love of figuring out how things work still shines through undimmed by decades at the coalface of research. “One of the most amazing things about working with Geltrude is seeing how such an accomplished physician-scientist with many studies and publications under her belt can still jump in excitement at the slightest hint of a new finding, or spread a contagious enthusiasm for a new paper that gets accepted for publication”, notes Francesco Rubino of Kings’ College London in the UK, and a long-time collaborator with Mingrone. “It is the same energy and genuine passion you would expect from a junior researcher at the first step in his or her career, and that’s quite instructive about what drives her”, he says.
David Holmes www.thelancet.com/diabetes-endocrinology Vol 2 February 2014