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Thomas Herald Rea
Courtesy of University of Southern California
Obituary
Thomas Herald Rea Dermatologist and renowned leprologist. Born in Three Rivers, MI, USA, on May 12, 1929, he died of cancer in La Cañada Flintridge, CA, USA, on Feb 7, 2016, aged 86 years. In September, 1997, a US Food and Drug Administration scientific advisory committee recommended that thalidomide, a drug never previously approved for use in the country, should be made available to patients with Hansen’s disease (leprosy) for the treatment of erythema nodosum leprosum. Given the drug’s disastrous record as a teratogen this move had faced stiff opposition, not least from within the committee itself. But in the end, by a majority of eight to two, its members came down in thalidomide’s favour. Among those welcoming the decision—indeed he’d long been actively lobbying for it—was Thomas Rea, Clinical Professor of Dermatology at the Keck School of Medicine of the University of Southern Californian (USC) in Los Angeles. His interest was more than that of just any dermatologist dealing with the skin manifestations of leprosy and eager for an agent that could make a difference to patients’ lives. Rea had been researching leprosy for well over 30 years, and collaborated on experimental studies that not only cast light on the activity of the immune system in that particular disease, but on how it operates more generally. With a degree in medicine from the University of Chicago, Rea decided to specialise in dermatology. 1958 found him embarking on a 2-year residency at the University Hospital in Ann Arbor. He then moved to New York, taking up his first academic appointment as an instructor at the 2086
New York University School of Medicine’s Department of Dermatology. It was in 1970 that he crossed to the west coast to join USC, and there he remained, chairing its Section of Dermatology between 1981 and 1996, and becoming a full professor. Rea’s fascination with leprosy began when he was still in New York and had accumulated a number of patients with the disease. “He wondered why it was that the same microorganism could cause such a varied presentation of the disease in different people”, says David Peng, current Chair of the Department of Dermatology at the Keck School of Medicine. He further began to suspect that the variation was due not to differences in the organism but to differences in the host’s response to it. His suspicions proved correct. “In leprosy the clinical manifestations of the disease correlate with the level of the immune response”, says Robert Modlin, Klein Professor of Dermatology and Chief of the Division of Dermatology at the University of California, Los Angeles’s David Geffen School of Medicine. The damage is attributable less to the leprosy mycobacterium than to the zealous activity it may trigger in its host’s immune system. At the time he met Rea, Modlin was still at the start of his research career, and contemplating work on atopic dermatitis. Rea persuaded him that leprosy would be a more fruitful target, partly on the ground that it offered such a good model for studying immunity. The pair went on to publish a series of revealing experimental studies. “We were able to use leprosy as a model to study inflammation”, says Modlin. “We showed that there are different types of T-cell cytokines, and different forms correlate with the immune response.” They were able to look at mechanisms of host defence and tissue damage relevant not only to leprosy but also to other infective and inflammatory diseases. “Tom really understood leprosy, and was committed to it”, says Modlin. He describes Rea as a very quiet man, and can remember only one occasion on which his sometime collaborator became visibly angry. Thinking back to 2003 Peng—then a “brand new” assistant professor of dermatology and about to meet Rea for the first time— recalls being in awe of the great man and his scientific reputation. What he found, he says, was someone down to earth, humble, and as eager to hear from Peng about his modest achievements as he was to talk about his own. “He never thought of himself as everyone else saw him”, says Peng. Rea’s benign influence lives on. Many of today’s USC dermatology staff, according to Peng, still aspire to be like their sometime chairman. And, in recognition of his many contributions, the Los Angeles County Hospital–USC clinic in which Rea continued to work until 2015 has been renamed the Thomas H Rea Hansen’s Disease Clinic. Rea is survived by his wife and two sons.
Geoff Watts www.thelancet.com Vol 387 May 21, 2016
Obituary
Thomas Herald Rea Dermatologist and renowned leprologist. Born in Three Rivers, MI, USA, on May 12, 1929, he died of cancer in La Cañada Flintridge, CA, USA, on Feb 7, 2016, aged 86 years. In September, 1997, a US Food and Drug Administration scientific advisory committee recommended that thalidomide, a drug never previously approved for use in the country, should be made available to patients with Hansen’s disease (leprosy) for the treatment of erythema nodosum leprosum. Given the drug’s disastrous record as a teratogen this move had faced stiff opposition, not least from within the committee itself. But in the end, by a majority of eight to two, its members came down in thalidomide’s favour. Among those welcoming the decision—indeed he’d long been actively lobbying for it—was Thomas Rea, Clinical Professor of Dermatology at the Keck School of Medicine of the University of Southern Californian (USC) in Los Angeles. His interest was more than that of just any dermatologist dealing with the skin manifestations of leprosy and eager for an agent that could make a difference to patients’ lives. Rea had been researching leprosy for well over 30 years, and collaborated on experimental studies that not only cast light on the activity of the immune system in that particular disease, but on how it operates more generally. With a degree in medicine from the University of Chicago, Rea decided to specialise in dermatology. 1958 found him embarking on a 2-year residency at the University Hospital in Ann Arbor. He then moved to New York, taking up his first academic appointment as an instructor at the 2086
New York University School of Medicine’s Department of Dermatology. It was in 1970 that he crossed to the west coast to join USC, and there he remained, chairing its Section of Dermatology between 1981 and 1996, and becoming a full professor. Rea’s fascination with leprosy began when he was still in New York and had accumulated a number of patients with the disease. “He wondered why it was that the same microorganism could cause such a varied presentation of the disease in different people”, says David Peng, current Chair of the Department of Dermatology at the Keck School of Medicine. He further began to suspect that the variation was due not to differences in the organism but to differences in the host’s response to it. His suspicions proved correct. “In leprosy the clinical manifestations of the disease correlate with the level of the immune response”, says Robert Modlin, Klein Professor of Dermatology and Chief of the Division of Dermatology at the University of California, Los Angeles’s David Geffen School of Medicine. The damage is attributable less to the leprosy mycobacterium than to the zealous activity it may trigger in its host’s immune system. At the time he met Rea, Modlin was still at the start of his research career, and contemplating work on atopic dermatitis. Rea persuaded him that leprosy would be a more fruitful target, partly on the ground that it offered such a good model for studying immunity. The pair went on to publish a series of revealing experimental studies. “We were able to use leprosy as a model to study inflammation”, says Modlin. “We showed that there are different types of T-cell cytokines, and different forms correlate with the immune response.” They were able to look at mechanisms of host defence and tissue damage relevant not only to leprosy but also to other infective and inflammatory diseases. “Tom really understood leprosy, and was committed to it”, says Modlin. He describes Rea as a very quiet man, and can remember only one occasion on which his sometime collaborator became visibly angry. Thinking back to 2003 Peng—then a “brand new” assistant professor of dermatology and about to meet Rea for the first time— recalls being in awe of the great man and his scientific reputation. What he found, he says, was someone down to earth, humble, and as eager to hear from Peng about his modest achievements as he was to talk about his own. “He never thought of himself as everyone else saw him”, says Peng. Rea’s benign influence lives on. Many of today’s USC dermatology staff, according to Peng, still aspire to be like their sometime chairman. And, in recognition of his many contributions, the Los Angeles County Hospital–USC clinic in which Rea continued to work until 2015 has been renamed the Thomas H Rea Hansen’s Disease Clinic. Rea is survived by his wife and two sons.
Geoff Watts www.thelancet.com Vol 387 May 21, 2016