Haralampos Moutsopoulos
Professor Haralampos M. Moutsopoulos received his MD and PhD degrees, both with honors, from the National University of Athens (1968, 1971). He was trained in Internal Medicine (1972-1974; Georgetown University, Washington, DC) and in Rheumatology/Immunology (1974-1976; University of California San Francisco). He worked at the National Institutes of Health (NIH), Bethesda, Maryland, USA (1976-1980) and was appointed Clinical Associate Professor of Medicine at Georgetown University Medical School (1977). He is Fellow of the American College of Physicians and the American College of Rheumatology (ACR).
In 1980, he was elected Professor of Internal Medicine at the University of Ioannina, Greece, where he served until 1993. During this period, he also served as Expert Clinical Consultant at the NIH (1980-1985), and as visiting Professor of Immunology at the University Hospital of Brest, France (1989-1990). In 1993, he was elected Professor and appointed Chairman of the Department of Pathophysiology at the National University of Athens and Head of its associated Department of Internal Medicine, academic posts that he holds until now.
In addition to his duties as a physician, Professor Moutsopoulos was actively and extensively involved in forefront clinical research making significant contributions.
In the early years of his research using animal models, he worked out the details of autoimmune systemic rheumatic disorders (ASRD). He showed the significant role of B-lymphocytes in the pathogenesis of ASRD and demonstrated that the elimination of the activated B-lymphocytes may contribute to the therapy of these disorders.
Dr. Moutsopoulos showed that, in the autoimmune disorder Sjogren’s syndrome, which has the tendency to evolve to lymphoid neoplasia, monoclonal and polyclonal B-lymphocyte activation coexists in patients who will develop neoplasia. His group was the first to discover that interferon-a, an antiviral agent, circulates in the blood of patients with active systemic lupus erythematosus. This finding strongly implied a viral etiology for ASRD. Recently, the interferon pathway has become a subject of intense research worldwide. Furthermore, Dr. Moutsopoulos through his bedside work showed that patients who underwent allogeneic bone marrow transplantation and suffer from chronic graft versus host disease develop autoimmune disorders like scleroderma, Sjogren’s syndrome and primary billiary cirrhosis. Subsequently, he reported clinical, serologic and genetic differences among patients suffering from Sjogren’s syndrome alone and patients with Sjogren’s syndrome associated with rheumatoid arthritis. He coined the term primary Sjogren’s syndrome for the former group of patients and secondary Sjogren’s syndrome for the latter group.
During the following thirty years Dr. Moutsopoulos concentrated his research on the clinical expression of Sjogren’s syndrome, systemic lupus erythematosus, antiphospholipid syndrome, and vasculitis in different organs. He also studied in detail the clinical, serologic and immunogenetic similarities and differences among patients with primary Sjogren’s syndrome or Sjogren’s syndrome associated with other autoimmune disorders, as well as the high incidence for lymphoma development and the clinical and histologic picture of B-lymphocyte lymphoma in these patients. Evaluating large number of patients with primary Sjogren’s syndrome, it was shown that simple clinical and laboratory manifestations, like parotid gland enlargement, palpable purpura, leucopenia, low C4 complement levels and cryoglobulinemia, at the first patient visit constitute strong risk factors for lymphoma development. The identification of these factors enables clinicians to intervene therapeutically early and improve the quality of life and survival. Finally, he described in detail for the first time the clinical, serologic and histopathologic manifestations of lymphoma in patients with Sjogren’s syndrome and demonstrated that combination of chemotherapy with B lymphocyte depletion therapy is life saving for this disorder.
Using primary Sjogren’s syndrome biologic material (sera and tissues) his laboratory work elucidated disease pathogenesis and discovered major targets for initiating novel therapeutic interventions. Evaluating the immunopathologic lesion of these patients he dissected the role of the epithelial cells that are attacked by autoreactive lymphocytes in the initiation and perpetuation of the autoimmune process. His studies showed that the epithelial cells of the affected exocrine glands are inappropriately activated and play a significant role in the initiation and perpetuation of autoimmune reactivity. Following these findings, he showed that the epithelial cells of autoimmune patients host enteroviral (coxsakie virus) DNA sequences, which are probably responsible for the epithelial cell activation that makes them appear as “foreign”. As a consequence, their attack by the immune system results in an autoimmune lesion. On the basis of these findings and clinicopathological observations, he proposed the now widely accepted term “autoimmune epithelitis” for Sjogren’s syndrome.
Finally, he studied and characterized the cellular epitopes of autoantigens of B and T lymphocytes and their role in the understanding of autoimmunity. Using as tools defined epitopes, he evaluated the complementary epitopes of autoantigens, particularly of the La (SSB) autoantigen. It was demonstrated that the development of autoantibodies follows the rules of idiotype-antiidiotype response. Using this approach he was able to discover mothers with autoantibodies to La autoantigen at risk to deliver children with neonatal lupus. The mothers at risk are those without antiidiotypic antibodies to La autoantigen. This fundamental finding provided a resolution to the etiology and therapy of neonatal lupus.
His original scientific work placed him as the major investigator of Sjogren’s syndrome worldwide. His peer-reviewed publications exceed 400. In addition, he has authored over 200 book chapters, editorials and review papers. His work is highly acknowledged (over 15000 citations, h factor over 60). As a result of his scientific contributions he was invited as a Visiting Professor to deliver lectures related to his research by many medical schools in the USA, Europe, Japan, China and Australia, and in scientific meetings in Europe, the USA, South America and Asia. He serves on the editorial boards of many rheumatology, internal medicine and immunology journals and he has been a reviewer for over 30 journals.
He was the president of the Scientific Committee of the European League Against Rheumatism (EULAR) Congress (1987) and organized two European Workshops for Rheumatology Research - one in 1988 in Corfu, Greece, and the other in 1998 in Athens, Greece. He also organized the III International Symposium on Sjogren’s Syndrome in 1991 in Ioannina, Greece, and the VII Mediterranean Congress of Rheumatology, 1994, the 5th European Conference on Systemic Lupus Erythematosus in 2002 and the Autoimmune Rheumatic Disease Days in 2004, all three in Athens, Greece. He has conducted “Meet the Professor” sessions for the American College of Rheumatology and served as president of the study group and chairman of the abstract selection committee for Sjögren’s syndrome for ACR and EULAR.
For his scientific contributions he has been awarded the “Alessandro Robecchi” Prize for Rheumatology Research (1987); the European-Australian award for Medical Research (1993); the Hellenic Society of Immunology award (2001); Honorary Membership of the Turkish Society for Research and Education in Rheumatology (2004); the “Xanthopoulos-Pneumatikos” Prize for Excellence in University Teaching (2005); Honorary Fellowships from the British Society of Rheumatology (2006) and the Royal College of Medicine (Edinburgh 1993 and London 2006); the “Distinguished Scholar Clinician Award” by ACR (2006); the “Charles Von Pirquet” award for distinction in Medicine and Immunology (April 2007) by the University of California, Davis; the Gold Cross of St. Andreas by the Greek Orthodox Archdiocese of Australia for international contributions to the advancement of medical science (2007); and Hippocratic Orator from the Hellenic Medical Society, London, U.K. (2008). Professor Moutsopoulos was made Master of the American College of Rheumatology (2009) for his outstanding contributions to the field of rheumatology through scholarly achievement and/or service to his patients, students, and profession; and was awarded the EULAR Meritorious Service Award (2010) for his outstanding services to rheumatology. The University of Ioannina bestowed upon him the title of Professor honoris causa (2010) for his contribution to medical science in general and more specific for his teaching, research and service to the patient.
In Greece, in addition to his academic duties, he served as a member or chairman of Biology and Biotechnology Committees of the Hellenic Secretariat for Research and Technology, president of National Organization for Medicines (1999 – 2000), member of the European Research Council for the “Ideas Programme”, chairman of the Scientific Committee, Research Center of Biomedical Sciences “A. Fleming”, and member of the scientific committee of the Hellenic Institut Pasteur.
Finally, Dr Moutsopoulos has written articles for the public, in major Greek newspapers related to autoimmune diseases, to problems of the Greek National Health System, and the Greek Universities. He has also written three books for the public, “Ideas for Deaf Ears” (Livanis Publishers, first edition, 2007, second edition, 2009, Athens, Greece), “Τhe Route to Knowledge” (Hestia Publishers, 2009, Athens, Greece) and “Encyclopaedia for Autoimmune Diseases” (Kapon Publishers, first edition, 2005, second edition, 2007 and third edition, 2010, Athens, Greece).
