Deborah Doniach (Abileah)
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About Deborah Doniach
Obituary Deborah Doniach
Outstanding pioneer of auto-immunology research
Jonathan Brostoff The Guardian, Thursday 15 January 2004 04.44 EST Article history
Deborah Doniach, who has died aged 91, was an outstanding clinical immunologist and pioneer in the field of auto-immune disease. Professor of clinical immunology in the mid-1970s at the Middlesex Hospital, she helped to establish new concepts in immunology that provided the stimulus for the understanding of auto-immune disease, where the patient's immune system damages their own tissues.
Doniach was born in Geneva, the oldest of three daughters in a bohemian household, and brought up in Paris where she was educated at the Lycee Moliére. Her father, Joseph Niswitzki, was a concert pianist and accompanist to Josef Szigeti, the violinist. He later became professor of music at the Jerusalem Conservatory. Her mother ran a school of therapeutic movement in Paris. Doniach was educated at the Lycée Molière and later the Sorbonne, where she was a medical student.
She interrupted her studies there in 1933 to marry Sonny Doniach, later professor of pathology at the London Hospital, and moved to London where she enrolled at the Royal Free Medical School. After graduation, she worked in the chemical pathology department and subsequently as an endocrinologist at the Middlesex Hospital. In the 1960s, she joined the newly formed department of immunology, where she became one of the first consultant immunopathologists and then professor of clinical immunology in 1974.
It was the combination of the acute observation of patients and her understanding of chemical pathology that provided a lead to the understanding of auto-immunity. Patients with inflammation of the thyroid, Hashimoto's disease, had raised levels of immune proteins in their blood, which returned to normal after the thyroid was surgically removed. Doniach also noted that the thyroid contained many plasma cells that produce the serum proteins - antibodies - that normally protect against infection. She made the imaginative jump that, in this situation, the antibodies were not directed against external microbes, as was expected, but against the thyroid gland itself.
At the same time, Ivan Roitt and Peter Campbell, also at the Middlesex, were working on the possibility that auto-immune reactions to milk may be protective against certain breast tumours. The two groups formulated the hypothesis that the body was making an immunological response to normal thyroid components, and this was confirmed when they showed that the serum from the patients reacted with extracts of normal thyroid gland.
These were startling ideas, of great importance in challenging some of the views of homeostasis of the body, and generated a new concept - organ-specific auto-immunity. The Lancet published, in 1956, the preliminary communication within a week of receipt.
The collaboration between Doniach and Roitt was very productive. The team worked out which of the components of the thyroid gland stimulated the immune response leading to the disease. They went on to show the immunological mechanism that damaged the stomach in pernicious anaemia.
Doniach continued her research and showed the central role for auto-immune reactions in other organs such as the liver (primary biliary cirrhosis) and pancreas (type 1 diabetes). The care she had for patients and her awareness of the value of auto-antibody tests were the driving force for the establishment of the diagnostic clinical immunology routine service now provided by most major pathology laboratories.
She received numerous awards, including the 1957 Van Meter prize of the American Goitre Association, the 1964 Gairdner Award Toronto (both jointly) and in 1967 the prize of the British Postgraduate Federation.
One of Deborah's greatest gifts was a lifelong interest in everyone and everything, but above all, her science. At any scientific lecture, she would maintain a running - and not always sotto voce - commentary on the topic (from her place in the auditorium). She was the most generous hostess - Sunday lunches at the Darlings, her country cottage in Hertfordshire, where she indulged her passion for gardening, were always memorable events. Her laughter would light up any gathering.
In retirement, she kept up with all advances in her area of science, writing her last immunological review in 2000. She would tackle new subjects for the pleasure of learning. She reread the whole of Proust, and studied Spinoza, Freud and Molière. She was fluent in many languages and an accomplished singer.
She is survived by her son Sebastian, a professor of physics at Stanford University. Her husband died in 2001; a daughter predeceased her.
· Deborah Doniach, doctor, born April 6 1912; died January 1 2004