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Interview with Dr. Edward P. Gelmann
This is an oral history interview with Dr. Edward P. Gelmann, formerly of the National Cancer Institute, and now professor of medicine and oncology at the Georgetown University School of Medicine. The interview was conducted on 1 May 1990 in Dr. Gelmann's office at the Lombardi Cancer Center. The interviewers are Dr. Victoria Harden, Director, NIH Historical Office, and Dennis Rodrigues, Program Analyst.
Rodrigues: Why did you decide to pursue a career in medicine?
Gelmann: That goes back considerably before AIDS. I was raised in a medical household and was exposed to discussions about patients every day. It was just something that I was brought up in the midst of and it was very natural to me. I suppose along the way I had questioned it and had thought about doing science exclusively, but when it came right down to it I never deviated from the goal of going to medical school. I trained in a scientists' training program. I was introduced to retroviruses when I was in medical school, working with [Dr.] Henry Kaplan, who has since died, but who is the father of radiation treatment for Hodgkin's disease and also is the founder of one of the original murine leukemia viruses.
Rodrigues: What medical school was that?
Gelmann: At Stanford University.
Rodrigues: So retroviruses were an interest of yours very early on? Was that after you received your degree or during your studies?
Gelmann: During the years of getting my M.D. I spent three and a half years in medical school working in Kaplan's laboratory and published several papers, and that is when I got interested in retroviruses. I committed myself to go to the NIH when [Dr. Robert] Bob Gallo came out to give a seminar. We were working with mouse viruses, and he was talking about a human virus that at the time was thought to be HL23V, but turned out subsequently to be a contaminant and not a human virus. What impressed me was the fervor with which he described the topic and went after it. I decided that I wanted to go to the NIH, after my house staff training, to work on human retroviruses.
Harden: So you came to the NIH right out of medical school?
Gelmann: No. I applied right out of medical school, but first did my house staff training and then went to the NIH to finish my clinical training. After I finished a year of clinical training in the Medicine Branch, I went to Gallo's laboratory in 1979.
Harden: What were you working on when you first got there?
Gelmann: Most of my work was with different viral and human oncogenes. I was one of the first people to get involved in gene cloning in Gallo's laboratory. In those days, it was not as simple and store-bought a technique as it is today. There were a number of technical hurdles that had to be overcome. I had done, from previous research experience, a substantial amount of work with bacteria. Since you had to know how to deal with prokaryotic systems, I got involved in setting up gene cloning. Once we succeeded in getting the techniques to work, we began to clone different animal tumor virus genes. From the animal tumor viruses, we obtained oncogenes and used the oncogenes as probes. We cloned a number of human proto-oncogenes and we published a number of papers in that area.
That was just about the time when [Dr. Bernard] Poiesz and [Dr. Francis] Ruscetti had identified and isolated HTLV-I [Human T-cell Leukemia Virus, type one]. The reagents from that work were being spread around the laboratory for other people to take on different aspects of it. We were supplied with virus particles and nucleic acid to try to clone a piece of HTLV-I. Because of our success with the animal viruses, we were provided with the material to try to isolate that. But I was never successful at that. A postdoctoral fellow named [Dr. Vittorio] Manzari finally cloned a small piece of the cDNA of HTLV-I. But that was only after the Japanese had cloned the whole thing and had sequenced it. It was a technical tour de force. That was [Dr. Mitsuyaki] Yoshida and a graduate student doing his postdoctoral work, [Dr.] Motoharu Seiki.
Harden: This explains why your interests seem to span a number of fields–virology, genetics, and oncology. So you had been investigating a number of fields in terms of bringing it all together.
Gelmann: When I went to Bob's laboratory as a postdoctoral fellow that was what I was told to do, so I started doing it.
Rodrigues: In 1979, you started working in Gallo's laboratory. The first CDC [Centers for Disease Control] reports [relating to AIDS] came out in mid-1981. Were you aware of those reports?
Gelmann: Yes, we were aware of the reports. There were these whisperings about the strange patients who appeared to have Pneumocystis [carinii] pneumonia, and, of course, we knew what that was, as well as having Kaposi's sarcoma. This was mentioned and some discussions were held. Very early on, Gallo, to his credit, seized upon this as a human analogy for the immunodeficiency induced by feline leukemia virus. He felt that the agent would be a retrovirus. That is rarely quoted and rarely cited, but in informal discussions in the halls and in laboratory meetings, he was very keen on this idea. It was because of its similarity with the feline leukemia virus. We did not know at the time that there would be a monkey model as well–the simian immunodeficiency virus was not yet discovered. That whole topic developed more or less simultaneously with AIDS and was done by the people at the New England Regional Primate Center.
Rodrigues: Some of the people we have talked to characterized their first reaction to AIDS as being a problem that was probably something unique to the gay population and related somehow to their lifestyle. They thought that because of that it would probably be a transient, localized problem as opposed to something that would eventually turn out to be a global problem. Different people seemed to change their perspective on this at different points in time. Some people saw the implications very early on, and other people were a bit more conservative about the implications of this new problem. In your first exposure to this problem, did you hold more with the former view or did you think it could possibly be an infectious agent?
Gelmann: I thought that we were just seeing the tip of the iceberg. My views on that came from the initial CDC information on the demographics and the characterization of those patients, when there were about a hundred patients or so. The epidemiologists were very interested in their sexual practices. The patients were largely homosexual and there was a use of nitrites. There were sexual practices that facilitated transmission. Basically, there were very few common denominators except for the fact that the very first patients were among the most promiscuous, having many sexual contacts in a day. It calculated out to more than a thousand a year. If you wanted to spread a new virus, a group within the gay population was the most fertile environment at that time. It was like getting a thousand blood transfusions in a year. It was apparent that this was just a group of people whose behavior facilitated transmission of a rare agent among many of them.
Harden: Did you think of it as a new agent–something that had not been around or was it just an unknown?
Gelmann: Certainly not in the Western world. The fact that, all of a sudden, young men started walking into emergency rooms with Pneumocystis pneumonia was not subtle. It appears now from studies that this had been going on in Africa for some time. But, yes, I think in the Western hemisphere, most of us were convinced that something had changed; that there was something new to contend with.
Harden: How did you feel about the assumption that it might be a retrovirus? Did that sound reasonable?
Gelmann: Yes. Actually, it appeared somewhere in the literature very early on. Bob and I speculated about that and I was one of the people who tried to get involved with that research very early. The way we did it, since the only handle that we had into human retroviruses, was by looking for viruses that were similar to the known one–HTLV-I. My work with HIV [Human Immunodeficiency Virus] was not even known then. But with the AIDS question, when I was in Gallo's laboratory, everyone was doing molecular studies trying to identify viruses, in infected and non-infected tissues, that were similar to HTLV-I. That did not succeed and I left the Gallo laboratory about a year before HIV was discovered, after [Dr. Luc] Montagnier had published the initial description in Science in parallel with the papers from the Gallo laboratory.
Rodrigues: I noticed that you gave a talk in April of 1983. It was at the first workshop that NIAID [National Institute of Allergy and Infectious Diseases] put on. The talk was titled “Search for the Etiologic Agent.” I think Gallo was originally scheduled to talk, but apparently you stood in for him. I do not know if you recall that particular workshop.
Gelmann: I gave several talks presenting some of our molecular data and one talk that was a little more speculative. But one, I think, was up at NYU [ New York University ], one was at the Masur Auditorium [at NIH], and one was at Cold Spring Harbor. I actually got to talk several times in public about it. I do not know exactly which one you are referring to, but I did give several talks on the subject.
Rodrigues: It was a meeting that Dr. Albert Sabin attended.
Gelmann: I do not remember. I know what Albert Sabin looks like; I just do not remember the specific meeting.
Rodrigues: Of those various meetings were there any that stood out in your mind as being particularly stimulating or provocative, helping people move in the right direction?
Gelmann: In those days they all were, because everything was so new. Every time you had a meeting the epidemiologists told you what was new about the next hundred patients. That is where all the real data and all the hints were coming from. No one really knew what the virology meant, if anything, at the time. Also, [Dr. Myron] Max Essex's people had been doing a bunch of serology with HTLV-I reagents and had come up with a number of positives.
The other group that I remember, with whom I actually collaborated, although we never published any papers, was the people at the New England Regional Primate Center. We heard about these macaques that had developed lymphomas and immunodeficiency that was apparently transmitted to other members of the colony. I visited up there, gave a seminar, and talked with [Dr. Ronald] Ron Desrosiers and [Dr. Norman] Norm Letvin, both of whom subsequently were involved in the isolation, identification and cloning of SIV [Simian Immunodeficiency retrovirus]. That seemed, at the time, to have great excitement and potential. Once again, we took samples from those monkeys and screened them with probes that were related to HTLV-I to see if there was any material that could be found that related to the human virus in the monkey samples.
Rodrigues: Something that varies from place to place, from individual to individual, is the process by which people began to move in the direction of doing AIDS research as opposed to something else. Some individuals said that they were not working on anything else at that moment and that AIDS seemed like an interesting problem. Other people said that it fitted in and dove-tailed exactly with where their research was going, so it was a natural extension. Some described it as a process in which someone galvanizes other people and begins to direct others to attack different pieces of the problem. How would you describe the process in Dr. Gallo's laboratory?
Gelmann: I hesitate to say what went on in Dr. Gallo's laboratory. I cannot represent what went on there or the general procedures.
Rodrigues: Just your perspective.
Gelmann: It was an interesting problem. It had to do with humans and T-cells. We had reagents that were relevant. It was a fascinating issue. It was something new and different, and there was always a tremendous support and enthusiasm in that laboratory to look into what was new and different, as long as it was related to human viruses and cancer. So we had some unique reagents to deal with that and an interesting problem. It was just a matter of trying to get specimens, which eventually began to come into the laboratory in 1982 and 1983, and then of working with them. Also, I went out and sought blood samples from hemophiliacs from a hemophilia clinic, because it had become evident from [Dr. James] Jim Goedert and others, that hemophiliacs were receiving the infection in their blood products.
Harden: You have talked about giving these names to the CDC. Can you comment on the interagency cooperation, or lack thereof, among the CDC, NCI, and NIAID and any other groups?
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