The work: Rheumatoid arthritis (RA) is a common, chronic, painful and disabling autoimmune disease. Prior to the work of Drs. Feldmann and Maini, the treatment of RA was not based on understanding of which molecules were produced in excess. In the mid-1980’s, the team began work on unravelling which molecules might be the culprit of this disease in hopes of determining which targets would be ideal for treatment. Experiments in the laboratory on cells from joints of patients and in an animal model of RA demonstrated that tumor necrosis factor (TNF), a molecule belonging to the ‘cytokine’ family, was a major driver of inflammation and joint damage. They discovered a monoclonal antibody-based treatment that blocked the action of TNF and was safe and effective for treating in RA. Anti-TNF therapy works in most patients rapidly to reduce pain, improve mobility, reduce work disability, improve social functioning, and, when compared with patients on conventional synthetic drug treatments, reduces the risk of heart attacks, strokes and increases life expectancy. It has a major role in protecting joints from degeneration, thus maintaining good physical function and reducing the need for joint surgery.
The impact: They discovered the first treatment for RA, using monoclonal antibodies which are genetically engineered natural defense molecules. Not only was this a novel treatment, but it was the first demonstration of the efficacy of a biological therapy for a chronic autoimmune disease and led to the recognition by the pharmaceutical industry that biological drugs are a viable class of therapeutic agents that can compete with traditional chemical drugs. The effective results have not only transformed the treatment for patients, but have led to other successful anti-TNF treatments, and encouraged much further work using antibodies for treatment.
Sir Ravinder Maini, born to Indian parents, received his early school education in Uganda and has resided permanently in the UK since 1955. After high school in London, he studied medicine at Cambridge University and Guy's Hospital; London (qualified BA MB BChir 1962). He undertook his postgraduate clinical training and a Fellowship in clinical immunology. Throughout his professional career since 1970 he has combined practice as a Clinician-Scientist in rheumatology and internal medicine with laboratory-based immunological research. From 1990 to 2002 he was Professor and Scientific Director/Head of The Kennedy Institute of Rheumatology, London.
His research has focussed on immunological and inflammatory mechanisms and therapy of autoimmune rheumatic diseases. His ‘bench to bedside’ research, in collaboration with Marc Feldmann which commenced in 1985, resulted in the development of anti-TNF immunotherapy of rheumatoid arthritis. He has been invited as a keynote speaker at International scientific meetings; published over 480 papers in scientific journals; served on the Editorial Board of immunology and rheumatology journals; and is currently Co-Editor in Chief of the open access journal 'Arthritis Research and Therapy'.
Since retirement, he is a Visiting Professor to the Kennedy Institute of Rheumatology at Oxford. He continues to serve as a Consultant and Advisor to the Biotechnology and Pharmaceutical industry and National Grant-Giving Agencies. He serves as a Trustee of Medical Charities, currently a Trustee and President of the Kennedy Trust for Rheumatology Research, UK, and Trustee of The Sir Jules Thorn Trust.
His research contributions have been recognised the awards of a Knighthood (2003) by HM Queen Elizabeth; election to learned scientific societies: he is a Fellow of Royal Society, London (FRS), Fellow of the Academy of Medical Sciences (FMedSci), Foreign Associate Member of the USA Academy of Sciences, Fellow of the Royal Colleges of London and Edinburgh and Honorary Fellow of Sidney Sussex College, Cambridge; honorary Doctorates of the Universities of Glasgow and University Rene Descartes, Paris; Distinguished Investigator Award by the American College of Rheumatology; and Honorary Fellowships of Scientific Societies in the United Kingdom, Europe and Australia.
Following the identification of TNF as a therapeutic target and translation of anti-TNF therapy to the clinic, Professors Maini and Feldmann have been jointly awarded many prizes, notably the Crafoord Prize by The Royal Swedish Academy of Sciences, The Lasker prize for Clinical Research, Dr Paul Jannsen Award for Biomedical Research, Ernst Schering Prize and in 2014, they have been selected as recipients of the Canada Gairdner International Award.