Obituaries

Gian Franco Bottazzo

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5120 (Published 06 November 2017) Cite this as: BMJ 2017;359:j5120
  1. Ned Stafford
  1. Hamburg
  1. ns{at}europefn.de

Pioneering researcher into type 1 diabetes and legendary lecturer

In 1969, at the age of 23, Gian Franco Bottazzo—a medical student at the University of Padua in Italy—travelled to London on a quest for knowledge. The young Italian was fascinated by immunology and spent countless hours in a university laboratory. To advance in the specialism, he wanted to learn the latest laboratory techniques.

In London, Bottazzo visited Middlesex Hospital and appeared before Deborah Doniach, an acclaimed researcher of autoimmune diseases (read obituary: http://www.bmj.com/content/328/7435/351.1), who had not met the charming young man before.

“I would like to learn immunopathology,” Bottazzo said.

With no hesitation, the world famous researcher replied: “Come tomorrow morning, nine o’clock.”1

After learning the techniques used in Doniach’s laboratory, Bottazzo went back to Padua to finish his medical studies. He returned to London in the autumn of 1973 to work with Doniach as a research fellow in the department of immunology at Middlesex Hospital.

Landmark discovery

A year later Bottazzo was the lead author, and Doniach a co-author, of a landmark paper published in the Lancet, which showed for the first time that type 1 diabetes is associated with the development of antibodies directed against insulin producing β cells.2 In simpler terms, Bottazzo showed that type 1 diabetes was an autoimmune disease.

The paper, according to PubMed, was only the second in Bottazzo’s research career and his first in English. In 1972 he had published a paper in an Italian journal.3

The discovery shown in Bottazzo’s study opened the door for countless investigations of autoimmunity as a basic cause of failure not only of islet cells of the pancreas, leading to type 1 diabetes mellitus, but also the loss of other endocrine producing cells, such as those in the thyroid and pituitary glands.

Bottazzo, who remained based in London until 1998, was the author in following years of numerous other important papers, including in The BMJ,4567891011 earning international recognition as one of the pre-eminent experts in autoimmune diseases, particularly diabetes. Outside the laboratory, Bottazzo was known—and loved—for his charismatic and often controversial personality, which livened up many scientific meetings and inevitably triggered debates.

“He challenged everyone and was quite aggressive. And he attacked everyone—including me—if he didn’t agree with them,” says David Leslie, professor of diabetes and autoimmunity at the Blizard Institute of Barts and the London School of Medicine and Dentistry. “He was lively, fun, intelligent, and enthusiastic.”

“Homicide or suicide?”

With his lively personality, Bottazzo was an extraordinary orator with an actor’s sense of the dramatic. He dazzled audience members during a lecture at Oxford University in March 1985, when he was honoured with the RD Lawrence lecture award of the British Diabetic Association (now Diabetes UK). The title of the lecture was Death of a Beta Cell: Homicide or Suicide?12

“He constructed the talk as a courtroom in which he served as the prosecutor and as the counsel for the defense,” recalls Leslie, who was in attendance. “On trial were the immune system (homicide) and the beta cell (suicide). It suited his personality and sense of drama. The presentation was so unusual and so brilliant that he had a standing ovation, the like of which you rarely see.”

Bottazzo repeated the lecture later the same year at the XII Congress of the International Diabetes Federation in Madrid. In 2011 some 11 diabetes experts in the US published a paper in the journal Diabetes that largely focused on the conceptualisations presented 26 years before by Bottazzo.13

Lorenzo Piemonti, director of the San Raffaele Diabetes Research Institute in Milan, told The BMJ that, as a researcher, Bottazzo was “innovative” and a “counter-current thinker,” who was always in search of truth. As a personality he was histrionic and irrepressible, Piemonti says, and as a friend, mentor, or colleague he was “lovingly available.”

“He was able to question everything based on the evidence,” says Piemonti. “His attitude was to put out many new ideas and then question these on the basis of the evidence. He always led this challenging vision to every table he attended, creating vivid discussions and debates.”

Early life and career

Bottazzo was born in Venice. As a teenager he loved to play football, recalls Corrado Betterle, a lifelong friend who grew up in the same neighbourhood as Bottazzo and is now a professor of clinical immunology at the University of Padua. Betterle says Bottazzo came close to joining Venezia FC, which at the time was playing in Italy’s top league Serie A. “He wisely decided to continue his studies instead,” says Betterle.

When a major earthquake struck Sicily in 1968 killing more than 200 people and leaving thousands homeless, Bottazzo, a medical student, organised an expedition to help care for survivors. “He was a very generous person and capable of great friendships,” says Betterle, who also studied medicine at Padua. “His home and his lab were open to everyone.”

Bottazzo was mentored at Padua by Mario Austoni, an internist who encouraged Bottazzo in 1969 to travel to London for the meeting with Deborah Doniach.

Bottazzo, says Betterle, was the driving force behind laboratory research that resulted in the landmark 1974 paper. “That was his idea and he was fascinated by immunology, at that time in its infancy. He thought that by entering in this area of biology and medicine, the research on diabetes would change the paradigm.”

In 1977 Bottazzo was appointed lecturer in clinical immunology at Middlesex Hospital. The next year he began a fruitful collaboration with Andrew Gordon Cudworth of St Bartholomew’s Hospital Medical College in London and founder of the Bart’s-Windsor Family Study of diabetes. Their first joint paper was published in 1978 in The BMJ14 and was followed during the next five years by 16 additional joint papers, mostly focusing on human leucocyte antigen (HLA) research, including a key 1981 paper in the Lancet.15

Bottazzo’s most important HLA papers independent of Cudworth include two that were published simultaneously in the Lancet in 1983 and another in the New England Journal of Medicine in 1985.161718

Bottazzo was promoted to senior lecturer at Middlesex in 1980 and received an appointment as reader in clinical immunology in 1984. In 1991 he moved to what was then the London Hospital Medical College as professor and chair of the department of immunology. He also served as honorary consultant at the Middlesex Hospital Medical School from 1980 to 1991, and at the Royal London Hospital from 1991 to 1998.

He returned to Italy in 1998 as scientific director of the Bambino Gesù Children’s Hospital in Rome. However, he retained a London apartment and served as scientific director of the Autoimmune Diseases Charitable Trust in London from 1992 to 2002.

Bottazzo was author of nearly 350 research papers and more than 200 reviews and book chapters during his career. His list of honours is long and includes the Minkowski prize of the European Association for the Study of Diabetes, the King Faisal international prize for medicine, and the Banting medal for scientific achievement award of the American Diabetes Association.

“Gian Franco was intelligent, brilliant, original, and lively—as some Venetian people are,” says Antonio Toniolo, a doctor and research microbiologist at the University of Insubria in Italy. “I hope the name of Gian Franco Bottazzo will be long remembered, as he deserves.”

Bottazzo leaves his wife, Lamya, a native of Kuwait, whom he met in London when she was a young immunologist; and a daughter, Dana.

Gian Franco Bottazzo (b 1946; q University of Padua, Italy, 1971), died after a short illness in his hometown of Venice on 15 September 2017

References

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