Gian Franco Bottazzo, known to his friends as ‘Franco’, was a pioneering researcher on diabetes and autoimmunity. He was born in Venice in 1946. His parents, Alfredo Bottazzo and Luigia Bottazzo née Calderan, were married in 1945 after Alfredo returned from the Second World War. They had two children: Franco and his sister Tiziana. Being born in such a magical city as Venice left an indelible impression on Franco that lasted his entire life. He completed his ‘liceo classico’ (secondary schooling) in Venice and went to enrol for military service. He was extremely disappointed when he was immediately rejected; due to complications at birth, Franco had lost the use of his left eye, which resulted in him being exempted from military service in all wars, including nuclear wars!
Franco went on to the renowned Padua Medical School, where he had the great fortune of being taught and mentored by Mario Austoni, professor of endocrinology and director of the Institute of Medical Semeiology.
In 1969, during his last year of medical school, Franco worked as an intern at the Institute. Austoni contacted Deborah Doniach [Munk’s Roll, Vol.XI, p.160], then professor of clinical immunology at the Middlesex Hospital Medical School in London, to see if she would take young Franco under her wing for one summer. Austoni even promised to sponsor the trip himself! At that time, Deborah Doniach was collaborating with Ivan Roitt, head of the immunology department, on thyroid autoantibodies. That visit was a turning point in Franco’s career.
The following year, in 1970, he went as a visiting student to the National Institute for Medical Research in Mill Hill, London. At that time immunology was a new and exciting topic for researchers around the world and the UK was a pioneer in the field.
After finishing his specialisation thesis on allergy and clinical immunology from the University of Florence in 1974, Franco returned to the Middlesex Hospital on a British Council research fellowship. He was to stay at the Middlesex until 1989. As it so happened, Deborah’s laboratory stored a trove of sera collected from patients with endocrine diseases. Franco started to screen under the microscope using immunofluorescence techniques and discovered islet cell antibodies (ICA), which changed our understanding of type one diabetes. When the islets were lit up under the microscope they looked like the Venetian islands at night. Showing these slides later on in lectures, Franco would say: ‘Only a Venetian would have been able to discover ICA!’ Following the publication of his discovery, Deborah was quick to point out that it all could have been ‘a stroke of luck’! Franco continued to discover new autoantibodies against various cells in a range of organs and the terms ‘polyendocrine/organ-specific’ and ‘non organ-specific’ became the norm.
Another key moment in Franco’s career came during his collaboration with Andrew Cudworth [Munk’s Roll, Vol.VII, p.129] and Edwin Gale on the Bart’s Windsor Family Study. The study paved the way for defining type one diabetes as a chronic disease by showing that ICA was detectable years prior to the onset of the disease. Later on, Franco collaborated with international centres to standardise ICA.
In 1983, Franco, in collaboration with Ricardo Pujol-Borrell, T Hanafusa and Luca Chiovato, produced a seminal work showing DR antigens expressed in thyroid cells. Later on, with Betty Dean, Jessica McNally and Marc Feldmann, this was also shown in the pancreas of a newly-diagnosed diabetic; from these findings, the idea that cells expressing HLA molecules could lead to organ specific autoimmunity was developed.
In 2013, Franco published a paper on children who developed type one diabetes early in life who were seen to have low levels of carnitine at birth. In 2014, with his friend Abdullatif Al-Bader, he researched the role of carnitine and amino acids in the etiopathogenesis of type one diabetes in the experimental non obese diabetic mouse model.
Franco continued at Middlesex Hospital Medical School, becoming a lecturer, senior lecturer, reader and then, in 1989, professor of clinical immunology. In 1991, he went to the Royal London Hospital Medical College as head of the department of immunology. He moved to Rome in September 1998 as scientific director of the Ospedale Pediatrico Bambino Gesù, a children’s hospital. In 2014, Franco became a visiting professor at Kuwait University Medical School.
In 1982, in Budapest, Franco received the Oskar Minkowski award of the European Association for the study of Diabetes. The award was a small sum of money that Franco spent the same evening inviting all his friends and collaborators to a banquet at the finest hotel in Budapest. Both his mentors, Austoni and Doniach, were there. That award was followed by several other notable awards, including the R D Lawrence prize from the British Diabetic Association, the Diaz Cristobal international prize of the International Diabetic Federation, the King Faisal prize for medicine and the Banting memorial medal from the American Diabetes Association.
The R D Lawrence lecture was the start of a string of memorable ‘Franco lectures’. He enjoyed transforming his lectures into performances, even using computer animation back in the eighties. His lecture entitled ‘Death of a beta cell: homicide or suicide?’ saw him acting as both prosecutor and defence in the trial of the beta cell. He let the scientific community be the judge and left the verdict open. Further emboldened, he went on to present ‘On the honey disease. A dialogue with Socrates’, where he involved a collaborator and even his 11-year-old daughter.
I first met Franco in 1976, while he was working in the department of immunology at the Middlesex Hospital. We were married in 1980 and we had a daughter, Dana. Franco was deeply passionate about his work and his family. His wife and his daughter are deeply grateful for all the memories that his collaborators left, not only with him, but also with us.
Lamya Al-Saqqaf
[BMJ 2017 359 5120 www.bmj.com/content/359/bmj.j5120 – accessed 22 April 2018; The Lancet 2018 391 (10118) e4 www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30093-X/fulltext – accessed 22 April 2018; IPITA: International Pancreas and Islet Transplant Association In Memoriam: Gian Franco Bottazzo (1946-2017) www.tts.org/ipita/home/2468-in-memoriam-gian-franco-bottazzo-1946-2017 – accessed 22 April 2018; Diabetologia (2018) 61: 3 https://link.springer.com/article/10.1007/s00125-017-4486-x – accessed 22 April 2018]