Professor Ravinder Maini, known as 'Tiny' to all, has had a most distinguished career as a rheumatologist, a clinical immunologist, a clinical triallist, and the head of a large academic research centre, the Kennedy Institute of Rheumatology. He steered the institute into being one of the world's leading 'translational' research centres in rheumatology and has received international recognition for his many achievements: the American College of Rheumatology awarded him the Distinguished Investigator Award – he was the first non-US citizen to be thus recognised – and the Université René Descartes of Paris awarded him the degree of Doctor honoris causa. He has been an enthusiastic teacher and mentor. Many of his trainees, friends, and colleagues, past and present, are participating in this conference and many have travelled long distances to do so.
This volume and the corresponding website are designed to fulfil two goals. First, they provide a summary of the presentations at the conference The Scientific Basis of Rheumatology, held in London on 24–26 June 2002 at the Royal College of Physicians. Secondly, they provide a useful introduction and teaching aid for scientists entering the field of rheumatology research. This multidisciplinary area requires knowledge of a number of research fields, including cytokines, cell signalling, matrix biology, vascular biology, immunology, and inflammation. The website will be continuously developed to enhance its teaching value. We will seek volunteers to flesh it out with further interesting and useful chapters.
When Tiny Maini started his scientific career at the Kennedy Institute of Rheumatology (the flagship research centre of the Arthritis Research Campaign, now at Imperial College) in 1968, his early work examined the activities of supernatants of lymphoid cell cultures. These bioactivities were eventually purified to yield the cytokines. So it is fitting that his best-known scientific contribution has been in establishing that a single cytokine, tumour necrosis factor alpha (TNF-α), is an important therapeutic target in rheumatoid arthritis and that his best-known medical contribution has been in leading the clinical trials that verified that TNF-α blockade, using anti-TNF-α monoclonal antibody, was indeed effective. This work has been recognized by the award of several prizes, most notably the Crafoord Prize awarded by the Royal Swedish Academy in 2000, which was shared with Marc Feldmann and was a fitting testimony to a successful collaboration spanning almost 20 years. This work has led to the approval of two drugs that are already widely used and two more in the pipeline. At the time of writing, approximately 250,000 patients have been treated with anti-TNF therapy worldwide, with significant benefits for patients who have severe rheumatoid arthritis that does not respond to other treatment.
The National Institute for Clinical Excellence (NICE) in the UK is a government body set up to advise the National Health Service on making new drugs available to patients. It has evaluated anti-TNF therapy for rheumatoid arthritis and appraised it as cost effective in March 2002. It should now be more readily available for patients in the UK, and this will be a source of much personal satisfaction to Tiny, as the culmination of a glittering career.
The scientific meeting reported here was made possible by significant contributions from Schering-Plough, Centocor, and Roche Bioscience, and the publication and website by a contribution from Abbott Laboratories. We are very grateful for their support. The organizers of the meeting, who are also the editors of these proceedings, are long-term friends and admirers of Tiny Maini, and this volume is dedicated to him with the warmest wishes for a productive and enjoyable next stage of life.