Rheumatology at Penn has a long history of contributions and innovations that go back as far as 1882 when Morris Longstreth at Pennsylvania Hospital published a monograph, Rheumatism, Gout and Some Allied Disorders
Ralph Pemberton, who was on the Penn faculty and a professor of medicine, started the first arthritis clinic at Presbyterian Hospital in 1926 and is now honored yearly at an Annual Lectureship at the Philadelphia Rheumatism Society. He was an organizer of the American Committee for Control of Rheumatism, which evolved into the American Rheumatism Association (ARA). He served as President of the ARA in 1938-39. In 1929 Pemberton authored his first edition of Arthritis and Rheumatoid Conditions that was to evolve over the years at Penn into a major text.
Bernard Comroe opened the first arthritis clinic at the Hospital of the University of Pennsylvania (HUP) in 1937 and is credited with coining the term “rheumatologist.” In 1940, he authored Arthritis and Allied Conditions through three editions until his early death in 1945.
At that time, Joseph Hollander moved from Pennsylvania Hospital to direct the arthritis clinic at HUP and started the first fellowship program in 1949-50. Dr. Hollander edited a 4th edition of Arthritis and Allied Conditions in 1949, adding authors from around the world. This was the first edition to include the collagen vascular diseases, making it “the text” in rheumatology for many years.
Dr. Hollander also led important initiatives for the ARA including development of the journal Arthritis and Rheumatism in 1958, and board certification for Rheumatology by the American Board of Internal Medicine. In addition, he trained fellows from around the world who would become international leaders in rheumatology, and served as ARA president in 1961-62.
Dr. Hollander's many contributions over his years at Penn included the development and evaluation of depot corticosteroids for intra-articular injection, a systematic approach to analysis of synovial fluid that led to identification of urate crystals in the fluid with his fellow Dan McCarty, and characterization of immune complexes in rheumatoid synovial effusion cells (RA cells) that remains an elusive component of the disease process in RA. In addition, Dr. Hollander performed fascinating experiments on the effect of climate changes on joint symptoms with his climate chamber and developed a rheumatology program at Children's Hospital of Philadelphia. He practiced and taught at Penn into his 80's.
In 1967 Dr. Ralph Schumacher finished a fellowship at Robert Brigham in Boston and joined Dr. Hollander as a second full time Rheumatologist. With the help of donations from Hollander's patients he set up what proved to be a productive pathology, electron microscopy, and small animal research laboratory investigating synovium and synovial fluid in a variety of types of arthritis.
He continued the tradition of developing educational material by editing three editions of The Primer on the Rheumatic Diseases and initiating the Journal of Clinical Rheumatology, which he continues to edit.
Contributions among his more than 500 papers included identification of apatite crystals in synovial fluids raising the still to be explored role of the virtually ubiquitous calcium crystals in osteoarthritis. He did a series of studies on gout and identified bacterial DNA and RNA in joints not only in reactive arthritis, but also in some clinically normal joints.
In 1969 with the arrival of Arnold Relman as chief of Medicine, Allen Myers was recruited from Massachusetts General Hospital. He dramatically expanded the Division role in treatment of systemic lupus and other collagen-vascular diseases and focused the growing program on a series of clinical research projects with more than 30 papers including studies on esophageal and duodenal function in scleroderma, phagocyte function of neutrophils, neurologic features of lupus, and mechanisms of gonococcal arthritis.
Robert Zurier came to Penn to lead the Rheumatology program in 1980 with his expertise in laboratory studies of fatty acids, prostaglandins, and cytokines. This led to productive collaborations and reports on prostaglandin metabolism and new insights including that gammalinolenic acid could have comparable anti-inflammatory effects to NSAIDs. Zurier obtained the first NIH rheumatology research training grant at Penn and built a growing division. He received a Guggenheim fellowship to work at the Imperial Cancer Research Lab in London.
Robert Eisenberg in 1995 moved from the University of North Carolina bringing his established research work in murine autoimmunity. His innovative work here included focus on the roles of B lymphocytes in RA. Eisenberg led a team studying aspects of murine lupus and mechanisms involved in pathogenesis of lupus. He won the Lady Barbara Colyton prize in autoimmunity.
Philip Cohen, also from North Carolina, joined Eisenberg in 1999 and continued his bench research on apoptosis, lupus, and conducted important studies on B cell depletion for Sjögren syndrome. He took over the VA rheumatology program and served on important NIH, ACR and AF grant review committees. He also served as an associate editor for Arthritis and Rheumatism. He has since become the Rheumatology Division Chief at Temple University.
Gary Koretzky, a graduate of Penn's MD and PhD programs, came from Iowa in 1999 to the Dept. of Pathology to conduct basic immunology research focused on signal transduction and immune cells maturation and function and to direct an immunology research program. In 2005 he became chief of Rheumatology and has been elected to the AAAS and Institute of Medicine. Dr. Koretzky then served as Vice Chair and Chief Scientific Officer in the Department of Medicine, continues to mentor basic scientist postdoctoral fellows and graduate students, supervises the NIH rheumatology T32 training grant and is editor of Immunological Reviews. He has since become the Dean of the Weill Cornell Graduate School of Medical Sciences.
Sharon Kolasinski, a former fellow at Penn, came from Indiana University in 1996 and in 2008 assumed the position of interim chief of Rheumatology at Penn. She initiated and then greatly expanded the impact of a Regional Fellows Conference at Penn for first year Rheumatology fellows, grew the clinical faculty, and took an active role in ACR program director activities. She was awarded an ACR Clinical Scholar award. Kolasinski authored papers on alternative medicine, “Why did you become a rheumatologist,” and clinical studies.
Other important contributions have come from former fellows. Some examples of these include:
Sergio Jimenez developed a scleroderma clinical and laboratory research program and evaluated penicillanine for therapy. He studied the roles of cytokines in collagen synthesis.
Antonio Reginato expanded on his observations from Chile on calcium pyrophosphate deposition disease (CPPD disease) and became the world expert on this, determined genetic factors in some cases and worked on other previously unrecognized crystal diseases publishing on oxalate crystals and liquid lipid crystals. He co-edited an atlas of synovial fluid with Schumacher.
Daniel Baker conducted extensive studies on models of crystal and particle induced inflammation and wrote a review on monoarthritis for the New England Journal of Medicine.
Lawrence Leventhal provided a resource for patients with fibromyalgia and published a series of clinical studies.
Theodore Pincus performed basic studies on the possible role of viruses in initiation of autoimmune diseases and published on herpes virus monoarthritis.
Stuart Silverman established a focus on osteoporosis and published a study evaluating the possible role of EB viral antigens in early RA.
Lan Chen initiated a series of studies on acupuncture, sleep and fibromyalgia, and coordinated gout and synovial fluid investigations.
Brian Mandel studied pathogenesis of gout and treatment of crystal induced inflammation with diets enriched in fatty acids.