Dr Ellis Samols

Innovative diabetologist
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Ellis Samols made his mark on medicine when, early in his career, he was given the task of measuring insulin in blood using a biological assay then in use. This consisted of giving the test dose and a range of standard doses to mice, and seeing how long it took for them to have hypoglycaemic convulsions. The test was expensive, laborious, and only crudely accurate. It could not differentiate between insulin and other substances that lowered blood sugar.

Samols was then a junior researcher at the Royal Postgraduate Medical School in East Acton, London, and the task was set by Professor Russell Frazer. In 1959 a paper was published in the journal Nature describing an accurate assay using an immune reaction with a radioactive anti-insulin antibody. This assay, which was adapted for assaying a whole range of hormones and other body chemicals, was to change the face of endocrinology.

Rebelling, Samols went to New York to learn the assay from its inventors, Sol Berson and Rosalyn Yalow. Yalow was awarded the 1977 Nobel Prize for it. Berson, who remained Samols's a friend and benefactor, missed the Nobel recognition that was his due as he died, aged 54, in 1972. The test is still in use, and has been automated by the manufacturers so that it is supplied in kit form.

Russell Frazer had no confidence in the new technology and in 1960 Samols joined Professor, later Dame, Sheila Sherlock, Professor of Medicine at the Royal Free Hospital. She not only recognised his talent but also the important contribution radio-immunoassay would make to medicine. She gave this young and still unproven immigrant laboratory facilities and left him to his own devices.

Samols's laboratory was the first in Europe to carry out radio-immunoassay and he collaborated with a number of physicians to solve complex clinical problems. At that time clinicians had little idea that there were two types of diabetes, insulin-deficient (type 1) and insulin-resistant (type 2), and his work helped clarify this. He also studied abnormalities of sugar metabolism in liver disease, abnormalities associated with growth hormone, and the biological role of glucagon. Such was his reputation that Sherlock was asked, on a visit to America, if she worked in Samols's laboratory.

His main collaborator was Vincent Marks, with whom he worked closely until he himself emigrated to America in 1968. Together in 1963 Samols and Marks published the world's first major paper on the use of insulin assay in the clinical diagnosis of hypoglycaemia. Even more important was their discovery, to everyone's amazement, that glucagon, the second major hormone produced by the pancreas, and which was regarded as an insulin antagonist, actually stimulated its secretion.

In 1963 Samols went to Seattle on a sabbatical leaving his immunoassay laboratory in the hands of Sherlock's successor, Neil McIntyre, and Desmond Turner, now MP for Brighton Kemptown. Together they rediscovered a third pancreatic hormone called incretin - first postulated to exist in the 1930s and dismissed again in the 1940s and 1950s.

On his return to the UK in 1965 Samols and collaborators showed that normal meals and oral glucose liberated a glucagon-like substance from the intestine, which they suggested might be incretin. Thirty years later incretin was identified as glucagon-like peptide 1 (GLP-1), a variant of which, called exenatide, was recently licensed in the United States for the treatment of type 2 (late-onset) diabetes.

Through the good offices of his friend Sol Berson, Samols secured a post, first as Associate Professor at the Medical College of Georgia in Augusta and soon after as Chief Staff Physician (later Chief of Staff) at the VA Hospital in Louisville, Kentucky, where he spent 24 years.

He became a diplomate of the American Boards of Internal Medicine, Endocrinology and Metabolism, and obtained recognition to practise in nuclear medicine, and nuclear cardiology. He took these in his stride whilst continuing to publish original research in diabetes and insulin biology. He demonstrated that each individual islet of Langerhans - there are a million in the human pancreas - is an elaborate functional unit that ensures each hormone is secreted appropriately as the body needs change during the course of the day.

His other major contribution was the demonstration, with John Stagner, that islets transplanted into the pancreas of rodents are more effective in correcting experimental type 1 diabetes in rodents than when transplanted into liver, as had been done previously.

Samols - focused, ambitious, charming, a good conversationalist, a good boss and a bad underling - often took on battles but fought them fairly; he was knowledgeable about art and music, and played tennis competitively. He could do anything he turned his hands to; he played the stock exchange and for many years was the cartoonist on a US government medical journal.

He was born in South Africa, the eldest of three sons of a doctor. He took his medical degree at the University of Cape Town and spent three years at Groote Schuur Hospital, as a resident, and then intern, in chemical pathology. He came to Britain to take up a research fellowship at the Royal Postgraduate Medical School; on the boat coming over he met Gay Meyer and they married a year later. He was based in London for eight years, minus the Seattle sabbatical, before emigrating to America.

After two years in Georgia he spent 22 years at the University of Louisville School of Medicine, then a year in California, at Livermore VA hospital and Stanford University, and the rest of his career in Las Vegas as chief of staff at the VA Hospital there and Professor of Medicine in the University of Nevada. He retired in June 2005 when, at the age of 69, his health deteriorated; he developed Lewy body dementia and died at home, cared for by his ex-wife, Gay.

Ellis Samols published over a hundred papers and was the editor of two books - The Endocrine Pancreas (1991), and, with George Chrousos and Jerrold Olefsky, Hormone Resistance and Hypersensitivity States (2002).

Caroline Richmond

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