Professor John Newsom-Davis
Neurologist who made important discoveries about the auto-immune diseases of the nervous system
Tuesday 18 September 2007
John Michael Newsom-Davis, neurologist: born Harpenden, Hertfordshire 18 October 1932; Lecturer, University Department of Clincial Neurology, National Hospital for Diseases of the Nervous System 1967-69, Consultant Neurologist 1970-80; Neurological Research Fellow, Cornell Medical Center, New York Hospital 1969-70; MRC Clinical Research Professor of Neurology, Royal Free Hospital Medical School and Institute of Neurology 1980-87; Professor of Clinical Neurology, Oxford University 1987-98 (Emeritus); FRS 1991; CBE 1996; editor, Brain 1997-2004; married 1963 Rosemary Schmid (one son, two daughters); died Adjud, Romania 24 August 2007.
John Newsom-Davis was one of a small number of physicians who in the 1970s began to apply advances in basic science to clinical problems, helping to keep Britain at the forefront of clinical research and inspiring many younger medical doctors to do likewise.
His greatest contribution was to identify auto-immune mechanisms and appropriate treatments in neurological diseases. Many neurological diseases like Alzheimer's and Parkinson's are chronic and progressive. A turning point in the 1970s was the discovery that at least one disease, albeit not the most common, is caused by a defect in the immune system and can be treated by drugs or other procedures.
Myasthenia gravis affects the signalling junction between nerves and muscles, leading to muscle weakness which can be life-threatening. Work in the United States, also performed by Newsom-Davis, Ricardo Miledi and colleagues, showed reduced signalling protein in the junction in patients' muscles, and that this was most likely caused by antibodies that search out and destroy this protein. A logical but previously untested treatment was to remove the offending antibodies, which was performed by Newsom-Davis, Anthony Pinching and Keith Peters using a procedure called plasma exchange. This produced a remarkable clinical effect, even in patients who had been partly paralysed for many years, and further work convincingly demonstrated that the antibodies to the receptor protein were the cause of the disease, which could also be treated with drugs that suppress the immune system.
In addition, genetic studies with Alastair Compston and Richard Batchelor helped to define distinct subgroups of myasthenia, including the younger patients in whom the thymus gland is enlarged, which Newsom-Davis and colleagues went on to show was a source of immune dysfunction and actively produced some of the harmful antibodies. He then hypothesised and demonstrated that two other diseases of the nerve-muscle junction, the Lambert-Eaton myasthenic syndrome and acquired neuromyotonia, were due to antibodies to different proteins that control the signalling process. This meant that these conditions too could be successfully treated with immuno-suppressive therapies, and his findings also threw new light on a poorly understood relationship between cancer and neurological diseases.
In each case, Newsom-Davis's research group was able to establish laboratory methods for the detection of the antibodies, ensuring that neurologists in other countries could also diagnose, and thence treat appropriately, their patients. In parallel, they defined several genetic diseases that involve the nerve-muscle junction, but are not caused by the immune system and require different treatments.
John Michael Newsom-Davis was born in 1932, the eldest child (by 10 minutes) and only son of Kenneth Newsom-Davis, the managing director of the Davis Gas Cooker Company, and his wife, Eileen, the daughter of a doctor. Less robust than his twin sister, Julia, John did not much enjoy prep school or his subsequent years at Sherborne. A positive influence was undoubtedly the two years he spent doing national service in the RAF when, because of the Korean war, a small cohort qualified for full pilot training and a chance to fly Meteors – an achievement of which Newsom-Davis remained immensely proud for the rest of his life.
Although originally offered a place at Cambridge to read English and History, he decided to follow his maternal grandfather into medicine and, after cramming for science exams, convinced Pembroke College to let him read Natural Sciences with a view to studying medicine, and he duly qualified at the Middlesex Hospital in 1960.
From the Middlesex he joined Tom Sears at the National Hospital, Queen Square, where they investigated the perception of breathlessness and physiological control of breathing – often recording with electrodes from their own intercostal muscles. He then spent a year in Cornell Medical Centre with Fred Plum dissecting the central pathways involved. Newsom-Davis completed neurology training at the National and in 1970 was appointed consultant neurologist jointly there and at the Royal Free Hospital where he established a very active research group, becoming the first MRC Clinical Research Professor in 1980.
Recruited by Oxford University in 1987 to the Action Research Chair of Clinical Neurology, with a Fellowship at St Edmund Hall, he arrived with most of his group and spent the next 11 years providing inspiration to the younger generation while he built up clinical neuroscience in Oxford, both in his own field of immune-mediated and genetic diseases and, with George Radda and Alan Cowey, establishing a Centre for the Functional Magnetic Resonance Imaging of the Brain which has become a world leader. An essential attribute was his ability to obtain funding from the Medical Research Council and charities to keep together the senior researchers who had transferred from London. Much of the work has thereby continued after his retirement, with further discoveries in related immune and genetic conditions.
He was at various times President of the Biomedical Section of the British Association of the Advancement of Science, President of the Association of British Neurologists, a founder member of the Academy of Medical Sciences, and twice chair of the MRC Neurosciences Board. In 1997, he took over from Ian McDonald as editor of Brain, the premier neurology journal, which he effortlessly took into the 21st century, making it one of the first journals to go on-line. He travelled widely, gave superb lectures, and was awarded many prizes and honours including election as Fellow of the Royal Society in 1991, a very unusual honour for a clinician. He was appointed CBE in 1996, and to Foreign Membership of the Institute of Medicine of the US National Academy of Sciences in 2001.
Despite editing Brain, a weekly myasthenia clinic and visits to the lab in Oxford, and many invitations to lecture abroad, following "retirement" from Oxford in 1998 Newsom-Davis needed a new challenge. Empirical removal of the thymus gland had been performed as treatment for myasthenia gravis for over 40 years but the treatment effect is unpredictable, and one could question whether it is ethical to perform invasive surgery when the currently used immuno-suppressive drugs are usually effective. In association with myasthenia experts in the United States, Newsom-Davis took on the huge task of organising and funding (via the National Institutes of Health in the United States) a multi-centre trial of thymectomy involving over 80 participating centres which will determine whether the operation has any place in modern treatment.
John's dark hair, good colour, large brown eyes and slim build meant that he always looked at least 10 years younger than he was; new recruits to the lab or clinic would say nervously, "I thought he was older", to which one could retort, "He is!" He had enormous energy but seldom seemed hurried despite massive workloads. He always showed concern for his colleagues, remembered their problems and took an interest in their children. This caring attitude was of course experienced by the patients he treated, and also extended to others that he met professionally, particularly the younger generation of neurologists for whom he was a most influential role model.
In 1963 he married Rosemary Schmid, an English Swiss, who later became an educational psychologist. Together they had two daughters, and a son who is a doctor. Their very happy family life is perhaps best illustrated by the children's relatively early marriages, and his seven grandchildren, which were a source of great pleasure and pride. Much of his babysitting, as he liked to call it, took place in their Dorset cottage where, after several hours poring over recipe books, John would produce fantastic meals, further enlivened by his conversational skills. His only other love was classical music, particularly opera.
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