Obituary: Professor Jack Pepys
Thursday 26 September 1996
His great gift was to unravel complex mechanisms in specific allergic processes. An association between farmer's lung and mouldy hay had been known since the 1930s but the specific cause eluded people and there was much debate as to whether the disease was allergic in nature. Pepys and co-workers discovered a specific cause (allergy to moulds) and developed a blood test for farmer's lung which has remained routine in clinical practice ever since.
It became clear that there were many variants of this particular form of allergic lung disease (for which the term extrinsic allergic alveolitis was coined). Related conditions included bird breeder's (fancier's) lung and a similar allergic lung problem caused by inhaled pituitary snuff used in the treatment of diabetes insipidus.
Pepys and his team also described these diseases and their causes. He furthermore achieved international acclaim for his work on allergic bronchopulmonary aspergillosis and allergic lung diseases caused by fungi. These complex conditions, which can be fatal if unrecognised, were found by Pepys and his team to have a basic immunological nature. This enabled them to explain the patterns of tissue destruction and develop further specific diagnostic tests. He also pioneered "experimental models" of provoked asthma and extrinsic allergic alveolitis in the clinical laboratory and in this way was able not only to unravel disease processes but also to explain the basis of the mode of action of various anti-allergic drugs.
He was born Jacob Pepys, in Johannesburg, in 1914. He obtained his MB ChB from the University of Witwatersrand in 1935 and remained in South Africa for the next 14 years working in general practice and having various affiliated academic appointments in Johannesburg and Cape Town.
It was during this time that he began his lifelong interest in allergy and allergic diseases. In 1948 he and his family moved to London. After appointments at the Institute of Laryngology and Otology and St Mary's Hospital, Paddington, he became clinical assistant to Professor J.G. Scadding at the Brompton Hospital. During the 1950s he set up an allergy clinic there which soon became world-renowned.
From this base and with his considerable energy and enthusiasm, he established an academic department of clinical immunology with a special interest in allergic diseases; the first of its kind in the UK. He was appointed honorary consultant in Clinical Immunology at the Brompton Hospital in 1960 and research laboratories were provided at the then Institute of Diseases of the Chest (now the National Heart & Lung Institute). The research group was initially set up with support from the Medical Research Council. He was appointed Reader in 1965 and Professor of Clinical Immunology in 1967.
Further landmark contributions were his studies on occupational asthma. He developed a series of simple inhalation tests which enabled a cause and effect relationship to be established between asthma and low molecular weight chemicals and other sensitising agents in the workplace. His published papers on platinum salts, isocyanates and colophony as occupational sensitising agents are classics of their time. Using serological tests he was able to set the scene for subsequent studies on the immunopathology of occupational asthma. This eventually led to occupational asthma's being recognised as a compensatable industrial disease.
In 1971 Jack Pepys founded and was first editor of the journal Clinical Allergy (now Clinical and Experimental Allergy), which was to become one of the most popular journals in the field. The early issues contained the classic descriptions on the causes of occupational asthma. He was a prolific and clear writer, publishing over 200 scientific articles in national and international journals.
Pepys was a founder member and first Treasurer of the British Society for Immunology and President of the British Society for Allergy and Clinical Immunology, and the International Association of Allergology and Clinical Immunology. He was immensely popular with staff and students and a very large number of clinical investigators passed through his department, many of whom eventually took up senior appointments in the UK and world- wide.
As a lecturer he was lucid and concise. He loved to travel and had a busy national and international agenda. He was a kind and gentle man and a delightful raconteur with a great sense of fun. Equally he could be decisive and firm with colleagues and students. His total commitment and absorption in his work was with him to the end.
He is survived by his devoted wife Rhoda and his daughter Sandra (both gifted artists) and his son Mark, Professor of Immunological Medicine at the Royal Postgraduate Medical School.
Jacob Pepys, immunologist: born Johannesburg 15 May 1914; Professor of Clinical Immunology, Brompton Hospital, London 1967-79; married 1938 Rhoda Kussel (one son, one daughter); died London 9 September 1996.
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