26th Symposium: Malta 2006

Light Minutes of the 26th Symposium of the Collegium Internationale Allergologicum held in Malta in May 2006

By STEPHEN J. GALLI

The 26th meeting of the Collegium Internationale Allergologicum, entitled: “Cellular & Molecular Targets in Allergy & Clinical Immunology”, was held from May 5-10, 2006, in St. Julian’s on the island of Malta. 

The fascinating and historically important locale was selected by the meeting’s organizers, Stephen Holgate and Barry Kay, in what has become a tradition of British organizers selecting meeting venues that are outside of the United Kingdom. In this case, the venue at least was once part of the British Empire, having previously been under the control of Carthage, the Romans, the Byzantine Empire, Arabs, Sicilian Normans, the Anjouvines, the Hohenstaufen, and the Aragonese. In 1503 the islands were given by Spain, in a perpetual lease, to the Order of Knights of the Hospital of St. John of Jerusalem, a militant monastic order that is now known as the Knights of Malta. Napoleon conquered the islands in 1798, but the French occupiers were said to be unpopular, especially because of their negative attitude toward religion. The British helped the Maltese rebel against the French and the islands became a British protectorate in 1800 and part of the Empire in 1814. Malta became independent in 1964, saw the last of the British forces leave in 1979, and joined the European Union in 2004.

To illustrate that forms of “foreign intrusion” continue in Malta to this day, I will depart from tradition and bring up something that actually occurred just before the meeting officially started. Before traveling to a country for the first time, I perform what could be called an “auto-Google”, that is, I look up my name in Google to see if I, or others with the same name, are in any trouble in that location. What I found when I did that explained why I got extra attention when I went through customs on arrival in Malta. Anne Galli went through customs without incident but I was delayed while three people examined my passport and their computer, and occasionally looked over at me. I was finally waved through without any additional questions. However, even when I checked Google just before leaving for this meeting, this is what I found under “Stephen Galli Malta”: It is a news report in what is called The Malta Fly: 

THIS ONE IS FOR YOU DU(M)BYA Aggressive bag snatcher ends up in jail

A US national, residing in Sliema, was jailed for two-and-a-half years for robbing a woman of her bag and assaulting two police officers last year.

Stephen Galli, 41, admitted to stealing the woman's bag, assaulting and slightly injuring a police sergeant and a constable, ignoring their orders and relapsing last October.

After hearing Mr Galli file a guilty plea, Magistrate Consuelo Scerri Herrera heard how a probation officer had been striving for three years to persuade him to attend a rehabilitation programme but to no avail.

She also noted that Mr Galli had eight previous convictions on his criminal record.

Police Inspector Stephen Gatt prosecuted.

I think that the only reason I was not retained for further questioning on entry was the fact that the other Stephen Galli already was in custody.

Except for marauding bag snatchers, Malta was peaceful and charming, and highly conducive to both scientific and social interactions.  

The excellent social program included a Maltese dinner at the Villa Bologna, first constructed in 1745, a Turkish boat ride (to be discussed later), a Gala Dinner and many optional excursions around the islands.   

Now, to the scientific program. Sir Ravinder Nath (“Tiny”) Maini gave the Paul Kallos Lecture (an excellent talk, entitled “Identification of TNF as a therapeutic target”), which described how he and Marc Feldman and their colleagues developed anti-TNF therapy and showed that such treatment significantly improved the lives of patients with rheumatoid arthritis. For this effort, Sir Ravinder and Marc Feldman were co-recipients of the 2003 Albert Lasker Award in Clinical Medical Research.

The President of the CIA, Johaness Ring, in his second meeting in that role, gave the Carl Prausnitz Memorial Lecture, entitled “From wheals and wheeze to tolerance: allergy quo vadis?”. I should mention here that in introducing Johaness, Steve Holgate noted that in his love of, and thoughtful service to, the CIA, Johannes is following the example set by one of the Collegium’s most exemplary members, Alain de Weck. As many of you know, this comment about Johaness both is very well-deserved and is high praise indeed. 

Johaness’s talk was both edifying and, as we have come to expect from him, very entertaining. He exclaimed “Allergy is serious! We are not talking about red patches after eating strawberries, as some of our grant reviewers may think.” Johaness included some thoughts about the management of allergies, and their epidemiology. Regarding management, Johaness listed “abstinence”. I am not an allergist, but I hope that by “abstinence” Johaness meant allergy avoidance. Is that right, Johaness? I wasn’t sure because Johaness went on to talk about “allergen potency or impotence” (and I became concerned that Johaness was heading in a dangerous direction). His management recommendations also included whisky, which I assume is taken by the oral route and works by a mechanism that alters the perception of allergic symptoms rather than their occurrence. 

Johaness, a true scholar, told us of a paper entitled “Does my partner cause my allergies” (Allergy 59:781-5, 2004). According to Johaness, this study reported an increased incidence of allergies in the long term partners of subjects with allergies. Although the underlying mechanism was not revealed, Johaness speculated that perhaps people with allergies fall in love with those with a propensity to develop allergies (a notion that is of course contradicted by the saying “opposites attract”). I suggest that Professor Ring might also investigate, perhaps in collaboration with Professor Heidrun Berhendt, the possibility that those who study allergies fall in love with people who also study allergies.   

You will recall that Stan Prusiner (who received the Nobel Prize in Physiology or Medicine for his work on prions) gave the Prausnitz Lecture at the 25th CIA Meeting in Bornholm. I reported in the minutes of that meeting that red meat was served at the banquet that night, which was either beef (that in theory could transmit mad cow disease), ostrich (which would have been safer) or, possibly, Austrian (the dish was listed in the menu as something that included “Oesterreich”). Stan did not eat the meat but many of the others present at the dinner did (including me). I still feel fine. Is everyone else feeling OK? I hope so.

As usual, the regular scientific program was full of interesting talks, penetrating questions, and funny remarks. In the interest of time, I will keep with the tradition of focusing on the latter in these minutes. Here is a sampling:

Bruce Bochner, apparently cognizant of the deep religious traditions associated with Malta, introduced his talk by saying that he would discuss the “Holy Trinity”, by which he meant eosinophils, basophils and mast cells. Strangely, he named them in reverse order of importance. He also noted “You waste all this time and money growing human mast cells and then you try to kill them!”

Barry Kay noted in his introduction that he was “surprised to be talking about CGRP”. I guessed from that comment that Barry didn’t look at the title of his presentation (that clearly mentioned CGRP) until just before putting together his talk. The moderator of that session (me) asked for short questions and short answers, apparently not realizing that: (1) no one in the CIA pays any attention to such comments, and (2) that he wasted 5 seconds by making the remark. Showing that he was in an uncharacteristically obedient mood, Barry’s first answer to a question was one word “Mixed”. Unfortunately, I don’t remember what the question was. Maybe it was something like: “What kind of a drink would you like this evening?” The second question must have been more interesting, as it elicited an answer so long that I lost count after the first 1000 words.

Judah Denburg gave a talk with a long title that he shortened to something like “An ode on progenitors” or perhaps it was “Odious progenitors”. At the end of the lecture, Judah said, “I am now going to summarize the findings, because they are counter-intuitive”. 

After Henning Lowenstein’s presentation, Rudy Valenta announced that he wanted to ask two questions; he then proceeded to ask three. Martin Chapman then said: “We have confusion here in the back, what is ‘1gx’? It sounds very mysterious.” Henning replied that he shouldn’t have used the term, as it was really just “laboratory slang”.

Barry Kay again. In a session that he was moderating, he also asked for quick questions and quick answers, and then took at least 3 minutes asking a question himself.

Eckard Hamelmann noted: “Parasites represent an interesting approach for immune modulation.” After mentioning a few clinical trials in which patients with asthma were fed Necator americanus or patients with food allergy were being infected with Tricuris, he noted “but I am not saying that parasite infections are great”. Thanks, Eckard, for clearing that up.

Francesca Levi-Schaffer noted that she uses ovalbumin as an allergen in some of her experiments because Israel would not let her import Aspergillus fumigatus due to a concern about bioterrorism. She also asked whether others thought there was an earthquake going on, since she felt the podium shaking.

Dale Umetsu listed himself on his acknowledgement slide. I guess that counts as a form of auto-citation.

In ending this session, Sven-Erik Dahlen said “We now can all go to lunch or, if we prefer, eat grass or parasites.” Bon appétit. 

We have come to expect a lot from those speaking on the genetics of allergy, and we were not disappointed in Malta. Eugene Bleecker noted that on April 24, 2006 Forbes magazine featured two articles on the cover, one was about long acting beta agonists, and the other had the title: “New tax haven: this one also has sex slavery”. However, in his talk, Eugene stuck to the genetics of allergy.

In her presentation, Susan Prescott referred to “in utero smoking”. Yikes! That can’t be good for either the fetus or the mother. 

Before his presentation, Jonathan Arm showed family photos which he claimed proved he was born on Malta while his father was stationed there during a tour of duty with the Royal Air Force.

There were 180 abstracts listed in the program. Seven abstracts included figures or tables and one (number 168, by M. Strolin Benedetti and colleagues) included a mathematical formula, which is very nice to find in the program. There were 18 abstracts with a single author (these people apparently don’t believe in collaboration). Two abstracts (numbers 124 and 179) each had thirteen authors, but this evidence of extensive collaboration probably was gone one better by abstracts 14 and 33 (by Jan Lotvall et al. and Peter Briza et al.), that included 6 or 12 listed authors plus a named group (respectively, “The Lung Pharmacology Group” and “The CREATE Consortium”). Abstract 33 explains that “One of the aims of the European Union CREATE project is to analyze natural and recombinant major allergens from birch pollen, grass pollen, olive pollen and house dust mite regarding their physico-chemical and immunological properties.” This seems rather ambitious, unless one compares it to the original CREATE project, which, according to the Old Testament, produced the entire universe (including all the natural allergens, as well as the immune system) in just 6 days. Remarkably, abstract number 179, entitled “Characterization of the structure and proteolytic activity of the major house dust mite antigen”, had no author listed. President Marone, I really think that, in the future, the Collegium should no longer accept anonymous abstracts. Of course, it will continue to be acceptable if the work described in abstracts is premature, irreproducible and/or wrong, or, at worst, boring, but it shouldn’t be anonymous.  

Now, notes on the social events.

In getting us to the first dinner, at least 3 of the buses couldn’t get past a car parked on the narrow street. After a period of uncertainty, most passengers decided to walk the rest of the way (which took only about 5 minutes).

During the boat ride, Erika Jensen-Jarolim asked Frank Austen to move out of the sun so that she and her friends could have his spot, and, I want to note for the record, Frank politely complied.

Sven-Erik Dahlen was one of the few swimmers. On hitting the water he declared “It feels like 17 degrees!” (I assume he meant Celsius). Someone checked his guess with the captain who said “Yes, exactly.” Apparently, Swedes know about such things.

On one of the tours on land, the guide walked so fast that two of the party (Joyce Austen and Linda Wasserman) were left behind and had to complete the tour on their own. Has anyone seen either of them since?

The Gala Dinner must have been one of the most memorable in the history of the Collegium. With music playing and uniformed guards in attendance, we walked over a red carpet to enter the historic Sacra Infirmia, built by the Order of St. John of Jerusalem in the 16th century. It was a grand chamber indeed, with high stone walls and colorful flags. Those who ventured below could see a fascinating historical exhibit, including figures and settings representing some of the best (and worst) aspects of life in Malta during the many centuries of its existence. 

Now, two highlights from the business meeting. Alain de Weck attended in a kimono (looking very stylish and claiming he had been locked out of his room). On taking on his role as President of the Collegium, Gianni Marone remarked that represented the highest honor in his academic career.  

  In keeping with a CIA tradition, we enjoyed a cultural or, in the words of the program, “Relaxing from Immunology”, evening lecture. It was presented by Charles Savona-Ventura of the University of Malta, and was entitled “History of medicine in Malta”. He commented that he was surprised to learn one could relax at a CIA meeting. A major theme of the talk was that the residents of Malta for many centuries have held complex beliefs related to fertility and death, which included the need to regularly appease the deity to ensure its benevolence. Of course, nothing like that would ever happen in academic circles. Other nuggets of information included the report by Pliny the Elder, in his Historia Naturalis, published in 77 AD, that stomach pains in Malta were treated by placing a Maltese dog over the epigastrium; that public latrines constructed by the Roman’s were “a community affair” and featured 9 seats; that Frederick III of Sicily declared in approximately 1307 that Jewish physicians could not practice on Christians but that this edict was routinely circumvented because most doctors at that time were Jewish; that long ago there was a 10% tax on imported pharmaceutical agents, including dragon’s blood tree resin; and that in 1479 it was announced that certain medicines could not be used by women during the first 7 months of pregnancy. He finished the presentation by announcing: “If there are any questions, I will try my best to avoid answering them.” He may not have realized it, but this is quite in the tradition of some of the speakers in the scientific sessions also.

At the 25th meeting of the Collegium, in Bornholm, Denmark, I reminded us of Hamlet’s famous question: “To be, or not to be?” I also recommended, for those who decide to answer that question in the affirmative, being a member of the CIA. Being a member of the Collegium in essence requires that we support the three major functions of our organization: (1) advancing the fields of basic, translational and clinical allergy and immunology and related disciplines; (2) deciding whom to invite to join our organization; and (3) having meetings every two years where we can fulfill the first two responsibilities and have an outstanding time doing so. 

Our meeting in Malta was a tremendous success as judged by each of these criteria. Accordingly, please join me now in expressing our deep thanks to the people who offered us the privilege of being at the 26th CIA meeting, our gracious Symposium Organizers, Stephen Holgate and Barry Kay, our President and Vice President for that meeting, Johannes Ring and Gianni Marone, and all those who made our gathering in Malta scientifically enlightening and socially delightful.