Clinical Immunology Society: The Early Years 1984 - 1989

C. 1987 - 1989: The New Clinical Immunology Society: CIS Organization

1. Professional Structure

Originally, there were four elected officers – President, President-Elect, Secretary-Treasurer, and Councilor–Elect. The latter would succeed to become President-Elect and eventually President. The President would have another year as a Past-President on the premise that each President would want to develop some area of particular interest and would need more than a year to get it established. Also, the lead-in time would educate the future Presidents about ongoing issues and possibilities for new developments in the CIS. Subsequently, elected Councilors were identified to be two, three, four, and five years from becoming President. In theory, this setup should encourage new initiatives and provide time for their achievement. Appointed Councilors were identified and included on the Board to represent important fields in Clinical Immunology not already represented. Also, the Secretary-Treasurer had a four-year term, which could be renewed one time. Later, when the CIS secured a journal, the Editor became a member of the Council.

CIS committees were established in the first year and were functioning in 1988:

1. Planning and Finance Committee was headed by the President (T. Waldmann) and President-Elect (H. McDevitt) in conjunction with six other members of the Council
2. Organizational Liaison - J.L. Fahey
3. Programs for the ACCI - Richard Lynch, T. Waldmann
4. Clinical Practice and Education - A. Kaplan, R. Goldstein
5. Clinical Laboratory Immunology - K. Osterland, Dan Stites
6. Scientists in Industry – J. Farrar and Nolan Sigal
7. Publication - Peter Lipsky
8. Membership Committee and Nomination Committee - Mary Ellen Conley, John Sullivan

Additional contributors to the program and to Topic Subcommittees included Warren Strober – Mucosal Immunology; Malcolm Mitchell – Lymphokines; Thomas Lawley – Immunodermatology; James Folds – Medical (Clinical) Laboratory Immunology; and, Vicki Kelley – Autoimmunity.

The principal features of individual committees were drafted by Susan Kanowith-Klein in consultation with the principle members in each. The purposes of the committees were detailed and agreed to by the Executive Committee. Specific actions, activities, and organizational responsibilities were indicated for each committee or workgroup.

Comments:

The Physician-in-Practice Committee basically did not function because most of the participants in the CIS were academically oriented. Physicians in practice had already established professional relationships, with educational and support systems needed in their current circumstances. Thus, the CIS did not identify needs that could be met by that committee as it was constituted.

2. Administration and Operational Issues

The CIS conducted its activities in 1987 from offices at UCLA and at The Johns Hopkins University. In Los Angeles, John Fahey and Susan Kanowith-Klein were working on the CIS's definition and development as well as on the interrelationship with other societies. S. Kanowith-Klein was the principal agent raising funds from industry and foundations. Financial records and membership roles were focused in the office of Noel Rose at The Johns Hopkins School of Public Health in Baltimore. The ACCI meeting management was continued by Jack Wyatt in 1987 and 1988.

Issues that were addressed in 1988 included the purposes of various working groups and committees that had been identified in the earlier plans for the CIS. By-Laws were proposed and legal advice obtained. Colleagues who had participated in the development or leadership of comparable professional societies contributed on the basis of their experiences.

The By-Laws were modified advantageously. One of the interesting features had to do with an original clause relating to "expulsion" from membership. It was suggested that this term be changed to "removal of membership," although the possible reasons for such actions were not detailed in the By-Laws intentionally.

To facilitate development of the CIS, S. Kanowith-Klein's role evolved to concentrate on operational development relating to the Council, including the Senior Officers, and to fundraising with approaches to potential funding sources. A key post of hers was to see that important questions were addressed by the Council and officers regarding the organizational and operational issues of the CIS in light of its goals. She worked with the specific committees, and her responsibilities were to make sure that their charges were identified and addressed, that officers understood their roles, and that those decisions were made and the results carried out. She knew the CIS’s operation and thinking, so she was in a good position to represent it in efforts to obtain funding from commercial and philanthropic sources. S. Kanowith-Klein prepared the initial brochures describing the CIS (Table V).

3. Finances and Fundraising

The budget in 1986, including the cost of the initial ACCI, came to about $50,000. In 1987, $70,000 was raised from commercial sources to supplement grant awards and expenditures totaled $67,000. There was a carry forward of funds from 1986 of $14,525, and at the end of 1987, $17,739. The 1988 budget totaled $75,000, including ACCI expenses.

The dues in 1987 were $50 per year, which was raised in 1988 to $60.

4. Use of Management companies for the CIS and the ACCI

Initially, the membership listing was retained in the office of Noel Rose at Johns Hopkins. The organization and the management of the ACCI were carried out by Jack Wyatt in 1986, 1987, and 1988. In 1988, organizations were solicited that might take on CIS management as well as conference activities. The responses were from the Slack Company, the Federation of Societies for Experimental Biology (FASEB), and Jack Wyatt. Eventually, the decision was made to ask Slack with its wider capabilities to start with CIS management and ACCI meeting organization in 1989.

The CIS was eager to involve as many academically-oriented clinical immunologists as possible. A wide range of clinical fields were identified (Table IV). Individuals working in those fields were invited to join the CIS and take a role in the ACCI and other activities.

5. Membership

1. Overall
   The initial membership group based on the attendance at the 1986 meeting was about 300, which increased to approximately 450 by 1989.
   
   Several membership categories were recognized. Initially, most regular members were established scientists in immunology research with M.D. and/or Ph.D. degrees (and based at academic institutions). The clinical disciplines were mainly Internal Medicine or Pediatrics and a wide array of subspecialties. Associate members were individuals with M.D., Ph.D., or equivalent academic or professional degrees engaged in the practice of Clinical Immunology or with a demonstrated interest in the field.
   
   Trainee members were enrollees in predoctoral or postdoctoral training programs relevant to Clinical Immunology but not yet qualified to be a Regular or Associate member. Early on, provisions were made for fellowship awards to allow trainees who had submitted abstracts for poster presentations to be funded to attend the ACCI.
2. Ph.D. Scientists in the CIS
   It might have seemed that the "Clinical" title meant a restriction or major emphasis on clinical care responsibilities, which was not the case. "Clinical" conveyed a primary focus on immunology and related disease of human systems but was not exclusive. Studies of autoimmunity or cancer that were conducted in animals were often highly relevant to human situations and frequently reported at ACCI meetings. Some of the most active members had Ph.D. qualifications.
   
   All CIS meetings had many presentations based on collaborations by clinical and laboratory investigators. Biostatistical Ph.D.s contributed to clinical studies, but not many became active CIS members.
3. Women in the CIS
   Women with expertise and experience were involved in CIS from the beginning but they were much outnumbered by men. Relatively few women had graduated from medical schools in the 1950s and 1960s and had time to develop careers in biomedical sciences. In ensuing years, women have had increasing roles in the CIS.
   
   Women scientists who did take active roles in CIS in the early years included Rebecca Buckley, chair of the AAI Clinical Immunology Committee and advisor to the CIS as an academic pediatrician. Mary Ellen Conley was already a leader in pediatric immunology with emphasis on primary immune deficiencies. Vicki Rubin Kelley was a major contributor to autoimmune disease studies. Janis Giorgi was widely known for her contributions to HIV/AIDS immune pathology. Charlotte Cunningham-Rundles focused on immune deficiency and reconstitution. Like Mary Ellen Conley, she later became a president of the CIS.
4. Scientists in Industry
   Immunologists working in the pharmaceutical industry or in biomedical start-up or other companies were welcomed into the CIS. Many worked on novel therapeutic or diagnostic areas of great relevance to Clinical Immunology research and practice. Their membership was expected to be a major contributor with two-way traffic. On the one hand, the CIS could meet their needs for knowing when and where various types of clinical research was occurring, with the potential for collaborations as well as applications to clinical research and practice. On the other hand, such members provided critiques and constructive suggestions based on their experience in a different environment. Some had resources not available in most academic settings.
   
   Pharmaceutical support for the CIS and its meetings and educational programs was welcome. Individual scientists from these companies participated in activities on the basis of their interests and professional qualifications.

6. Journals and Educational Activities

Early on, the CIS considered but deferred initiation of a societal journal. The AAI Journal of Immunology had a Clinical Immunology section, which the CIS co-sponsored for several years. The AAAAI had the Journal of Allergy and Clinical Immunology. These journals, however, did not meet the needs of the CIS, and it was judged that the interests of clinical immunologists were not being well-served by the AAI and AAAAI publications. Independently, Journal of Clinical Immunology was developed by Sudhir Gupta.

Initially, CIS communication needs were met by a twice-yearly CIS Newsletter and Information Update prepared by Susan Kanowith-Klein (Table V). Included were reports of meetings and workshops, new developments, and a news-and-views column from 1988 - 1992. Co-sponsorship of several journals were explored including the Clinical Spectrum, and later, The Immunologist with the IUIS.

Peter Lipsky's goal in 1990 was to provide timely scientific information as quickly and comprehensively as possible. There were many questions, however, relating to financing and whether it would be free or sold to members or others. Arrangements were made for the monthly publication, Clinical Immunology and Immunopathology, to be available at reduced rates from the Academic Press. Also, the Journal of Clinical Immunology, published every two months, was offered at reduced rates to CIS members. Another proposal was to have information from ACCI symposia and workshops published in a hardcover volume called Immunology and Allergy Clinics of North America, which was then being published by Saunders. This did not materialize and the publication ceased.

In his 1997 presidential message, Raif Geha indicated that there were four areas in which the CIS demonstrated great strength: Immunodeficiency, HIV/AIDS, Medical Laboratory Immunology, and Immunotherapeutics. He suggested that they could be the main themes of a CIS-sponsored journal but, of course, not the only areas to be covered. Subsequently, the CIS Publications Committee established Clinical Immunology as a transfer from the Journal of Clinical Immunology and Immunopathology edited by Noel Rose. This CIS publication flourished under the editorial leadership of Andrew Saxon and George Tsokos.