Arthur J. Ammann (August 12, 1936 – August 15, 2021) was an American

pediatric Pediatrics (American English) also spelled paediatrics (British English), is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, pediatrics covers many of their youth ...

immunologist and advocate known for his research on

HIV transmission The human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a preventable disease. It can ...

, discovering transmission and the risk of contaminated transfusions and blood products, and his role in the development of the first successful

vaccine A vaccine is a biological Dosage form, preparation that provides active acquired immunity to a particular infectious disease, infectious or cancer, malignant disease. The safety and effectiveness of vaccines has been widely studied and verifi ...

to prevent

pneumococcal infection Pneumococcal infection is an infection caused by the bacterium ''Streptococcus pneumoniae''. ''S. pneumoniae'' is a common member of the bacterial flora colonizing the nose and throat of 5–10% of healthy adults and 20–40% of healthy childr ...

in 1977. He founded Global Strategies for

HIV Prevention HIV prevention refers to practices that aim to prevent the spread of the human immunodeficiency virus (HIV). HIV prevention practices may be undertaken by individuals to protect their own health and the health of those in their community, or may ...

and was Clinical Professor of Pediatrics at the

UCSF Medical Center The UCSF Medical Center is a research and teaching hospital in San Francisco, California, and is a medical center of the University of California, San Francisco. It is affiliated with the UCSF School of Medicine and the UCSF Helen Diller Famil ...

."The Littlest Index Case: How Pediatric Patients in San Francisco Helped Decode HIV/AIDS"
Nairi Strauch. Stanford Journal of Public Health. Retrieved May 21, 2012. Published February 8, 2012. Retrieved May 22, 2012.

Education

Ammann was born in

Brooklyn Brooklyn is a Boroughs of New York City, borough of New York City located at the westernmost end of Long Island in the New York (state), State of New York. Formerly an independent city, the borough is coextensive with Kings County, one of twelv ...

, New York, to

German German(s) may refer to: * Germany, the country of the Germans and German things **Germania (Roman era) * Germans, citizens of Germany, people of German ancestry, or native speakers of the German language ** For citizenship in Germany, see also Ge ...

parents, neither of whom finished

grade school A primary school (in Ireland, India, the United Kingdom, Australia, New Zealand, Trinidad and Tobago, Jamaica, South Africa, and Singapore), elementary school, or grade school (in North America and the Philippines) is a school for primary ...

."Pioneering Pediatrician Leads Charge to Cut Infant HIV Infections."
Jan Sluizer. Voice of America. Retrieved May 21, 2012. He graduated from

Brooklyn Technical High School Brooklyn Technical High School, commonly called Brooklyn Tech and administratively designated High School 430, is a public specialized high school in New York City that specializes in science, technology, engineering, and mathematics. It is on ...

and attended Wheaton College in Illinois, continuing on to study medicine at

New Jersey Medical School New Jersey Medical School (NJMS) is the medical school of Rutgers University, a public university in Newark, New Jersey. It has been part of the Rutgers Health since the 2013 dissolution of the University of Medicine and Dentistry of New Jersey ...

, where he received his

M.D. A Doctor of Medicine (abbreviated MD, from the Latin ) is a medical degree, the meaning of which varies between different jurisdictions. In the United States, and some other countries, the ''MD'' denotes a professional degree of physician. This ge ...

in 1962."Distinguished Alumnus/Alumna Awards"
New Jersey College of Medicine. Retrieved May 22, 2012. Ammann later became the first pediatric immunologist at UCSF, where he served his residency in pediatrics."Eminent Doctor Chooses Service Over Retirement."
Alice C. Chen. SF Gate. Retrieved May 21, 2012.

Research

Early research

In 1966, for the first time, Ammann and Richard E. Stiehm documented

Immunoglobulin A Immunoglobulin A (IgA, also referred to as sIgA in its secretory form) is an antibody that plays a role in the immune function of mucous membranes. The amount of IgA produced in association with mucosal membranes is greater than all other ty ...

(IgA) as the major

immunoglobulin An antibody (Ab) or immunoglobulin (Ig) is a large, Y-shaped protein belonging to the immunoglobulin superfamily which is used by the immune system to identify and neutralize antigens such as pathogenic bacteria, bacteria and viruses, includin ...

class in

breastmilk Breast milk (sometimes spelled as breastmilk) or mother's milk is milk produced by the mammary glands in the breasts of women. Breast milk is the primary source of nutrition for newborn infants, comprising fats, proteins, carbohydrates, and a va ...

, present in high concentrations in

colostrum Colostrum (, of unknown origin) is the first form of milk produced by the mammary glands of humans and other mammals immediately following delivery of the newborn. Animal colostrum may be called beestings, the traditional word from Old English ...

mature breastmilk. They postulated that the protection afforded to infants by breast-feeding was a result of exposure to local antibodies contained within IgA rather than absorption of maternal antibody into these infants circulation. Ammann, Stiehm and James D. Cherry identified that there are elevated levels of

Immunoglobulin M Immunoglobulin M (IgM) is the largest of several isotypes of antibodies (also known as immunoglobulin) that are produced by vertebrates. IgM is the first antibody to appear in the response to initial exposure to an antigen; causing it to also ...

(IgM) in the

cord blood Cord blood (umbilical cord blood) is blood that remains in the placenta and in the attached umbilical cord after childbirth. Cord blood is collected because it contains stem cells, which can be used to treat hematopoietic and genetic disorders ...

of newborn infants born with the

congenital rubella syndrome Congenital rubella syndrome (CRS) occurs when a human fetus is infected with the rubella virus (German measles) via maternal-fetal transmission and develops birth defects. The most common congenital defects affect the ophthalmologic, cardiac, a ...

. This was a major step forward in understanding the fetal immune response and developing diagnostic tools to differentiate between in utero infection with infectious agents such as

rubella Rubella, also known as German measles or three-day measles, is an infection caused by the rubella virus. This disease is often mild, with half of people not realizing that they are infected. A rash may start around two weeks after exposure and ...

toxoplasmosis Toxoplasmosis is a parasitic disease caused by ''Toxoplasma gondii'', an apicomplexan. Infections with toxoplasmosis are associated with a variety of neuropsychiatric and behavioral conditions. Occasionally, people may have a few weeks or month ...

and

cytomegalovirus ''Cytomegalovirus'' (CMV) (from ''cyto-'' 'cell' via Greek - 'container' + 'big, megalo-' + -''virus'' via Latin 'poison') is a genus of viruses in the order '' Herpesvirales'', in the family '' Herpesviridae'', in the subfamily '' Betaherp ...

from infections acquired following birth."Elevated cord macroglobulins in the diagnosis of intrauterine infections."
NEJM, 275:971-977, 1966. In 1973, Ammann led his research team to perform the first successful reconstitution of

T-cell T cells (also known as T lymphocytes) are an important part of the immune system and play a central role in the adaptive immune response. T cells can be distinguished from other lymphocytes by the presence of a T-cell receptor (TCR) on their ce ...

immunity in a patient with severe combined

immunodeficiency Immunodeficiency, also known as immunocompromise, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that aff ...

. This was achieved through fetal thymus transplantation. This study demonstrated that the

thymus The thymus (: thymuses or thymi) is a specialized primary lymphoid organ of the immune system. Within the thymus, T cells mature. T cells are critical to the adaptive immune system, where the body adapts to specific foreign invaders. The thymus ...

holds only the potential of developing T cells and will not result in reconstitution of

B cell B cells, also known as B lymphocytes, are a type of the lymphocyte subtype. They function in the humoral immunity component of the adaptive immune system. B cells produce antibody molecules which may be either secreted or inserted into the plasm ...

immunity as was subsequently shown by others who utilized

bone marrow transplantation Hematopoietic stem-cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood, in order to replicate inside a patient and produce a ...

, which contained multi-potential

stem cells In multicellular organisms, stem cells are undifferentiated or partially differentiated cells that can change into various types of cells and proliferate indefinitely to produce more of the same stem cell. They are the earliest type of cell ...

. Thymus transplantation. Permanent reconstitution of cellular immunity in a patient with sex-linked combined immunodeficiency.
NEJM, 275:971–977, 1966. Working with E. R. Giblett in 1972, Ammann described the first patient with purine nucleoside phosphorylase deficiency in association with a unique genetic profile that included depressed T-cell immunity with normal levels of

immunoglobulins An antibody (Ab) or immunoglobulin (Ig) is a large, Y-shaped protein belonging to the immunoglobulin superfamily which is used by the immune system to identify and neutralize antigens such as bacteria and viruses, including those that cause di ...

. The resulting publication was listed as one of the 500 most widely cited articles in 1984. Ammann's discovery represented an essential step to understanding new treatments for immunodeficiency diseases and developing drugs that could interfere with the

immune response An immune response is a physiological reaction which occurs within an organism in the context of inflammation for the purpose of defending against exogenous factors. These include a wide variety of different toxins, viruses, intra- and extracellula ...

.Giblett ER, Ammann AJ, Sandman R, Wara DW, Diamond LK. "Nucleoside-phosphorylase deficiency in a child with severely defective T-cell immunity and normal B-cell immunity". ''The Lancet'', 1:2020–1014, 1975.

Pneumococcal vaccine

From 1971 to 1985, Ammann was director of Pediatric Immunology and Clinical Research Center at UCSF. It was during this period that Ammann performed a series of

clinical trials Clinical trials are prospective biomedical or behavioral research studies on human subject research, human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel v ...

aimed at protecting children with

sickle cell anemia Sickle cell disease (SCD), also simply called sickle cell, is a group of inherited haemoglobin-related blood disorders. The most common type is known as sickle cell anemia. Sickle cell anemia results in an abnormality in the oxygen-carrying ...

and the elderly from

pneumococcal ''Streptococcus pneumoniae'', or pneumococcus, is a Gram-positive, spherical bacteria, alpha-hemolytic member of the genus ''Streptococcus''. ''S. pneumoniae'' cells are usually found in pairs (diplococci) and do not form spores and are non mo ...

infection An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...

, a bacterium that causes fatal

. He and his

colleagues Collegiality is the relationship between colleagues, especially among peers, for example a fellow member of the same profession. Colleagues are those explicitly united in a common purpose and, at least in theory, respect each other's abilities t ...

were successful in creating the first U.S.

Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...

-approved

effective against the

bacteria Bacteria (; : bacterium) are ubiquitous, mostly free-living organisms often consisting of one Cell (biology), biological cell. They constitute a large domain (biology), domain of Prokaryote, prokaryotic microorganisms. Typically a few micr ...

; it granted individuals

immunity Immunity may refer to: Medicine * Immunity (medical), resistance of an organism to infection or disease * ''Immunity'' (journal), a scientific journal published by Cell Press Biology * Immune system Engineering * Radiofrequence immunity ...

against a life-threatening

."Marin Doctor Cited on Sickle Cell Work" George Nevin. Independent Journal. Published October 27, 1977. Ammann's vaccine has since been expanded and its

immunogenicity Immunogenicity is the ability of a foreign substance, such as an antigen, to provoke an immune response in the body of a human or other animal. It may be wanted or unwanted: * Wanted immunogenicity typically relates to vaccines, where the injecti ...

has been improved, increasing the effectiveness of the vaccine in young

infants In common terminology, a baby is the very young offspring of adult human beings, while infant (from the Latin word ''infans'', meaning 'baby' or 'child') is a formal or specialised synonym. The terms may also be used to refer to juveniles of ...

. This discovery has saved the lives of millions"Dr. Arthur Ammann M.D
Global Strategies for HIV Prevention
Retrieved May 22, 2012. of individuals by preventing pneumococcal infection, particularly in children and the elderly.

HIV transmission and treatment

In 1981, while working at UCSF in a lab that could perform the immunologic tests needed to detect

in AIDS patients, Ammann observed immunodeficiency disorders in children that mirrored those of

gay ''Gay'' is a term that primarily refers to a homosexual person or the trait of being homosexual. The term originally meant 'carefree', 'cheerful', or 'bright and showy'. While scant usage referring to male homosexuality dates to the late ...

men who had contracted the

Human Immunodeficiency Virus The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause AIDS, acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of th ...

. Ammann's investigations into the cause of the

symptoms Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature ...

led him to identify two new means of

transmission Transmission or transmit may refer to: Science and technology * Power transmission ** Electric power transmission ** Transmission (mechanical device), technology that allows controlled application of power *** Automatic transmission *** Manual tra ...

, mother to infant and

blood transfusions Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but ...

. With the medical community wanting not to believe that AIDS could affect infants, Ammann's initial publication blood transfusion infection was rejected by prominent medical journals. This discovery changed the perception of HIV/AIDS as an

epidemic An epidemic (from Greek ἐπί ''epi'' "upon or above" and δῆμος ''demos'' "people") is the rapid spread of disease to a large number of hosts in a given population within a short period of time. For example, in meningococcal infection ...

solely within the

gay community The LGBTQ community (also known as the LGBT, LGBT+, LGBTQ+, LGBTQIA, LGBTQIA+, or queer community) comprises LGBTQ individuals united by a common culture and social movements. These communities generally celebrate pride, diversity, individua ...

. In 1985, Ammann left his position at UCSF in order to work with the

biotechnology Biotechnology is a multidisciplinary field that involves the integration of natural sciences and Engineering Science, engineering sciences in order to achieve the application of organisms and parts thereof for products and services. Specialists ...

firm,

Genentech Genentech, Inc. is an American biotechnology corporation headquartered in South San Francisco, California. It operates as an independent subsidiary of holding company Roche. Genentech Research and Early Development operates as an independent cent ...

. There he developed clinical products focused on HIV/AIDS,"Honored Physician an Expert in HIV/AIDS Transmission and Treatment."
Viral Genetics, Inc. Retrieved May 23, 2012. and although while with Genentech a successful vaccine was not developed,"AIDS: Our Samaritan Call."
Katherine Halberstadt Anderson. Wheaton Magazine. Spring 2003. the discoveries made by Ammann's research team were used by other researchers in a partially successful study performed in Thailand in 2009.HIV Vaccine Trial Results — An Opening for Further Research
, Raphael Dolin, M.D. N Engl J Med 2009; 361:2279-2280 In 1994, Ammann was selected to become a member of the Presidential National AIDS Task Force on Drug and Vaccine Development."Arthur J. Ammann, MD"
International Antiviral Society-USA. Retrieved May 24, 2012. Three years later, in 1996, he was recognized by '' POZ'' magazine as one of the fifty most influential

AIDS The HIV, human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a Preventive healthcare, pr ...

researchers.

Advocacy

Ammann spent much of his life fighting injustices within the

health care Health care, or healthcare, is the improvement or maintenance of health via the preventive healthcare, prevention, diagnosis, therapy, treatment, wikt:amelioration, amelioration or cure of disease, illness, injury, and other disability, physic ...

system, nationally and internationally. From 1992 to 1996 he served as director of research programs for the Pediatric AIDS Foundation. Ammann was also the chairman of the Conference on Global Strategies for Prevention of HIV Transmission from Mothers to Infants. Ammann became a member of the

American Foundation for AIDS Research amfAR, the Foundation for AIDS Research, known until 2005 as the American Foundation for AIDS Research, is an international nonprofit organization dedicated to the support of AIDS research, HIV prevention, treatment education, and the advocacy of ...

(AmFAR) Board of directors in 1988, and was also appointed chairman of the AmFAR scientific advisory committee."A Message from the Foundation; AmFAR's New President, Dr. Arthur J. Ammann, Shares His Vision for the Future of AIDS Research." The AmFAR Newsletter. Spring 1997. Volume 2. From 1997 to 1998 Ammann served as president of AmFAR. In these positions, Ammann fought for an increase in research funding in HIV, in particular for women and children, and the development of more cost-effective treatments."Spotlight On: American Foundation for AIDS Research."
Nancy Lazar. Children's Legal Rights Journal. Volume 13, No. 2, Spring 1998. Retrieved May 22, 2012. In 1997, Ammann founded Global Strategies for HIV Prevention."Saving Lives, 85 Cents at a Time." Update, New York Academy of Sciences Magazine. November/December 2002. Page 11. In his position as president, Ammann advocated for the needs of the most marginalized populations that are affected by the HIV epidemic. The organization is aimed at helping to prevent HIV

from mothers to infants in order to slow the spread of the HIV virus.

Death

Ammann died in

San Rafael, California San Rafael ( ; Spanish language, Spanish for "Raphael (archangel), St. Raphael", ) is a city in and the county seat of Marin County, California, United States. The city is located in the North Bay (San Francisco Bay Area), North Bay region of th ...

, on August 15, 2021, three days after his 85th birthday.

Selected awards and honors

* 1977 E. Mead Johnson Award for Pediatric Research, New York, NY. * 1987 Distinguished Alumnus Award, New Jersey College of Medicine, Newark, NJ. * 1994 Selected as one of "The POZ 50," individuals who have most influenced the course of HIV/AIDS. * 1995 AmFAR's Outstanding Research in Pediatric AIDS Award. Presented on World's AIDS Day. * 2000 American Society of Microbiology Heroes in Medicine Award * 2001 Research in Action Award. Presented by

Treatment Action Group Treatment Action Group (TAG) is a U.S.-based organization that has been prominent within the movement of HIV/AIDS activism. Being formed in 1991, it has possessed the goals of working with worldwide efforts to increase research on treatments for HI ...

. December 8, 2001. New York, NY. * 2007 Wheaton College Outstanding Alumnus Award for Service to Humanity * 2010/2011 Purpose Prize Fellow Encore Career for continued dedication to issues of justice and equity. * 2013 Bakken Invitation Honoree.

Selected publications

*Ammann AJ and Stiehm ER
Immune Globulin Levels in Colostrum and Breast Milk, and Serum From Formula- and Breast-Fed Newborns.
Proc Soc Exp Biol Med, 122:1098-1100, 1966. *Stiehm ER, Ammann AJ, Cherry JD
Elevated cord macroglobulins in the diagnosis of intrauterine infections.
NEJM, 275:971-977, 1966. *Ammann AJ, Wara D, Salmon S, Perkins H. Thymus transplantation
Thymus Transplantation — Permanent Reconstitution of Cellular Immunity in a Patient with Sex-Linked Combined Immunodeficiency.
NEJM, 289:5-9, 1973. *Wara DW, Goldstein AL, Doyle NE, Ammann AJ
Thymosin Activity in Patients with Cellular Immunodeficiency.
NEJM, 292:70-74, 1975. (One of the 500 most widely quoted articles in 1980

*Giblett ER, Ammann AJ, Sandman R, Wara DW, Diamond LK
Nucleoside-phosphorylase deficiency in a child with severely defective T-cell immunity and normal B-cell immunity.
Lancet, 1:2020-1014, 1975. (One of the 500 most widely quoted articles in 1984

*Ammann AJ, Addiego J, Wara DW, Lubin B, Smith WB, Mentzer WC
Polyvalent pneumococcal-polysaccharide immunization of patients with sickle-cell anemia and patients with splenectomy.
NEJM, 297:897-900, 1977. *Ammann AJ, Cowan MJ, Wara DW, Weintrub P, Dritz S, Goldman H, Perkins HA
Acquired immunodeficiency in an infant: Possible transmission by means of blood products.
Lancet, 1:956-958, 1983. *Curran TW, Lawrence DN, Jaffe HS, Kaplan JE, Zyla LD, Chamberland M, Weinstein R, Lui KJ, Schonberger LB, Spira TJ, Alexander WJ, Swinger G, Ammann AJ, Solomon S, Auerbach D, Mildvan D, Stoneburner R, Jason JM, Haverkos HW, Evat BL
Acquired immunodeficiency associated with transfusions
NEJM, 310:69-75, 1984. *Cowan MJ, Hellmann D, Chudwin D, Wara DW, Chang RS, Ammann AJ
Maternal transmission of acquired immune deficiency syndrome.
Pediat, 73:382-386, 1984. *Cao Y, Krogstad P, Korber BT, Koup RA, Muldoon M, Macken C, Song J-L, Jin Z, Zhao J-Q, Clapp S, Chen ISY, Ho DD., Ammann AJ and the Ariel Project Investigators
Maternal HIV-1 viral load and vertical transmission of infection: The Ariel Project for the prevention of HIV transmission from mother to infant.
Nature Medicine 3: 549-552 1997. *Ammann AJ
HIV in China: An Opportunity to Halt an Emerging Epidemic.
Ammann AJ AIDS Patient Care and STDs 14:109-112, 2000. *Ammann AJ
Introduction to the Second Conference on Global Strategies for the Prevention of HIV Transmission from Mothers to Infants.
Annals NY Academy of Sciences 918:1-2, 2000. *Kim JY, Ammann AJ
Is the "3 by 5" initiative the best approach to tackling the HIV pandemic?
PLoS Med. 2004 Nov;1(2):e37. Epub 2004 Nov 30. *Ammann AJ
Feminization of the HIV Epidemic.
Radix 32:8-13 2006 *Ammann AJ
Advances in HIV Care and Treatment in Resource Poor Countries.
HIV Therapy. 2009 3:329-338.

References

{{DEFAULTSORT:Ammann, Arthur J. 1936 births 2021 deaths American pediatricians American immunologists Wheaton College (Illinois) alumni Rutgers University alumni Scientists from Brooklyn American people of German descent University of California, San Francisco faculty