‘It began with an observation’

Ronald Falk, MD, earns National Institutes of Health honor for seminal work as a physician-scientist.

‘It began with an observation’ click to enlarge Ronald Falk, MD. Photo by Rochelle Moser.

By Caroline Curran, caroline.curran@unchealth.unc.edu

In June 1985, a 15-year-old girl was rushed to UNC Hospitals. She was coughing up blood. Her pediatrician consulted Ronald Falk, MD, professor of medicine. She had aggressive inflammation of glomeruli – filtering units of the kidney made up of small blood vessels. Falk had just read an article in the journal Lancet suggesting that a form of vasculitis could be associated with an unusual autoantibody.

He and his colleague Charles Jennette suspected the unusual autoantibody could be causing this young patient’s severe problems. They collected the girl’s serum, drew blood from Jennette and put her serum on his blood to run an experiment. They detected the presence something unusual, which would later be defined as ANCA – anti-neutrophil cytoplasmic antibody.

“At that time, we were clueless about what she had,” Falk said. “Today, we’d be able to diagnose her in four hours. ANCA has revolutionized the diagnosis of this form of vasculitis.”

Since this moment, Falk, now chair of the department of medicine at the UNC School of Medicine, has dedicated his research to studying autoimmune kidney diseases and ANCA vasculitis.

“In a relatively short period of time, we came up with a seminal observation – a biomarker called ANCA,” Falk explained. “The condition we first observed in that patient now has a name, we know its underlying cause, and we know its treatment.”

For his decades-long effort, Falk, who also founded the UNC Kidney Center, received two national honors. He will deliver the National Institutes of Health (NIH) Astute Clinician Lecture on Nov. 2 at the NIH. Falk also received the Edward N. Gibbs Lecture & Award in Nephrology, a lifetime achievement award.

The NIH Astute Clinician Lecture Series is an annual award that “honors a U.S. clinician-scientist who has observed an unusual clinical occurrence, and by investigating it, has opened up an important new avenue of research.”

“The NIH doesn’t give out very many awards. I’m very honored by this,” Falk said. “Here at UNC, we do real, human-based, hypothesis-driven research. That’s what we’re known for. It’s great to be recognized for that.”

Falk says the role of a physician-scientist is a unique, challenging, and rewarding one.

“You take care of patients, you figure out what’s going on in the lab, and you go back and you alter what’s happening to patients,” he said. “That’s why being a physician-scientist is so fun.”

Falk added: “I get asked the same three questions every time I see a patient. ‘What caused my disease? What’s going to make it better? What’s going to make it worse?’ It brings me joy to be able to look at the patient and say that I can answer some of those questions because of the research that’s being done right here at UNC.”

In addition to the NIH award, Falk was also honored by the New York Academy of Medicine, where he delivered the Edward N. Gibbs Lecture & Award on Oct. 24.

“I’m humbled that it’s me, but more than anything I’m happy that UNC got this clinician-scientist award. It happens to be me, but it could also have been Charles Jennette. This institution has helped figure out a disease,” Falk said.

Jennette, MD, Kenneth M. Brinkhous Distinguished Professor at UNC School of Medicine and chair of the department of pathology and laboratory medicine, is Falk’s mentor. In fact, Falk often playfully refers to him as his “work spouse” due to their decades-long work side by side on ANCA and other auto-immune research.

“We’ve never had a physician-scientist that has gotten an award like this,” Jennette said. “It’s a great honor for the UNC School of Medicine and it speaks to our dedication to not only our patients, but to the research that’s ultimately going to help them beat their disease.

“It is cliché to say that an academic physician is a triple threat,” Jennette added. “However, Ron Falk is a quadruple threat: a stellar clinician, teacher, researcher, and administrator,” Jennette said.

“We’re a team. We’ve done all this research together,” Falk said of Jennette, as well as other researchers at UNC. “All this work would never have happened without Charles and Patrick Nachman and the cascade of brilliant physician-scientists and PhD-scientists here at UNC.”

Ronald Falk, MD, is the Nan and Hugh Cullman Eminent Professor at the UNC School of Medicine.

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