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Dr
Friedrich C. Luft Chief, Nephrology/Hypertension Section Medical Faculty of the Charité Humboldt University of Berlin HELIOS Kliniken - Berlin Franz Volhard Clinic at the Max Delbrück Center Berlin, Germany |
Dr Zoccali: After about two decades at Indiana University, where, in the early nineties, you focused mainly on sodium and blood pressure, you moved to Berlin to establish one of the leading research centres dealing with cardiovascular and renal diseases. I think that your experience of starting this ambitious enterprise must have been a great and quite rewarding challenge. Could you tell us the story of this success?
Dr Luft: I was born in Berlin, but my parents emigrated to the USA when I was five years old. I lived there 41 years. In 1989, I accepted an offer to join Bernd Sterzel, who was on the faculty of Yale University, in setting up a large department of Internal Medicine and Nephrology at the University of Erlangen/Nürnberg. Language was not a problem since my parents had always insisted in speaking German at home. The Americans call this kind of move on my part “mid-life crisis”. In 1991 I received an offer to start my own department here in East Berlin. The recruitment was for someone knowledgeable in molecular genetics of cardiovascular disease. I knew relatively little about that, but then no one else did either. I had taken some courses in recombinant DNA given at NIH a few years earlier, but that was the extent of my molecular genetic knowledge. I had a pretty good background in experimental animal work and had lots of experience in patient-oriented research from our General Clinical Research Center at Indiana University, where I had worked in the USA. Thus, I was fairly confident that we could get something going.
Dr Zoccali: How did you recruit the initial research team of the Franz Volhard Clinic and Research Centre?
Dr Luft: I had incredibly good luck in recruitment. I convinced Hermann Haller, now Chief of Internal Medicine and Nephrology at the University of Hannover, to join me. He had infectious enthusiasm. I was able to give Hermann ample protected time. He established cell biology in the department and recruited several key young people. I recruited Herbert Schuster, who was certified in Internal Medicine and Medical Genetics. Herbert currently runs a company called INFOGEN. Herbert is an expert in lipid metabolism. This area was highly clinically relevant and an excellent area for us in terms of molecular genetics. We focused on familial hyperchosterolemia and familial combined hyperlipidemia, and started recruiting large numbers of families. In all, we obtained samples from 20,000 people. Herbert and I were able to convince Sylvia Bähring, a post-doc molecular biologist, to run the genetics laboratory. With help from two wonderful medical students, Hakan and Okan Toka, we were able to recruit a family with Mendelian hypertension and brachydactyly. We are still working on that project. Hakan Toka is currently with Richard Lifton at Yale and Okan Toka is with Christine Seidman at Harvard. Hermann, Herbert, and I always focused on winning young clinicians into research. Some trained here and others we sent to the USA for additional training. These young people now run the vascular biology and patch clamp labs, the vasculitis program, the General Clinical Research Center, the twin project, the animal physiology and other key focal points of our program.
Dr Zoccali: Do you still have time to devote to clinical medicine or are you entirely absorbed in your scientific and managerial duties?
Dr Luft: I love teaching and always wanted to be a teacher. Thus, I make clinical rounds every day. I go through the Franz Volhard Clinic intensive care unit three times per week and cover two large general internal medicine wards. I see patients individually if they insist on it, but I have avoided attracting “private” patients. Actually, it is my administrative and managerial duties that I allow to slide if sliding is necessary.
Dr Zoccali: The distance between basic and clinical research is widening. Do you think that it is more difficult now for young investigators to acquire experience “from the bench to bedside”?
Dr Luft: From the bench to bedside is always difficult but no harder today than earlier. I have one young associate who is working on nuclear transport. He focuses on Inportins/Importins, proteins that serve a shuttle function across the nuclear membrane. We both are a bit unclear how important this line of research will be to nephrology in the next few years, but he made the cover of Kidney Int last year so I am confident he will continue to do well. Clinicians need to have the necessary imagination to apply their bench to the bedside.
Dr Zoccali: Hypertension associated with brachydactilia has
intrigued you very much. At what stage have you arrived at with regard to understanding
this genetic disease you identified in a Turkish family?
Dr Luft: We have new, unpublished information on the Turkish family that we hope to present at the WCN2003 this summer. Suffice it to say that lots of clinical and molecular work needs to be done. In terms of the clinical, we are at the very moment studying 10 subjects from the family here in Berlin including performing buttocks biopsies that we learned from Tony Heagerty’s group and some forearm physiology studies. We are now confident that this is a contiguous gene syndrome and that several genes probably explain the phenotypes.
Dr Zoccali: What research problems are you primarily interested in now?
Dr Luft: It is hard to say what is on top. My former bosses and mentors, and I am thankful to them all, always accused me of being diffuse and poorly focused. Now, I see that as a compliment. I love all our projects and get wildly enthusiastic about each one, oftentimes more than once each day. I am happy to accommodate new projects. A medical student who joined our group is doing Xenopus oocyte studies on the INDY gene (I’m Not Dead Yet) and has shown that the gene codes for a transporter. When the gene is absent, fruit flies live longer. This is a great project for a young nephrologist!
Dr Zoccali: What scientific paper has had the greatest impact on your scientific projects?
Dr Luft: My favorite paper is by Adolph Fick. The paper was published in 1871 after a 10-minute talk Fick had given before the Würzburg Medical-Physical Society. Fick’s talk was entitled: “On the measurement of the blood volume in the cardiac ventricle”. Fick was a great experimentalist, but this solution he realized solely by reasoning. He relied on some data generated in Carl Ludwig’s laboratory some time earlier. Fick reasoned that if oxygen consumption were known, and if oxygen content of mixed venous and arterial blood could be determined, then one could easily calculate how much blood would have to run by to explain the difference in content. He then proceeded to suggest that by determining carbon dioxide excretion and carbon dioxide content in both blood samples simultaneously, one would have the ideal simultaneous control experiment. What a great scientific solution to a tough problem with a built-in control! We use this formula or derivations, every day for cardiac output, clearances, shunt equations, micro and macro dialysis problems etc. I wish I had a sharp and quick a mind as Adoph Fick.
Dr Zoccali: The way scientific information is evaluated and communicated is changing rapidly. For you, what is the most challenging aspect of Science in the Internet era?
Dr Luft: For me, the worst problem is keeping track of dozens of passwords and secret numbers. Furthermore, when I finally get around to it, late in the evening or on weekends, all the teenagers have already gone home and I am left to my own devices!
Dr Zoccali: What is your favourite hobby?
Dr Luft:
Listening to young people telling me how hard life is!
