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Prof. Alan Ebringer,B.Sc, MD, FRCP, FRACP, FRCPath, HonFRSHKing’s College London

Your Royal Highnesses, Mr. Chairman, Ladies and Gentlemen. I would like to thank The Royal Society for the Promotion of Health for the great honor it has bestowed on me in awarding the Donaldson Gold Medal to me for the work from our group,on “Bovine Spongiform Encephalopathy or BSE or more commonly known as MAD COW DISEASE. This work is a credit to the outstanding group of research workers in our Unit, especially Dr. Clyde WILSON , who recently was elected a Member of the “Royal College of Pahologists” rather than to anything I may have done personally. I graduated in Medicine from the University of Melbourne way back in 1962, obtained a Travelling Scholarship from the “Royal Australasian College of Physicians” to come to the U.K. and I have been working in the University of London since 1970.Over the last thirty years, our group has been studying the autoimmune diseases, ANKYLOSING SPONDYLITIS, a chronic condition characterized by backache and also another arthritic disease RHEUMATOID ARTHRITIS. We have found that ANKYLOSING SPONDYLITIS is triggered by the bowel microbe KLEBSIELLLA and RHEUMATOID ARTHRITIS is produced following a urinary tract infection by the microbe PROTEUS. Prof. Feltkamp from Amsterdam in the Netherlands, asked us to cooperate in a joint study, which showed that Dutch patients with ANKYLOSING SPONDYLITIS have antibodies to KLEBSIELLA and Dutch patients with RHEUMATOID ARTHRITIS have antibodies to PROTEUS, as do English patients. These results have been published. In AUTOIMMUNE DISEASES patients have antibodies which attack their own organs and these are called AUTOANTIBODIES. Our model for studying autoimmune diseases was RHEUMATIC FEVER, which is caused by the microbe STREPTOCOCCUS, which infects the tonsils and has components which resemble the human heart. Following a STREPTOCOCCAL TONSILLITIS antibodies are produced which attack not only the microbe itself but also the human heart and cause RHEUMATIC FEVER.

Thus MOLECULAR MIMICRY or similarity between a microbe and a target organ produces an AUTOIMMUNE DISEASE. RHEUMATIC FEVER is no longer a problem in the Western world because


STREPTOCOCCAL TONSILLITIS responds to antibiotics but in countries of the Third World where access to such drugs is financially prohibitive, the disease remains a serious problem.