This year, the Asthma and Allergy Foundation of America (AAFA) celebrates the 40th year of designating May as National Asthma and Allergy Awareness Month and, together with the American College of Allergy Asthma and Immunology (ACAAI) and the American Academy of Allergy & Asthma & Immunology (AAAAI), is focusing its efforts on empowering individuals and communities by providing resources, education, and opportunities for advocacy.1 It is appropriate, therefore, that we recognize a visionary advocate for the patient with asthma and allergic disease.
George Miller O’Brien (June 17, 1917 – July 17, 1986) was a Republican US House of Representatives member, representing Illinois’ 17th and fourth districts. He served from 1973 until his untimely death from prostate cancer in 1986. Notably, he played a pivotal role in establishing the Centers for Interdisciplinary Research on Immunologic Diseases (CIRIDs) program of the National Institute of Allergy and Infectious Diseases (NIAID) in 1978.2 Alongside Congressman Edward R. Roybal, a Democrat and Chair of the Appropriations Subcommittee, representing California’s 25th Congressional District, O’Brien championed legislation supporting this groundbreaking interdisciplinary research initiative in immunology. Dr Joseph A. Bellanti and Dr. Vijaya L. Melnick worked closely with Mr. O’Brien and Mr. Roybal to highlight the need for interdisciplinary research in immunology.3 Mr. O’Brien’s deep-rooted commitment to the support of research in the field of allergic diseases stemmed, in part, from his own struggle with asthma and allergic disease, for which he was being treated by his local allergist, Dr. Robert J. Becker, past-president ofthe American College of Allergy, Asthma and Immunology (1987), in Joliet, Illinois—a poignant reminder of the human face behind the crusade he led for the conquest of these conditions.
The purpose of the CIRIDs was to advance understanding and treatment of immunologic diseases through interdisciplinary collaboration and research that brought together scientists, physicians, and other healthcare professionals to study a wide range of allergic and immune-related disorders, including some of the first studies of an unusual immunodeficiency syndrome, now known as HIV/AIDS.4 By fostering collaboration and innovation across different disciplines, CIRIDs sought to drive forward scientific discovery, develop new treatments, and improve patient outcomes in the realm of immunology.
The CIRIDs were the first program of the NIAID to include Demonstration and Education (D&E) Outreach Projects aimed at tackling health issues in patients with asthma and their families prevalent in underserved communities, particularly in inner-city areas. The CIRIDs implemented outreach initiatives targeted at addressing the high prevalence of asthma among inner-city residents, providing education, resources, and support to improve asthma management and prevention in these communities. By prioritizing outreach and intervention programs tailored to the needs of disadvantaged populations, CIRIDs aimed to reduce health inequalities and promote equitable access to healthcare and disease prevention measures.5
In formulating the legislative language that brought about the creation of the CIRIDs, Congressman O’Brien employed unusually precise and prescriptive wording:
‘‘The Committee directs the Institute to establish a program for interdisciplinary research in immunology consisting of 3 pilot centers geographically dispersed and university-based. The Committee believes that priority should be given to applicants which have an ongoing interdisciplinary program in immunology or allergic diseases. Furthermore, the pilot program should operate for at least 5 years with evaluation at 3 years to ascertain productivity and accomplishments. Let me suggest the amount of money being applied to this effort will be approximately $900,000.’’
O’Brien went on to describe the mission of the CIRIDs as part of the overall goal of NIAID: ‘‘This particular Institute does one thing which is singular. It cuts across fields of health care horizontally. It will one day reveal the ways in which the immune systems can deal with cancer, arthritis, aging, and so on. I would like to suggest that this particular effort will provide a harvest of improved medical care far beyond our present dreams and expectations.5
The Inner-City Asthma elements within the CIRIDs laid the groundwork for the establishment of the Inner-City Asthma Consortium (ICAC) by NIAID. The ICAC aimed to identify risk factors and evaluate treatments for reducing asthma symptoms and exacerbations. After the initiation of the seminal CIRID initiative in 1978 which first introduced the Inner-City Asthma concept, NIAID over the years has continuously supported initiatives targeting Inner-City Asthma. The first subsequent NIAID ICAC initiative focusing on Inner-City Asthma was the National Cooperative Inner City Asthma Study (NCICAS) that was launched in 1991. This was followed by the Inner-City Asthma Study in 1996, the ICAC in 2002, with the latest program, the Childhood Asthma in Urban Settings being launched in 2021.
Funding for these initiatives has increased significantly, from the initial $900,000 for the initial 1978 CIRID initiative to $18.7 million for the inaugural 1991 ICAC program to approximately $66.5 million for the current seven-year program. This sustained support underscores NIAID’s commitment to addressing health disparities and advancing understanding and treatment of inner-city asthma.(Rotrosen D, MD [personal oral communication, 2024]).
As Rotrosen et al2 so aptly stated in their commentary of the history of the CIRID initiative, “This account would not be complete without giving thanks and due credit to the hundreds of scientists, physicians, nurses, technicians, and research coordinators and the thousands of inner-city families who were involved in these efforts, the NIAID provided the resources, but whatever successes these programs have achieved are due to the ingenuity, intuition, drive, and commitment of many others”…..and among these, Congressman George O’Brien was the visionary architect and the pioneering force behind this initiative.
Disclosures
The authors have no conflicts of interest to report.
Funding
The authors have no funding sources to report.
| Authors | |
|---|---|
| Joseph A. Bellanti, MD, FACAAI Departments of Pediatrics and Microbiology-Immunology Georgetown University School of Medicine Georgetown University Washington, DC bellanti@georgetown.edu |
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| Russell A. Settipane, MD, FACAAI Department of Medicine Alpert Medical School Brown University Providence, RI russ.settipane@gmail.com |
References
- Asthma and Allergy Foundation of America, National asthma and allergy awareness month empowers individual and communities. Accessed May 13, 2024. Available at: https://aafa.org/national-asthma-and-allergy-awareness-month-empowers-individuals-and-communities/
- Rotrosen D, Plaut M, Hackett C, Fauci AS. The National Institute of Allergy and Infectious Diseases’ asthma research programs: a retrospective. J Allergy Clin Immunol. 2007 Jan;119(1):258-62.
- Bellanti JA. Allergy and Clinical Immunology: an interdisciplinary concept. The Bela Schick Memorial Lecture. Ann Allergy 1978; 41(3):129.
- Gottlieb MS, Schroff R, Schanker HM, Weisman JD, Fan PT, Wolf RA, et al. Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men. Evidence of a new acquired cellular immunodeficiency. N Engl J Med 1981; 305:1425-1431.
- Congressional record. 95th Cong, 1st Sess (1977).
This article is reprinted on the ACAAI website with the kind permission of Annals of Allergy, Asthma & Immunology.
