Clinical Chemistry 45: 1321-1322, 1999;
(Clinical Chemistry. 1999;45:1321-1322.)
© 1999 American Association for Clinical Chemistry, Inc.
Raging Hormones: Closing the Loop from Bench to Bedside. The Twenty-Second Arnold O. Beckman Conference in Clinical Chemistry
Edward R. Ashwood
Department of Pathology, University of Utah School of Medicine, ARUP Laboratories, Inc., 500 Chipeta Way, Salt Lake City, UT 84108. E-mail ashwood{at}med.utah.edu
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Abstract
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The Twenty-second Annual 1999 Arnold O. Beckman Conference was held on
February 21 and 22, 1999, in San Antonio, Texas. In keeping with the
tradition of the conference, the goal of this year's meeting was to
strengthen attendees' knowledge of clinical endocrinology and the use
of the clinical laboratory. The conference was divided into four
sessions: basic science, diabetes, bone, and diagnostic endocrinology.
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Acknowledgement and Historical Summary of A.O. Beckman
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K. Michael Parker, PhD, AACC President, opened the conference. He
thanked Dr. Beckman for his "generous gift and visionary foresight,
which have endowed 22 conferences. Dr. Beckman stated that his actions
were taken to contribute to the professional growth of clinical
chemistry and to the improvement of healthcare". In accordance with
the gift from the Arnold and Mabel Beckman Foundation, AACC publishes
the proceedings of each conference.
Following Dr. Parker's introduction, I briefly reviewed both Dr.
Beckman's history and the history of the conference. Readers
interested in learning about Dr. Beckman are referred to the recent
article about him in this journal (1) and to the Beckman
Coulter web site that more completely describes Dr. Beckman's life
story (2). A table highlighting the events of his
illustrious career was published in the proceedings of last year's
conference (3). Dr. Beckman received the 1999 Public Welfare
Medal, the most prestigious award of the (US) National Academy of
Science. Dr. Beckman is one of three honorary members of
AACC.
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Historical Summary of the Beckman Conference
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The Beckman conference began in 1977 with the purpose of educating
both clinical chemists and clinicians. Although there has been strong
attendance by clinical chemists, clinicians are more apt to attend
meetings sponsored by their own professional organizations. Therefore,
the conference has evolved into one that includes clinical chemists as
attendees and superb clinicians as speakers. The meetings have been
small enough to allow interaction of attendees with speakers, have been
highly evaluated by attendees, and have been free from commercial
content, consistent with the terms of the Arnold O. and Mabel Beckman
Foundation. The topics of the Beckman conferences since their inception
have been summarized recently (3). The conference committee
is committed to continuing the proceedings so that all members of AACC
and the broader biomedical community may benefit from this activity.
Beginning in 1998 and continuing this year, the proceedings are also
available in Clinical Chemistry Online (www.clinchem.org).
This evolution is consistent with the founding purpose of the
conference.
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1999 Conference Summary
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The conference speakers were recruited to discuss human
endocrinology. This topic was divided into four sessions: basic science
of receptors and rhythm, diabetes, bone, and diagnostic endocrinology.
In addition to the formal presentations, the participants attended two
case study sessions.
The basic science session started with an excellent presentation by Dr.
Andrés Negro-Vilar (Ligand Pharmaceuticals, Inc.) on the function
of endocrine receptors. He predicted the discovery of 500 receptors by
the end of the Human Genome Project. Dr. Jean Wilson (University of
Texas Southwestern Medical Branch) next discussed the receptor genes.
The understanding of hormone receptors has been greatly assisted by the
identification and sequencing of their genes, and studies have shown
that most hormone resistance is caused by abnormal or absent hormone
receptors. Dr. Martin Kroll (The Johns Hopkins Hospital) presented a
review of biological rhythms in endocrine processes. Pathological
conditions are often accompanied by loss of the normal rhythms, and
understanding the rhythms may lead to more effective treatment for
disorders such as osteoporosis and diabetes. To end this session, Dr.
George G. Klee (Mayo Clinic) reviewed pre- and postanalytical factors,
patient preparation, specimen collection and stabilization, and
laboratory report formatting. During the luncheon, Dr. Mitchell I.
Burken (Health Care Financing Administration) discussed payer
approaches to endocrine testing.
Diabetes mellitus was the subject of the second scientific session. Dr.
Åke Lernmark (University of Washington) reviewed the immunological
etiology of type 1 diabetes. Autoantibodies against three major islet
cell autoantigens (insulin, glutamic acid decarboxylase, and a protein
tyrosine phosphatase) are strongly associated with type 1 diabetes. The
second presentation was by Dr. Harold E. Lebovitz (SUNY Health Science
Center) and covered type 2 diabetes, which is a polygenic disorder.
The third session reviewed bone and bone metabolism. Mechanisms of
calcium homeostasis were covered by Dr. Gregory Mundy (University of
Texas Health Science Center at San Antonio). Specifically, he discussed
parathyroid hormone, parathyroid hormone-related peptide, and the
mechanism of bisphosphonate treatment. Speaking next, Dr. Lawrence G.
Raisz (University of Connecticut) reviewed bone physiology and
remodeling. The latter process is a set of highly regulated phases that
include activation, resorption, reversal, and formation. Finally, Dr.
Nelson Watts (Emory Clinic) discussed the clinical application of bone
markers: formation markers, which include alkaline phosphatase,
osteocalcin, and procollagen-1 extension peptides; and resorption
markers, which include pyridinoline, telopeptides, cross-linked
telopeptides of type 1 collagen, and others.
The last scientific session was composed of disparate topics in the
area of diagnostic endocrinology. Dr. Horace M. Perry III (St. Louis
Veterans Affairs Medical Center) presented the endocrinology of aging.
His topics included leptin, vitamin D, dehydroepiandrosterone,
testosterone, and growth hormone. Next, Dr. Michael Kaplan (Associated
Endocrinologists, West Bloomfield, Missouri) gave a clinician's
perspective on the diagnosis of thyroid disease. His presentation used
the case study approach. Lastly, Dr. Clifford Rosen (St. Joseph
Hospital, Bangor, Maine) reviewed new discoveries in the field of
insulin-like growth factors and their binding proteins.
The conference attendees and speakers participated in two case study
sessions, one each day. Four months before the conference, a call for
cases was mailed to members of the AACC Texas and Rocky Mountain local
sections. Drs. Jim Smith (University of Oklahoma) and Charles Bradley
(Texas Tech University) submitted cases and assisted with the
discussions. Dr. Frank Wians, Jr. (University of Texas Southwestern
Medical Center) submitted cases but was unable to attend.
I could not have chaired the 1999 conference without the generous
contribution of time and able knowledge of my fellow committee members:
Ronald J. Elin, Joseph H. Keffer, Michael Kleerekoper, and Martin H.
Kroll. Their pleasant cooperation, dedicated recruiting of superb
clinicians, and broad knowledge of clinical laboratory medicine were
essential for the successful planning of this conference. The
assistance of the AACC office staff was timely and profession. Special
thanks to Lisa Dunay, Angela Johnson, and Penny Jones.
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References
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Anonymous. Arnold O. Beckman to receive 1999 Public
Welfare Medal. Clin Chem 1999;45:446–7..
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The Arnold O. Beckman Story.
http://www.beckman.com/beckman/gen-info/foundr.asp..
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Ashwood ER. Acute coronary syndromes: from bench to bedside—the Twenty-first Arnold O. Beckman Conference in Clinical Chemistry. Clin Chem 1998;44:1795-1797.
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