For me, the dream began in the early 1960s. As a medical student, I was helping with the care of a 16-year-old girl who had classical Hashimoto thyroiditis, a disease that more commonly occurs among middle-aged women. I guessed that this girl's early onset signified a particularly strong genetic predisposition. Indeed, further investigation identified numerous cases of thyroid disease or other endocrine-system problems in family members. It occurred to me that genetic information might predict future development of autoimmune disease and, thus, open avenues to intervene before the pathologic process reached an irreversible level.
The opportunity to pursue this idea arose 15 years later at Wayne State University School of Medicine in Detroit. There, I worked with William H. Hoffman, a pediatric endocrinologist who had an active clinic of children and adolescents with autoimmune thyroid disease, and Lynne Burek, a clinical laboratory immunologist. Later, Avi Gimelfarb, a population geneticist, joined ...