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Born in Marburg in 1937, Joachim (Jochen) R Kalden studied medicine in Freiburg, Marburg and Tübingen. He developed his passion for immunology early on: ‘The immunological histamine release in the diagnosis of drug allergic conditions’, was the title of his doctoral thesis in 1966, and it was the first testimony to his occupation with immunology, his later great professional love. Always at the forefront of research, he developed this passion with his characteristic great curiosity and visionary power over many decades. As a postdoctoral fellow in the Department of Therapeutics at the University of Edinburgh, he was deeply involved in the scientific basis of immunopathogenesis of autoimmune diseases with a then very novel idea: autoantibodies were responsible for the development of myasthenia gravis, an autoimmune disease of the neuromuscular endplate. He was dedicated to find new methods to detect such autoantibodies to open diagnostic and, more importantly, therapeutic opportunities. This was the temptation that drove him throughout his life: to develop methods based on an understanding of the pathophysiology of autoimmune diseases that could be used to precisely intervene into their disease processes. This concept is the basis of modern therapy of inflammatory rheumatic diseases and the concept to induce remission, which is intensively connected with Joachim R Kalden as a worldwide appreciated, extremely active protagonist.
Joachim R Kalden received his clinical training in Hannover, Germany, as an assistant in the Division of Clinical Immunology at the Department of Internal Medicine at the Hannover Medical School, which had just been founded and had set itself the goal of promoting innovative approaches in teaching and research. His mentor, Helmut Deicher, had discovered the anti-DNA antibodies in parallel to Maxime Seligmann, Paris, when he was a postdoctoral fellow in the Kunkel Laboratory at the Rockefeller University in New York. In this new and modern environment, Joachim R Kalden was then able to complete his habilitation on the immunopathogenesis of myasthenia gravis. After a short period as a senior physician in the Division of Clinical Immunology and Transfusion Medicine, he accepted the position as chair of the Institute of Clinical Immunology (later also ‘and Rheumatology’) at the Friedrich-Alexander University Erlangen-Nuremberg at the age of 39 years. After restructuring of the Department of Internal Medicine at the Medical Faculty, he eventually became Director of the Department of Medicine III with a focus on clinical immunology, rheumatology, oncology/haematology and allergology.
Joachim R Kalden early recognised the exciting new opportunities offered by rheumatology if it only was understood scientifically and immunologically. He understood how to put his visions into practice—for the good of the discipline, but above all for the good of the care of patients suffering from inflammatory rheumatic diseases. When he started in Erlangen in 1976, rheumatology, in particular with the conservative German tradition of spa-based treatments, was backward in many areas; it often had little scientific basis, nor was it anchored in medicine as an independent specialty. In fact, there was hardly any academic rheumatology unit in Germany at that time and there was even a dispute over the introduction of the subspecialty ‘rheumatology’. In Erlangen, Joachim R Kalden created the basis for the development of this new field—clinically, scientifically, in terms of personnel, with national and international reputation. With his charisma, he inspired young scientists to become involved in various aspects of rheumatology and clinical immunology. He created an atmosphere of collaborative scientific discourse, recognised early the value of international networking and allowed his staff to gain experience in designated laboratories and clinics around the world. He was always open minded and supportive of new ideas. Thus, the Department of Medicine III in Erlangen grew into a nationally and internationally leading research institution. International reviewers quickly confirmed the quality of the Department under the direction of Joachim R Kalden. The establishment of two research groups of the Max Planck Society in Erlangen attached to his department was a great success of Joachim R Kalden’s scientific work.
The very first therapeutic uses of monoclonal antibodies in rheumatoid arthritis in a larger clinical trial then arose from collaborative work between his institution and scientists from one of the Max Planck groups. This scientific excellence, which included a deep understanding of autoimmunity, especially in systemic lupus erythematosus, was later the basis for major collaborative research centres and the selection as one of the sites for an Interdisciplinary Centre for Clinical Research by the German Research Council. Thus, through Joachim R Kalden, a small laboratory with very limited staff was transformed into an internationally highly appreciated research centre in Erlangen. The Franconian location, with its beer gardens, wine cellars and restaurants, offered excellent opportunities for exchanging new ideas and making scientifically innovative plans outside the daily clinical routine. Joachim R Kalden’s motto in life was ‘joie de vivre’ combined with science. In his youth, he had been an excellent and ardent hand ball player, was able to play the drums (his love were 4/4 drum tracks) and then developed a keen passion for modern art. His office was both a harbour for scientific papers, but also for piles of museum catalogues. He was also a connoisseur of excellent wines, which was of course easy in the Franconian environment.
Throughout Germany, Joachim R Kalden worked tirelessly to strengthen rheumatological research. He was instrumental in the idea of establishing a German Rheumatism Research Centre, currently headed by Andreas Radbruch, and as a member and President of the Board of Trustees, he played a decisive role in its development over many years, making it a German model institution for cooperation between hospitals and non-university research institutes (figure 1).
Jochen Kalden at the 30 year anniversary of the German Rheumatism Research Center (DRFZ) 2018.
In clinical care, Joachim R Kalden has had a major impact on the development of modern therapies. He was involved in the clinical trials of biologics from the very beginning and helped to launch and advance this development based on new ideas created by the European rheumatology ‘dream team’ of Sir Ravinder Maini, Ferdinand Breedveld, Josef Smolen and himself, which was later joined by Peter E Lipsky from the USA. Apart from clinical science, he and his colleagues made seminal discoveries on the pathophysiology of autoimmune disease. For instance, his group showed that impaired phagocytosis of apoptotic material is a key step for the development of systemic lupus erythematosus. This environment of scientific excellence, translational competence and rapid clinical development that he created is the basis of modern rheumatology. Joachim R Kalden understood how to develop all aspects of the field and he was one of the leaders in modern rheumatology. Consequently, he was president of the German Society of Rheumatology and of the European League Against Rheumatism (figure 2), but he also served as long-term president of the German Society of Immunology. He connected clinical medicine with science and understood early on that the connection of the two fields has tremendous potential and that it is worthwhile to align one’s life with them. In his environment, as a mentor and teacher, he has inspired, trained, promoted and shaped many scientists and rheumatologists who are active today (figure 3) and he was also able to successfully hand over this great environment to his successor in 2006. He was significantly involved in international exchange programmes (figure 4), through which young colleagues were given the opportunity to become acquainted with experimental and clinical rheumatological work and care as guests in other countries.
Joachim Kalden and members of the Academy of Rheumatology in Kairo 2008 (from left to right: Joachim Kalden, Josef Smolen, Ferdinand Breedveld, Paul Emery, Maxime Dougados, Gerd Burmester, all former EULAR presidents).
Joachim Kalden and Gerd Burmester at the ILAR Congress, Sydney, Australia, 1984.
Joachim Kalden at the Targeted Therapies Meeting in Miami 2000.
Thus, he was not only an outstanding scientist, teacher and visionary, a doyen of German rheumatology and a great shaper of international immunology and rheumatology. Above all, he was a great, a loving, a wonderful friend to us, whom one could always ask for advice and who was literally at hand at day and night times not only for clinical and scientific matters, but also for private matters.
Footnotes
Handling editor Josef S Smolen
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Commissioned; externally peer reviewed.