Lloyd Mayer, MD, Remembered for Groundbreaking IBD, PIDD Research

Gary J. Stadtmauer, MD

Disclosures

October 24, 2013

In This Article

Introduction

Lloyd Mayer, MD

There are great physicians and great scientists, and very occasionally they are one and the same. I was very fortunate to know such a person: Dr. Lloyd Mayer. Dr. Mayer was a clinical immunologist and gastroenterologist whose research advanced our understanding of both primary immunodeficiency disease (PIDD) and inflammatory bowel disease (IBD).[1]

Beyond that, his devotion to mentoring and training the next generations of scientists earned him wide recognition and awards. But to me, and others who knew him, he was simply "Lloyd," a kind and down-to-earth man who never acted as if he was someone held in high esteem. Sadly, he died far before his time at the age of 61 years on September 5, 2013, and is sorely missed by many.

From a Simple Childhood to a Remarkable Adult

Dr. Mayer was just a kid from the Bronx, but nothing about him was average. The younger of 2 siblings born to Hungarian Holocaust survivors, he grew up in a poor neighborhood where he and his sister played improvised games using ordinary household items, he told me.

He helped his family by working part-time in his father's print shop. At a glance, he was outgoing, funny, athletic, and handsome. He was the captain of his high school swim team. As a teenager, he sold concessions at Yankee Stadium, but he did it on his own terms: He sat and watched the game, and fans who wanted drinks knew where to find him.

It had been clear from a very young age that Mayer was exceptionally bright. He skipped third and eighth grades and his senior year of college, then graduated from Icahn School of Medicine at Mount Sinai with high honors.

Dr. Mayer trained at the best places -- internal medicine at Bellevue Hospital Center and gastrointestinal medicine at Mount Sinai Medical Center in New York, where Dr. Burrill B. Crohn, after whom the disease is named, had served as Chief of Gastroenterology. Dr. Mayer then honed his research skills at Rockefeller University in the laboratory of renowned immunologist Dr. Harvey Kunkel.

Because of his interest in IBD, Dr. Mayer focused on B-cell differentiation factors that influenced IgA production, and he published about a dozen articles on the influence of T cells on B-cell function. Among his many major contributions was the discovery of the underlying T-cell defect in hyper-IgM syndrome, his former colleague Shu Man Fu, MD, PhD, recalled.[2]

In this primary immunodeficiency syndrome, serum IgM levels are very high while serum IgA and IgG levels are low or absent, resulting in repeated sinopulmonary infections. The nature of the immunologic defect was unknown until Dr. Mayer and colleagues identified a clone of malignant T cells in a patient with Sézary syndrome that were inducing an immunoglobulin class switch at such a rapid rate that it was depleting IgM production.[3] Using the malignant cells, he was then able to "turn on" IgG and IgA production in B cells from patients with hyper-IgM syndrome.

This observation established the true nature of the hyper-IgM syndrome -- that the defect lay in the T-cell ligand (CD40 ligand) thereby also elucidated the key role of T cells in immunoglobulin class switching.[2] Later, Dr. Mayer and his and Rockefeller colleagues also helped characterize the whole process of T-cell cytokines helping B cells before T-cell subtypes (Th1, Th2), or even interleukin-4, was described.[4]

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