J. Wayne Streilein, MD, 1935–2004

Privilege in the Science of CutaneousImmunity: The Impact of J. Wayne Streilein

on Dermatological Science

On Monday, March 15, 2004, J. Wayne Streilein, MD, whohad served for 10 years as the Charles L. Schepens Pro-fessor of Ophthalmology and Professor of Dermatology atHarvard Medical School, died suddenly and unexpectedlyin Boston. Dr Streilein’s three-decade career in immuno-logical science spanned three institutions and influencedthe way scientists think in three distinct areas of inquiry:transplantation immunology, ophthalmology, and dermatol-ogy. Wayne brought to each of these areas a distinct wayof thinking and a unique combination of imagination, humor,discipline, and energy.

Many who felt the impact of J. Wayne Streilein’s con-tinuous adventure in science considered his friendship tobe a privilege, sort of an ‘‘immune privilege,’’ as he was themaster in characterizing the special anatomical regions inwhich immunity deviated. At the same time he was a masterin generating enthusiasm, ideas, and experiments amongthose whose lives he touched. With acknowledgment ofWayne’s contributions to transplantation and ophthalmolo-gy, we write now for the readers of this Journal, the Journalof Investigative Dermatology, to address his unique contri-butions to dermatological science.

Beginning with numbers, Wayne had more than 400 sci-entific publications (hhttp://www.theschepens.org/faculty/streilein/documents/jwscv.pdfi), almost all in highly regard-

ed journals, with approximately 100 addressing issues ofcutaneous immunology, and one-third of those published inthis Journal. Wayne’s first contribution may be found in hisinvited recounting of a presentation to the 1977 SouthernSID Regional Meeting in New Orleans. His paper, entitled‘‘Lymphocyte traffic, T cell malignancies and the skin’’ (JInvest Dermatol 71:167–171, 1978) illustrates even today hisextraordinary capacity to use ideas from disparate areas ofscience to forge new concepts. He gathered four contem-porary sets of data demonstrating that: (1) T cells home toskin in lymphomas such as mycosis fungoides; (2) immuno-competent cells capable of primary sensitization arepresent normally in skin; (3) skin has the capacity to retainimmunologic memory; and (4) skin is an inductive microen-vironment. From this, he proposed that skin possesses aspecial relationship to the remainder of the immune appa-ratus, establishing the concept of ‘‘skin-associated lymph-oid tissues’’ or ‘‘SALT’’. This analogy, with newly recognizedgut-associated lymphoid tissues (GALT) and bronchial-associated lymphoid tissues (BALT), predicted a substantialportion of what was to take place in cutaneous immunologyover the next two decades.

In fact, Wayne Streilein’s entry into dermatology was notsurprising, because he had been identified by the eminentskin biologist Rupert Billingham in Philadelphia as a man ofconsequence, and he was recruited to accompany Dr Bill-ingham to his new position in Texas. In 1972, Wayne, Joan,and their three young children moved to Dallas where heset into motion a scientific trajectory that has shaped ourspecialty. As Professor of Cell Biology at UT SouthwesternMedical Center in Dallas, he established his own scientificcredentials, while at the same time creating the cross-de-partmental Immunology Graduate Program. Ten years later,as Professor and Chairman of the Department of Microbi-ology at the University of Miami, he brought to life an en-ergetic group of scientists and established collaborationsthroughout the University. And finally as Professor of Oph-thalmology and Dermatology at Harvard University andPresident and CEO of the Schepens Research Institute inBoston, he recreated arguably the most prominent oph-thalmologic research enterprise in the nation. In each ofthese environments, Wayne’s influence and the impact ofhis personality extended well beyond departmental andinstitutional boundaries. But he always had time for skin, healways had time for junior scientists, and he always hadtime to imagine.

Wayne’s interests in skin biology were not incidental.Rather, he attended virtually every Annual Meeting of theSociety for Investigative Dermatology for 20 years. His ca-pacity to integrate ideas, stimulate discussion, and focus onscientific truth reverberated through countless small andlarge meetings: the Langerhans cell workshops, immunology

Copyright r 2004 by The Society for Investigative Dermatology, Inc.

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symposia, dendritic cell meetings, the Symposia on Biologyof the Skin, and many more. He gave ideas away,stimulated conversations, and provided energy to manywho attended. Some of his ideas were incorrect but mostwere not. His ideas sometimes appeared to be outrageous,but he always had reason(s). Not uncommonly, what ap-peared outrageous turned out to be true; it was alwaysdelightful to see his concepts evolve. He was full of pithystatements that raised the enthusiasm of those around him:‘‘The most difficult concept to prove is that which is wrong.’’‘‘Nobody said that this was going to be easy.’’ To a trainee:‘‘Get out there and make me proud.’’

On the other hand, Wayne Streilein was not casual, and hewas always careful with his data. His conversations might beunconventional and outrageous, but his data and the data ofhis collaborators were invariably reproducible. He knew thatdiscussions and concepts might evolve, but that good datalasted forever. He always wanted to know whether an ex-periment had been verified, commonly three or four times.And once he was certain, new concepts would emerge.

Wayne Streilein influenced the scientific studies ofnumerous investigators, publishing with individuals wellknown in dermatology: Gilliam, Sullivan, Elmets, Tigelaar,Bergstresser, Falanga, Rico, Yoshikawa, Taylor, Vermeer,Shimizu, Eaglstein, Mertz, Mommaas, Nemeth, Pinnell, Ni-izeki, Itami, and many others. But recognizing that eachperson knew Wayne in a different way, we hope that ourconsensus statement about his impact on dermatology willaffirm and reveal his unique talents in generating anddefending new ideas, identifying, motivating, and thenmentoring talented young investigators, and ultimately,transforming the institutions that he loved.

Wayne Streilein’s talents were not limited to dermatology,or to medicine, or even to science. He was gifted at thepiano, knew and loved music, read widely, and even en-joyed athletics. He was just as much at home in an artmuseum as in a lecture hall. He knew that life’s work wasa continual performance, with never a rehearsal. In fact, hewove a life fabric that included all of these elements, sci-ence, art, music, and culture, together. The last but not leastof these elements was his humor. Original ideas were in-variably humorous, because they defied convention. Out-rageous laughter would follow as one considered fifteenpossibilities for an answer to a problem.

We close with Wayne Streilein’s concept of personalaccess to information as appearing in the form of a largescreen, a screen on which all of a person’s information wouldbe placed. From that screen, but only from that screen, couldinformation be combined, recombined, integrated and thenused. Obviously, the larger this screen of knowledge, themore information could be integrated into the formulation ofthe next experiment or discussion. Wayne Streilein’s screenwas larger than most, and we will miss him.

Paul R. Bergstresser,� David A. Norris,w and Georg Stinglz�Department of Dermatology, University of Texas Southwestern

Medical Center, Dallas, Texas, USA; wDepartment of Dermatology,University of Colorado Health Sciences Center and Denver Depart-

ment of Veterans Affairs Hospital, Denver, Colorado, USA;zDepartment of Dermatology, University of Vienna Medical School,

Vienna, Austria

DOI: 10.1111/j.0022-202X.2004.23429.x

J. WAYNE STREILEIN v123 : 4 OCTOBER 2004