Having studied Medicine in Recife, a tropical and poor city in Northeast of Brazil, host-parasitic relationships soon gained my interest, particularly when concerned to immature hosts. Moving to the University of São Paulo Medical School (FMUSP) for residency in Pediatrics, followed by a fellowship in Allergy & Immunology in Internal Medicine Department, I developed my PhD studies in Immunology, concluded in 1978. By then, I had the privilege of identifying the first cases of humoral PIDs in Brazil, at the recently established Allergy & Immunology Unit at FMUSP Children’s Hospital. The first pediatric AIDS cases were also recognized in the same Service in the 1980’s.
My clinical activities have been predominantly dedicated to PIDs, and I consider myself fortunate for being involved in an area that has had major breakthroughs over the past four decades: from mere speculations of possible unknown immune defects in patients with severe forms of infections in the early 1970, to the diagnoses of SCID as true death sentences until the early 1990’s in Brazil; and to the present scenario, with extensive and ever growing number of PIDs, unraveling the consequences of monogenic defects in almost all immune elements and pathways. These progresses were followed by the emergence of successful HSCT procedures, and even some thriving gene therapy protocols! I also hope to see babies with SCID and other PIDs detected by neonatal screening being promptly and completely cured by CRISPR-related techniques.
Since 2005, a fruitful collaboration with Prof. Antonio Coutinho, (from Instituto Gulbenkian de Ciência, Portugal) has taken place in order to study autoimmune manifestations of PIDs; and in 2007, a meeting at FMUSP was dedicated to this topic, which may have been one of the first events in this field. Key lectures were published in a special issue of the Journal of Clinical Immunology on “Autoimmunity in PIDs” [Carneiro-Sampaio M, Gupta S, Editors. J Clin Immunol. 2008;28(Suppl 1):1-89]. We recently described the first cases of intrauterine-onset autoimmunity in IPEX fetuses, which have been followed by report of several other equivalent cases (Clin Immunol. 2015;156:131-140). Presently, in collaboration with Prof. Carlos Moreira-Filho, from FMUSP, I have been involved in the investigation of genomic mechanisms related to thymic development and demise.
Together with other female doctors [Marta Zelazko (Argentina), Monica Cornejo de Luigi (Chile) and Diana Garcia de Olarte (Colombia)], aiming at promoting interest and better care for PID patients in Latin America, in 1993, we co-founded LAGID (Latin American Group for PIDs). In 2009 LAGID became LASID, which currently includes members from several South and Central American countries, besides Mexico.
Among the numerous pediatricians whom I have had the privilege to supervise, some women became leaders in PID field: Anete Grumach, an expert in Hereditary Angioedema, Beatriz Costa-Carvalho, founder of Brazilian Group for PIDs (BRAGID), Celia Martinez, a leader in Paraguay, and Adriana Jesus, a NIH researcher on auto-inflammatory syndromes, among others.
I must not fail to thank the encouragement received from many colleagues throughout my career, especially when faced with circumstances involving gender bias. In fact, these situations never affected me deeply, perhaps as a consequence from hearing early on from my mother that a woman's life experiences were usually more interesting, and also due to my father, a scholar as well, and a great supporter of his four daughters.