WSPHA founders portraits. An interview with Professor Gerald Simonneau

Professor Simonneau, please introduce yourself:

I am Professor Simonneau. I’m Professor Emeritus at the University of South Paris, and I have been working in the field of Pulmonary Hypertension since 1978.

What was the most important reason for the founding of the WSPH Association?

The Association was founded in order to maintain the philosophy of collaboration between each category of people working around this disease, Pulmonary Hypertension is in fact a rare disease, at the borders of medical specialties: cardiology, pneumology, internal medicine, rheumatology.

The different World Symposia give the opportunity to have a unification of all these specialties.

How and when did you become interested in Pulmonary Hypertension disease?

I started to work in this disease in 1978, at this time I was a young pulmonologist and during my resident period, I was very interested in pulmonary circulation and I had the opportunity to see some patients with Pulmonary Hypertension, and I was very fascinated by this very complex and very dramatic disease because all the patients died within few months. In my centre at the Paris University, I had a surgeon colleague, Philippe Dartevelle, working in the surgical hospital and developing a program of transplantation, lung and heart transplantation, and this transplantation was a possibility for people suffering from Pulmonary Hypertension and we worked together after 1981 and progressively a lot of patients were referred to evaluation.


What is the main goal of the WSPH Association?

The main goal of this Association is to maintain the philosophy of the World Symposium to work together with people from different countries but also from different medical domains, cardiologists, pulmonologists, internal medicine, rheumatologists in order to exchange and to address all the different parts of this disease, which is very complex.

Who would you say were the most important figures for the progress of your studies on Pulmonary Hypertension treatment?

My old partner is Lewis Rubin and he was a pioneer in this disease because he was at the origin of the first randomized trial with prostacyclin, long time ago. When I was resident I worked with him to start the program in France and it was very important in my career. The second person very important to me is Nazzareno Galiè because we worked together a lot to develop new drugs in this disease and we were at the origins of many pivots of trial to put on the market new drugs, Endothelin receptor antagonists, PDE5 inhibitor, but also and new drugs targeting very new pathways and new prostacyclin drugs. And Valerie McLaughlin is a younger person but very active, very important in the field of Pulmonary Hypertension because she is a very active doctor in drug development but also for risk assessment.

Would you describe an important episode related to your work on Pulmonary Hypertension?

A very important episode is the first patient suffering from Pulmonary Hypertension needing to be transplanted in France in 1983. At this time we had two centres for transplantation working on this disease (heart-lung transplantation). One was the cardiologic centre in Pitie Salpetriere, a hospital in Paris. The problem in this centre was that after ten transplantations, ten patients died, immediately after. In the other centre, my colleague Philippe Dartevelle worked for three years on dogs, but all the dogs died very soon after the transplantation. And the patient asked me: “What do I have to do? Because the situation is not good”. And that is when I had the idea of making the cardiologic and the pulmonary surgeons work together to do my transplantation. I succeeded to convince the two surgeons to do the transplantation together and the patient survived for 15 years after transplantation.

How has the treatment of Pulmonary Hypertension improved over the years and how it can continue to improve in the future?

After 15 years of successful trials, leading to the labelling and approval of drug targeting three pathways, prostacyclin pathway, Endothelin pathway, NO pathway, now is difficult to approve new drugs, targeting new pathways. Today we have a lot of negative trials and it’s difficult to imagine new drugs. But we have to remember that the three drugs targeting the three pathways led to the Nobel Prize for the people who discovered them. Now we use some hypothesis, targeting more peripheral pathways, not targeting pure vascular disease, drug with pure anti proliferative effect, and is more complex, and probably we will succeed but today with the combination of the three pathways, the drugs targeting the three pathways, we have improved a lot the prognostics of the disease and now we have long term survival in many patients.

How important, in your view, is the contribution of new generations in the studies on the disease?

It is very important that new physicians are involved in the Association because it is very important to have some contact with old and new generations in order to have continuation of the work because in this disease we did a lot of progress during the last 10/20 years, but we have to continue to progress and to improve the quality of life for the survivors of this population. It is very important to have new ideas, new generations very active and very motivated to work in this field.