11/11/2004
Chiesi European Prize for Excellency in Neonatology

Mikko Hallman

Professor Hallman was born in Finland 1945. He finished medical School in Helsinki 1970 and became doctor of medicine at the very young age of 27.
Between 1972-73 and 75-77 he did his training in pediatrics at University of Helsinki and from 1977-79 as fellow in neonatology.
His first stay in the USA was in 1973-75 when he was fellow of Neonatal/Perinatal Medicine in San Diego.
He became Assistant professor of Pediatrics and Associate adjunct professor of Pediatrics at University of California San Diego 1978-82.
He was then back in Finland some years as senior investigator of Finnish Academy and Chief Division of Neonatology, Dept of Obstetrics and Gynecology, University of Helsinki. In 1989 he returned to the USA as a full professor of Pediatrics, at the University of California, Irvine. However in 1997 he returned back to Finland when he was appointed professor and Chairman of Department of Pediatrics, University of Oulo.

Professor Hallman’s research is most of all associated with respiratory distress syndrome and surfactant, although his earliest works were dealing with mitochondria and different aspects of energy metabolism. In 1974 he published his first paper related to surfactant which was a study on biosynthesis of disaturated lechitin in the lung. The same year he published together with the legendary Louis Gluck his seminal paper: Phosphatidylglycerol in lung surfactant. This was followed by a series of articles about phosphatidylglycerol. Professor Hallman was the first to detect phosphatidylglycerol in surfactant and that it is a needed component of a well functioning and mature surfactant. This contributed significantly to the development of the so-called lung profile which is a test to assess whether or not the lungs are mature or not and has been used as an important tool for the obstetricians to decide the maturity of the lung and assess optimal time to deliver the baby.

A new era in his research started with surfactant treatment. Already in 1982 he published his first experimental study testing out human surfactant in immature rabbits and the year after he published together with coworkers in San Diego the first clinical trial using human surfactant. Three years later he and dr Allen Meritt published in NEJM a prophylactic trial with human surfactant. Professor Hallman’s idea was impressive indeed. He had calculated that the amount of surfactant that may be isolated from amniotic fluid of women undergoing C-section would balance the need of surfactant in all babies with respiratory distress syndrome in need of surfactant therapy. This approach was of course relatively simple and inexpensive and would provide the worlds preterm babies with the surfactant they would need. However, a new aspect emerged in the beginning of the 1980’s: the HIV epidemy. The fear of infections stopped this very elegant approach.

What is perhaps most impressive with professor Hallman’s research is that he at a steady pace opens new fields. He was a pioneer regarding research on oxidative stress in the newborn and he and his coworkers in 1990 were the first to demonstrate signs of oxidative stress in babies going on developing bronchopulmonary dysplasia. Before that it had only been hypothesized that reactive oxygen species are involved and only experimental data existed showing oxidative stress may induce lung injury.
Professor Mikko Hallman then went on making sophisticated studies on inflammation and nitric oxide and how these are related to surfactant function. He also started to study Toll like receptors long before the rest of us understood what Toll like receptors are. It takes too far to go through all aspects of professor Hallman’s research presented in more than 200 original articles.
However, the recent years he has made impressive contributions to the genetic variation of surfactant protein alleles and how these contribute to different risks and severities of respiratory distress syndrome. Polymorphism of Surfactant proteins as A and B are coupled to different risks of RDS. The same seems to hold true regarding RS infections. He clearly has shown there is a genetic susceptibility to RDS and he also has shown that the severity of RS infections is related to gene variations.

During these 3 decades he has therefore contributed profoundly to our understanding of surfactant function, developed tools to diagnose immature lungs, taken important parts in introduction of surfactant therapy, and given us evidence for which infant that is going to develop the most severe disease. His research therefore is both very basic and also very clinically relevant. Indeed a rare combination. His research without doubt has promoted the health of preterm infants.

Mikko Hallman has published more than 230 papers and given numerous international lectures.
He has received a number of awards and honors as the Arvo Ylppo price in 1992.

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