ESSAY | TOWARD JES 100TH ANNIVERSARY
My endocrine research and the development of women specialists
2024 Volume 71 Issue 10 Pages 935-937
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2024 Volume 71 Issue 10 Pages 935-937
Congratulations on the 100th anniversary of the founding of The Japan Endocrine Society (JES). “JES We Can” is a committee that was launched to solve various issues so that we, as female physicians, can continue to work and shine throughout our careers as endocrine specialists. Given my experience serving as the inaugural chairperson, I would like to contribute an article titled “My endocrine research and the development of women specialists.”
Upon completing my graduate studies at Tokyo Women’s Medical University, I was encouraged by Professor Kazuo Shizume to study Somatomedin (now called IGF), and I engaged in research at the Karolinska Institute as a Swedish government scholarship student. At that time, “Somatomedin” was called a “phantom hormone,” and its very existence was in doubt. The existence of this factor was reported by Salmon and Daughaday in 1957.
This factor, based on the contributions of many researchers, eventually later came to be known as IGF. I will briefly describe its history.
During in vitro experiments, it was observed that the direct addition of growth hormones (GH) did not show an uptake of sulfate into cartilage. However, when GH was injected into hypophysectomized rats, the serum obtained from these rats increased the uptake. This suggested that the injection of GH induced the production of a substance in the body that promoted the uptake of sulfate. This factor was initially named Sulfation Factor. Furthermore, since this factor was GH-dependent and a mediator of the effects of growth hormone Somatotropin, it was named Somatomedin in 1972. Among those belonging to this Somatomedin group were Somatomedin A, C, and MSA (multiplication-stimulating activity). From 1973, I engaged in research on Somatomedin A at the Karolinska Institute, developed a Radioreceptor Assay for Somatomedin, and measured its blood concentration in various diseases to investigate its pathophysiological significance.
Meanwhile, the research on Somatomedin also revealed the presence of a non-suppressible insulin-like activity (NSILA) in blood that was not neutralized by insulin antibodies. This activity, called NSILA-S, was found to promote sulfate uptake and DNA synthesis. Later, the chemical structure of NSILA-S was determined to have two types, and due to their similarity to insulin, they were named in 1978 as insulin-like growth factor I and II (IGF-I, II). Later, the chemical structure of Somatomedin was also determined revealing that IGF-I and somatomedin C, A were identical, and that MSA was rat IGF-II. In 1987, it was proposed that IGF and Somatomedin were synonyms, and should thereafter be referred to as IGF.
After returning to Japan in 1975, I used this method to conduct research on the pathophysiological significance of IGF and basic clinical research on GH. I summarized my research into papers such as the following:
1. Measurement of blood IGF-I in pathological conditions and its significance
2. Various hormones and nutrients that regulate IGF-I
3. Factors that regulate IGF-I receptors
4. Towards the clinical application of IGF-I
5. Pathophysiological significance of IGFBP
6. Non-islet cell tumor hypoglycemia (NICTH) and IGF-II
Around the time I returned to Japan from Karolinska in 1975, GH extracted from human pituitary glands was used to treat short stature caused by growth hormone deficiency (GHD). Pituitary glands obtained from autopsies across Japan were collected and sent to Sweden, where the GH was purified and used for treatment. I also conducted clinical trials of recombinant GH formulations from 1982, which contributed to the successive approval of therapeutic options for short stature caused by growth hormone deficiency (GHD), Turner syndrome, pediatric renal failure, achondroplasia, and adult GH deficiency. I also conducted clinical trials of drug therapy for acromegaly, which contributed to the approval of dopamine agonist (DA) in 1979, somatostatin analogs Octreotide in 1989 and LAR in 2004, and the GH receptor antagonist Pegvisomant in 2007.
In April 2009, under the initiative of Professor Masatomo Mori, who was then appointed president of the JES, the “Committee for Continuing Medical Education for Female Endocrinologists” was established. This committee was established from the observation that the number of female physicians was increasing, and its future counted on their active participation. To this end, it was deemed “necessary to solve the problems faced by female physicians and devise strategies to enable them to work with pride and confidence as endocrine and metabolism specialists throughout their careers.” As a result of an open call for members, 28 individuals who identified with these ideals gathered from across Japan, from Hokkaido in the north to Kyushu in the south, and I was honored to serve as chairperson. The committee’s acronym was inspired by the Women in Endocrinology (WE) of the Endocrine Society of the U.S. where the name WE CAN (Women Endocrinologists Association) was proposed. Incorporating the JES of The Japan Endocrine Society, it was decided to call the committee “JES We Can.” This was around the time the phrase “Yes We Can” was made famous by U.S. President Obama.
The JES We Can committee initially focused on the following areas.
I. Survey on the development of specialists
A. Understanding the situation of certified endocrinologists
B. Survey of facilities available for re-education
II. Approaches to the Society’s Board of Directors
A. Handling of childcare leave as equivalent to study leave
B. Requiring childcare facilities at Society (and branch) meetings
C. Reconsidering the handling of cases submitted at the time of specialist application
D. Prioritizing the appointment of women as chairs, symposiasts, panelists, etc., at Society meetings (aiming for 1/4 to be women) and setting up sessions for women’s initiatives
III. Verification and evaluation by the board of directors regarding women appointments and activities in Society (and branch) meetings
IV. Others
A. Creating solutions to issues as they arise
B. Various issues faced by female physicians and the preferred responses, etc.
According to the survey results from 2010, female members of the JES accounted for 24.6% of the total membership, and in terms of age distribution, female members accounted for nearly half (44%) of the members under the age of 40. Working groups were established to address the emerging issues and preferred responses were implemented. After my retirement, the position of chairperson was passed on to Dr. Naomi Hizuka, Dr. Mari Suzuki, Dr. Mayumi Yamamoto, and then Dr. Noriko Asahara, and the Society has continued to develop.
I am grateful for the opportunity to have learned through spirited engagement with many individuals at the JES. Over the years, the Society has created and incorporated new technologies, integrating basic and clinical research to contribute to the development of endocrinology. Furthermore, amidst the calls for promoting women’s active participation, the Society has assumed a pioneering role among other societies in establishing an organizational framework as part of its projects with an expanding scope of activities so that its female members can shine and thrive throughout their careers.
Looking ahead, I believe it is essential to further enhance efforts in developing female endocrinologists and researchers into future leaders, in addition to providing support for job safety nets, such as retraining and return-to-work programs. While the Society’s support is crucial and its female members must take their own initiative, it’s important for the Society to create such an enabling environment. Furthermore, I commend the Society’s continued dedication to nurturing the next generation, and I wish them continued success in their endeavors.
Kazue Takano
Honorary Member
Professor Emeritus, Tokyo Women’s Medical University
Shizume Clinic
E-mail: takanok@a08.itscom.net
Careers in JES
2014– Honorary Member
2011– Senior Councilor
2009–2011 Advisor
2009–2011 Committee Chairperson, JES Women Endocrinologists Association (JES We Can)
2005–2007 Director (Finance)
2003–2005 Auditor
1982– Councilor
1972– Member
Activities in JES
2007 Chair, 17th JES Clinical Update on Endocrinology & Metabolism
JES Awards
2012 Distinguished Endocrinologist Award
1981 1st JES Research Award
