European Society for Paediatric Gastroenterology, Hepatology and Nutrition Distinguished Service Award 2019 to Professor Stefano Guandalini (2019)

The Distinguished Service Award is presented annually by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) to one of its esteemed members. The purpose of this award is to recognize an individual who has made a major contribution in our field, which can be recognized as a whole life accomplishment, or to celebrate a recent major achievement. Criteria for selection include the following: outstanding scientific achievements related to pediatric gastroenterology and/or hepatology, and/or nutrition, usually documented by the candidate's publication and citation record; outstanding contributions to the standards, practice, and training in the fields of pediatric gastroenterology and/or hepatology and/or nutrition; outstanding contributions to ESPGHAN as a Society; and personal integrity. For 2019, the ESPGHAN Distinguished Service Award recipient is Professor Stefano Guandalini (Fig. 1), Professor Emeritus and former Chief of the Section of Pediatric Gastroenterology, Hepatology and Nutrition of the University of Chicago.FIGURE 1: Professor Stefano Guandalini.Professor Guandalini was born in Rome, but educated in Messina where he graduated in Medicine summa cum laude. Professor Guandalini started his scientific career in a Pathophysiology Department, and only by chance, he approached Pediatrics: in fact, his MD thesis supervisor happened to not be able to participate in the graduation session, and asked his friend, Chair of Pediatrics, to replace him. Thus, soon after graduation, in the summer of 1971, the Pediatric Chairman offered the young Dr Guandalini a job as Assistant Professor and he took it. Immediately thereafter he was sent to Professor Salvatore Auricchio in Naples in order to do research and learn pediatric gastroenterology under the mentorship of Professor Armido Rubino, 2 figures who soon introduced him to ESPGHAN. In fact, he began his love affair with ESPGHAN very early on in his career: he presented his first oral abstract at the Hamburg meeting in September 1972, at the age of 25. That presentation represented a major progress in the understanding of the advantage of di- and tri-peptide absorption over that of free amino acids. In 1977, shortly after becoming member of our Society, Stefano went for his first experience in the United States, to be trained by Michael Field in studying the pathophysiology of intestinal ion transport using Ussing chambers and other techniques. Among the results of those 2 years of research was the unravelling of the role of cyclic GMP in intestinal secretion and the demonstration of the pro-absorptive role of somatostatin, a finding that eventually led to the development of its analogue octreotide. Shortly after his return home to Naples, his interest in exploring the pathophysiology of intestinal transport, mechanisms of action of enterotoxins and of antidiarrheal agents, naturally led him to focus on childhood acute diarrhea, a field where Stefano had a substantial impact as part of the Working Group on Acute Diarrhea of ESPGHAN led by John Walker-Smith, to define and implement an improved, low-osmolality, oral rehydration solution in the treatment of acute gastroenteritis. In the meantime, as Head of the Working Group for Gastroenterology of the Italian Society of Pediatrics between 1985 and 1988, having sensed that the times were ripe to simplify the cumbersome diagnostic procedure for celiac disease, he set up and led a massive multicenter study on the topic. This study, published in 1989, gathered in a retrospective, as well as prospective manner, the experience of 32 Italian centers on more than 3000 celiac children, concluding that by applying careful criteria, the diagnosis of celiac disease could be correctly reached in almost all cases by just 1 biopsy, thus markedly shortening the diagnostic algorithm and the aggravation of adhering to the time-honored 3-biopsy approach. The impact of this work had an immediate repercussion within ESPGHAN: a task force was created, of which he was of course part, that led to the publication the following year of the revised diagnostic criteria, that have been widely followed for more than 20 years and continues to be one of Journal of Pediatric Gastroenterology and Nutrition's most cited articles. In the mid-90s, Professor Guandalini began focusing on a field that was at the time relatively new: that of the potential use of probiotics. An ESPGHAN-centered multicenter trial on the use of Lactobacillus GG, in oral rehydration solutions, designed and led by Professor Guandalini, continues to be one of the most quoted original articles published by Journal of Pediatric Gastroenterology and Nutrition during the first 20 years of the journal. Professor Guandalini was religious in attending, and contributing to our Annual meetings and witnessed its growth while serving the society. He served as Treasurer between 1990 and 1996 and then became our President in 1998. Of note, he was elected in spite of having already just moved to live and work in the US: a testimony of the trust our members had for his leadership! During his 3-years tenure, Professor Guandalini focused on achieving his vision that built on the joint NASPGHAN-ESPGHAN congresses: creating a federation of the international societies. Working to this aim with the colleague Presidents of NASPGHAN, LASPGHAN and APPSPGHAN, he succeeded in this effort, and FISPGHAN was created, celebrating in Boston in 2000 the first World Congress, that has since become a 4-year recurring event. After moving to the University of Chicago, Professor Guandalini soon realized that awareness of celiac disease in the United States was incredibly poor. He thus established in 2001 a Celiac Center in the university that has since achieved strong international visibility and recognition, hosting in 2013 the bi-annual world congress on celiac disease, known as the International Celiac Disease Symposium. In 2011, gathering physician scientists from all over North America, he founded and served as first President of the North American Society for the Study of Celiac Disease. Stefano is the recipient of many awards, author of more than 200 publications in peer-reviewed journals. He contributed more than 30 chapters to gastroenterology books and has also published 5 books, as editor. He has presented over 400 invited speeches at national and international meetings and has organized 12 national and international meetings. Stefano has dedicated his life to his family and is loved and supported by Greta, his wife, his children, Liliana and Marco and now also by his grandchildren, Hugo and Chiara, whom he literally adores. He has kept strong links with Italy and not only with his family. Many colleagues (not only from Italy) still look for his advice on difficult clinical problems and rely on his wise and thoughtful input. In conclusion, Professor Guandalini is a great researcher with seminal contributions to the pathophysiology of acute diarrhoea, a superb clinician with expertise in all domains of pediatric gastroenterology, educator, and mentor for future generations of pediatricians. But probably his main merit has been to create a warm, mutually supportive environment where people from very different cultural origins could work together in the interest of patients and that is witnessed by his leading role in Continental and Global scientific Societies, some of these created by him. On behalf of ESPGHAN, we wish to congratulate Stefano and to express our sincere gratitude to him for his friendship and great contributions to the field of paediatrics, paediatric gastroenterology, and to ESPGHAN.