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Lindley, Keith J

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Journal of Pediatric Gastroenterology and Nutrition: December 2007 - Volume 45 - Issue - p S91-S92
doi: 10.1097/MPG.0b013e31812e5f84
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On March 10, 2006, the career and professional achievements of Prof Peter J. Milla were honoured with a symposium and Festschrift held at the Institute of Child Health in London. It was attended by friends and colleagues from all over the globe, reflecting Peter's wide international associations and friendships. This was of course inevitable, given that he has been influential, directly or indirectly, in the training of large numbers of paediatric gastroenterologists in Europe and abroad. Indeed, Peter's distinguished career as a clinical academic at the University College London Institute of Child Health and Great Ormond Street Hospital in London has embraced a broad range of areas within paediatric gastroenterology. In many of them, his original thinking has led the way.

Peter's early medical training was undertaken at St Bartholomew's Hospital, London, Portsmouth, Winchester, then back to Barts. His academic career proper started in 1975 with a research training fellowship in the Department of Child Health at the Institute of Child Health in London.

Initially, under the influence and mentorship of Dr John Harries, Peter was particularly interested in intestinal transport studying water, electrolyte, and nutrient transport in children with protracted diarrhoea. He demonstrated that protracted diarrhoea in infants was due to a heterogenous group of conditions that resulted in both increased intestinal secretion and malabsorption of nutrients. Highlights of his work included the definition of a new congenital defect of intestinal transport, congenital Na+/H+ exchange deficiency, and a description of the ontogeny of colonic-transport mechanisms in the human infant. Subsequently, Peter oversaw groundbreaking research in which fluorescent probes and laser-scanning confocal microscopy were used to study transport in human colonoscopic biopsies in close collaboration with Prof Richard Naftalin at Kings College Hospital. His work, and studies arising from it, won the Glaxo Prize of the Physiological Society, the John Harries Prize of the European Society for Paediatric Gastroenterology and Nutrition, and the Mowat Prize of the British Society for Paediatric Gastroenterology and Nutrition for 1996 and 1997.

Early in his studies on intestinal transport, Peter realised that opioids affected intestinal transport as well as motility, and that at the time no systematic studies had been done on gastrointestinal motility in childhood. Peter developed methods of characterising and studying motility that were appropriate for children, enabling definition of the mechanism of toddlers' diarrhoea, exploring the ontogeny of small-intestinal motor activity in human infants, and developing an understanding that chronic intestinal pseudoobstruction was due to enteric neuromuscular disease, which was commonly congenital in nature. During this work, Peter established the first clinical research laboratory devoted to gastrointestinal motility in children. With the widespread introduction of molecular biological methods into research methodologies, he went on to explore the role of homeobox containing developmental-control genes in the development of the enteric neuromusculature as part of a programme of work designed to establish the nature of congenital defects of gut nerve and muscle. He has been instrumental in establishing and facilitating a program of work looking at the use of enteric neuronal-progenitor cells as therapeutic agents in children with congenital disorders of the enteric nervous system. Peter has been and is the epitome of a clinical academic taking an observation at the bedside, elucidating it in the laboratory, devising a treatment, and taking it back to the patients.

In addition to his commitment to original research, Peter was devoted to clinical excellence, to teaching, and to developing the discipline of paediatric gastroenterology throughout his career. Together with the late Dr Harries, he developed a clinical unit that rapidly developed an international reputation in which only the best was just good enough, resulting in fellows from both home and abroad beating a way to its door. He was determined that Great Ormond Street would always be 1 of the 6 great children's hospitals of the world, but it was always the children who mattered most to him.

In his early years, he taught at the Institute of Child Health and on British Council courses. Later, he was instrumental in establishing the highly successful European Society of Paediatric Gastroenterology and Nutrition Summer Schools. Peter was active in organising symposia in the emerging area of neurogastroenterology on a national and an international level on both sides of the Atlantic, and indeed has taken part in the various Rome working groups on functional disease in paediatrics from 1996 to the present. Peter has been visiting professor at a number of universities in Europe and North America, including Harvard and Tufts University, Boston; the University of Leuven in Belgium; and the University of Tampere in Finland. His commitment to education is illustrated by the large numbers of lectures he has delivered on both sides of the Atlantic. Indeed, there were few better educational experiences in paediatric gastroenterology than to attend the weekly ward round at Great Ormond Street and experience the depth of his understanding of gastrointestinal physiology in health and disease, especially in the context of the unusual array of patients commonly encountered at that hospital.

Throughout his career, Peter has been active within national and international societies, playing a significant role in the development of the discipline of paediatric gastroenterology. He became secretary to the European Society of Paediatric Gastroenterology and Nutrition, and later the president, overseeing a number of radical changes within the society. Peter still sits on the Council of the United European Gastroenterology Federation, guiding its finances and playing a substantive role in the development of the interface between paediatric and adult gastroenterology.

The articles that follow are selected from the talks given at Peter's Festschrift. The nature of some of the other papers has precluded their inclusion in this special edition, so as not to jeopardise their publication as original works. In this respect, papers given by Profs Mike Gershon, Colin Rudolf, David Evans, Vassilis Pachnis, and Dallas Swallow have not been included. Nevertheless, the breadth of the manuscripts, all given by colleagues with whom Peter has close associations, reflect the breadth of Peter's interests in all things gastroenterologic. Peter's other big love, a “life on the ocean wave” is, for obvious reasons, omitted from this celebration of his professional life, other than to note that at 1 stage during the Festschrift his presence was likened to that of Lord Nelson, who stands proud above London at the top of Nelson's Column. By analogy, his many contributions to paediatric gastroenterology will likely be remembered by many of his professional colleagues in a similar manner.

FIG. 1
FIG. 1:
Peter Milla, when a junior paediatrician at St Bartholomew's Hospital.
FIG. 2
FIG. 2:
Peter Milla, as president of the European Society of Paediatric Gastroenterology and Nutrition, during the Prague meeting in 2004.
© 2007 Lippincott Williams & Wilkins, Inc.