Paavo Nurmi Foundation 50 Years

Distinguished Board of the Paavo Nurmi Foundation; esteemed guests. I am grateful for the opportunity to take part in the celebration of the Paavo Nurmi Foundation’s 50th anniversary, and to examine the Foundation’s medical policies over the years.

It is paradoxical and even tragic that, of all people, Paavo Nurmi contracted a coronary artery disease. After all, he was an active super athlete with no known risk factors for coronary artery disease. He was not overweight, did not smoke, and his blood pressure and cholesterol levels were reportedly normal – at least by the standards of the time. When it comes to cardiovascular health, he was the “perfect” man. He was a man who should have been the model example of cardiac health for all Finns. But despite all this, Paavo Nurmi suffered a heart attack in the 1950s at the age of 60. About ten years later, in 1968, he was hospitalized because of a brain infarction.

If Paavo Nurmi’s coronary artery disease had been caused by a common risk factor that could have been treated by changing one’s lifestyle, Nurmi, being a determined man of action, would have undoubtedly done everything he could to prevent the onset of the disease. But Paavo Nurmi was a child of his time. The same applies to the development of invasive procedures to open clogged arteries. Back then, about half a century ago, doctors did not know how to open a clogged coronary artery like they do now. If they did, it is possible that Paavo Nurmi would have never suffered a heart attack. Equally true for the brain infarction: if doctors had known how to dissolve or suck out the blood clot in the brain, the infarction could have been avoided. But back then, doctors had no preventive advice or cures to give to this man with an iron will.

The development of the coronary artery disease puzzled Paavo Nurmi greatly. He actually considered it his enemy, as Nurmi, a master of his own destiny, was not used to surprises. That is why he, being a man of action, decided to financially support activities that would once and for all explain what causes the disease. This knowledge would help many patients both in Finland and abroad, and also himself. This is how the Paavo Nurmi Foundation was born. For Finnish cardiovascular researchers, it was a dream come true.

When the foundation was established in 1968, two ways to promote the goals of its founder were defined: firstly, organizing international symposiums in Finland, and secondly, awarding research grants to young talented Finnish researchers.

The planning of the first Paavo Nurmi symposium moved at a brisk pace, and it was held already in 1969 – only a year after the Foundation was established. The father of Finnish cardiology, Professor Pentti Halonen from the University of Helsinki, was asked to take part in the symposium’s planning work. Halonen, in turn, asked his friend Sir John McMichael from London for help. Sir John was a pioneer of modern cardiology in Great Britain, and a physician who has been characterized as one of the most prominent clinical researchers of his generation. As you can see, the basis that the Foundation was built on was quite strong.

Together, Professors Halonen and McMichael developed a conference format that featured twenty lecturers from both Finland and abroad, all leaders in their respective fields. Later, Professors Halonen and Antti Louhija were responsible for planning the meetings, followed by Professors Heikki Frick and Vesa Manninen, as well as Professor Kimmo Kontula, all of whom have also been members of the Foundation’s Board. It should be noted that, unlike many other symposiums, the choice of topics at the Paavo Nurmi symposiums has not been based on an open call for proposals, but rather on the Foundation’s own decisions. This means that all the excellent topic choices are solely to the merit of the Foundation’s medical Board members.

Researchers who attended the first symposiums also had the opportunity to meet Paavo Nurmi himself, who participated in the evening events of the symposiums. There, attendants had the opportunity to hear “His Master’s Voice”. Nurmi enjoyed the evening events and was curious to learn what had happened in the conference: what news of coronary artery disease and its treatment? These encounters have undoubtedly been important and unforgettable for both parties. After Paavo Nurmi’s death, a symposium on the importance of exercise was held, and Nurmi’s good long-time friend, President Urho Kekkonen, was also among the dinner guests. Kekkonen was pleased that the Foundation upheld the good name of Paavo Nurmi in a new way. In his dinner speech, he emphasized the importance of exercise for the well-being of the whole body. The homework for the dinner speech was “mens sana in corpore sano”, and its conclusion was “a sound mind is the best doctor”. Perhaps he was worried about the stress inevitably associated with the daily life of a successful businessman.

Although the symposium programs were initially quite clinically focused, the aim has been from the start to cover a wide range of studies around the topic chosen as the theme of the meeting – from laboratories to hospital beds. By combining different parts of the whole spectrum of cardiovascular research, the symposium program has become increasingly multidisciplinary, ranging from basic laboratory research to pathological-anatomical, clinical, genetic, and epidemiological studies – which is perfectly in line with the original views of Professors Halonen and McMichael.

However, coronary arteries and the cardiac muscle that they feed have always been at the center of this cardiological kaleidoscope: what harms them, how, and why. This coherent, well-focused topic has been the strength of the eighteen symposiums held so far. When selecting the subject for a specific Paavo Nurmi symposium, the goal has always been to stay topical. What are the burning questions of today, and what new discoveries have been made? What kind of topics should we discuss and report about in a multinational meeting of researchers in order to turn our gaze towards the future?

The topics of the series of eighteen symposiums and the merits of the speakers show how the Foundation’s later policy “to give Finnish experts in the field free rein to invite the world’s leading scientists to the Paavo Nurmi symposiums” has been a huge success. It has been crucial for the international dissemination of the symposiums’ scientific message and for the recording of their history that the presentations held at the symposiums have been available for reading in the special issues of various international publication series.

The series of symposiums started with a meeting on arterial thrombosis. This topic has clearly been the most interesting one, as it has been discussed more times than any other: a total of three times in 1969, 1979 and 2000. The topic is obviously very important: the rupture of coronary artery plaque leads to a clot (that is, a thrombosis), which may clog a coronary artery partially or completely, leading to a myocardial infarction – the leading cause of death globally, and which Paavo Nurmi also suffered from. It is no surprise that it was at the thrombosis symposium of 1979 that the undisputed guru of the field, the British Professor John Vane, told the audience about prostacyclin, a molecule naturally produced by the body that prevents the formation of thrombi. Just a few years after the meeting, in 1982, John Vane was awarded the Nobel Prize in Physiology or Medicine for the discovery of this molecule.

The renowned Professor Russell Ross from Seattle also attended the 1979 meeting. Exactly 20 years later, in 1999, just before his death, in the distinguished New England Journal of Medicine, he presented his theory that atherosclerosis is an inflammatory disease. This paradigm-shifting article canonized Ross in the world of atherosclerosis research, and his radical idea was finally proven to be true last September, when a medical trial that attracted world-wide attention showed that a modern anti-inflammatory drug can reduce the prevalence of heart attacks. The early participation of Russell Ross, and particularly that of John R. Vane three years prior to receiving his Nobel Prize, show that the Paavo Nurmi symposiums have always been visionary and had their finger on the pulse. They are also proof of the great international fame of the symposiums among the world’s top researchers – they are willing to come all the way here to the far north, after all!

When considering the focus of the symposiums, other important topics have included exercise, hypertension and blood cholesterol. As was already mentioned, the topic of the first symposium held after Paavo Nurmi’s death was “Exercise and the Coronary Artery Disease”. The selection of this topic was a tribute to Paavo Nurmi’s sporting achievements and the embodiment of the greatness and illness of his life. Other topics of discussion at the Paavo Nurmi symposiums have included the role of the nervous system and the psyche in the development of coronary artery disease, the connection between diabetes and atherosclerosis, cardiac arrhythmia, identifying the risk factors for atherosclerotic arterial diseases, and preventive treatment for children and adolescents, an important topic that has become world-renowned thanks to the scientific research conducted here in Turku, the hometown of Paavo Nurmi.

The most recent Paavo Nurmi symposium was held in the same building where now, in 2018, we are celebrating the 50th anniversary of the Foundation. The program for the “Future Technologies for Heart Diseases” symposium, held in the late summer of 2016, was new in many ways, and its scientific content reflected the ongoing technological revolution and the expectations it sets for the field of biomedicine. The results generated by medical technology and research are also indicative of the radical changes in the understanding, diagnostics and treatment of the pathology of heart disease in patients. The star speaker of the 2016 symposium was Shinya Yamanaka, a Japanese researcher who received the Finnish Millennium Technology Prize and the Nobel Prize both in 2012. Yamanaka’s lecture on his stem cell research was dazzling in its optimism: the skin cells of a cardiac patient may someday be used to build a new, healthy heart for him or her!

The Paavo Nurmi Foundation also awards grants worth approximately €200,000 each year. The annual cost of the symposium, held once every three years, is approximately €50,000. As for the financial support provided by the Paavo Nurmi Foundation, we may ask whether we have found the correct balance between symposiums and grants in order to best reach the Foundation’s goals? Can we afford both? The answer is definitely yes. How can I be so sure? Because young people are the future.

The driving force behind the symposiums has been to act as a platform particularly for both younger – and why not older – Finnish medical researchers who are passionate about cardiovascular research, as well as their partners, to meet international experts in the field and to establish personal relationships. Ideally, this would offer the researchers a chance to be recruited as post-doc researchers and to work alongside the science heroes in their laboratories. This has happened many times, directly or indirectly.

For example, Professor Riitta Lassila, a clinical thrombosis researcher currently working at the Helsinki University Central Hospital, was given the opportunity to work in the laboratory of world-famous Professor Valentin Fuster, perhaps the most important cardiologist in the United States, at the Columbia University in New York. Dr. Fuster was a speaker at a thrombosis symposium in 1980. Dr. Riitta Lassila, who is a very busy clinician these days and whose professorship at the University of Helsinki was strongly supported by the Foundation, sends you the following greetings:

I am very sorry that I cannot attend the Foundation’s 50th anniversary celebration, as I am working at the clinic. I want to warmly thank the Foundation for my professorship, which I became fully aware of only now after the publication of the ”On the Pulse of Heart Research” book. This professorship project is like a fairy tale – too good to be true. But it is true: on June 8, which is next Friday, the University of Helsinki will confirm the professorship, meaning that it will become permanent very soon. In this form, the Paavo Nurmi professorship is a wonderful lifelong surprise for me!

The future also looks bright in terms of international networking. At the most recent symposium in Turku in 2016, Finnish researchers were dying to talk with Nobel prize winner Yamanaka. If, in the future, a young Finnish researcher wants to work in the Nobel prize winner’s hi-tech laboratory in Japan, Yamanaka is sure to recall any prior encounters with the candidate as well as any pleasant memories of Finland, which has profiled itself as a country with a strong research and innovation performance. This will certainly improve the chances of the Finnish candidate to be selected among the large international group of applicants. And a few months ago, at a large international Atherosclerosis Symposium in Lisbon, Petteri Rinne, a talented young researcher from Turku, closed his presentation by thanking the Paavo Nurmi Foundation for the grant he had received. He also told the audience that he works in the same city where Paavo Nurmi was born in.

The provider of this oral appetizer also received a significant grant from the Paavo Nurmi Foundation for his doctoral dissertation starting in the early 1970s. Without dissertation, the opportunity to become a postdoc researcher in Dallas, Texas, USA, in the laboratory of Professors Michael Brown and Joseph Goldstein would have passed me by. They had just discovered the LDL receptor by studying the cells of a patient with familial hypercholesterolemia. They really hit the jackpot with their discovery, completely changing our understanding of the cholesterol metabolism of cells and the body – whether we are talking about the genetic, dietary or pharmacological regulation of plasma cholesterol levels. This also opened completely new perspectives to the implementation of the effective prevention and treatment of atherosclerosis and the cardiovascular diseases caused by it. The groundbreaking significance of these translational research results was the reason why Brown and Goldstein were awarded a Nobel Prize in 1985.

A big International Conference on Vascular Biology is currently underway in Helsinki, chaired by Academy Professor Kari Alitalo, Director of the Wihuri Research Institute. In an interview published yesterday, Alitalo highlighted the importance of face-to-face meetings and discussions between researchers during this era of electronic communication. He said that there is also a biological explanation for this, as facial recognition and trust signals that are important for evolution are encoded in our neural networks. I am certain that small-scale conferences like the Paavo Nurmi symposiums lead to personal interaction signals that make it easier to contact people later on.

The above examples of the power and impact of international networking on the future of young people strongly support the notion that the international symposiums organized by the Paavo Nurmi Foundation and the grants awarded by the Foundation are and will be an important cornerstone of the excellence of Finnish cardiac disease research well into the future.

And finally, I want to highlight that Paavo Nurmi suffered from  cardiovascular disease half a century too early. The locations and sizes of the arterial occlusions, one in the heart and another in the brain, ultimately determined his fate. Today, clogged arteries can be opened fast enough to prevent organ damage from occurring. After rapid restoring of blood flow, the heart beats healthily and the brain can continue with its complex work with minimal damages. For Paavo Nurmi, this was not yet possible. But his fantastic physical – or should we say “psychophysical” – condition allowed him to recover excellently. He lived an active life for another fifteen years after the myocardial infarction, and for about five years after the brain infarction.
Back then – 50 years ago – Finland needed patrons like him to support the research into cardiovascular diseases. Today, he would be happy to see that matters of the heart are in a much better shape now than in the old days, and he would be proud of having been a part of this development.

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