Willy Gepts described the pathology of the endocrine pancreas in human diabetes and identified key morphological differences between the types and stages of the disease. He is best known for showing that insulitis—inflammatory infiltrates in and around pancreatic islets—is characteristic of recent-onset juvenile diabetes. This led him to propose that the immune system plays a role in the pathogenesis of the disease. His other histopathological reports have attracted less attention, although they also provided unique information on islet pathology in human diabetes. The data and material he generated have been, and remain, a rich resource for further analysis and reference.
Born in 1922, Gepts grew up in Antwerp and studied medicine at the Université Libre de Bruxelles (ULB, Brussels, Belgium) where he graduated as MD (in 1946) and specialised in pathology. An excellent student and trainee, he was given the opportunity to combine clinical work with research in the school of Professor Paul Bastenie, where he investigated the morphology of the endocrine pancreas in disease models. He soon appreciated the need to avoid subjective judgement and developed quantitative methods for expressing microscopic observations in the pancreas of laboratory animals and of patients. This enabled him to quantify the reduction in the number of beta cells in the two main types of diabetes; a drastic decrease was observed in the “juvenile” form. In preparing his PhD thesis , Gepts collected and read virtually all existing papers on the pathology of the diabetic pancreas, a compendium of information that he kept up-to-date until the end of his career. In 1959, after reading Philip LeCompte’s paper on “insulitis” in four patients with early juvenile diabetes, he sent his thesis to the author, together with the proposal to subject histological sections from these cases to quantitative analysis. LeCompte invited him to Boston, where he stayed for 3 months, and his enthusiastic support contributed significantly to Gepts’ career; it was also the basis for their lifelong mutual respect and friendship. “Willy did the cutting of the paraffin blocks and the staining of the slides himself”, Dr LeCompte wrote, and he continued to do just this in subsequent years when extending his collection to pancreatic tissue samples from Belgian hospitals. Years of meticulous bench work and analysis, based on detailed knowledge of techniques and encyclopaedic knowledge of the literature, went into his landmark paper in Diabetes.
In 1965 he was appointed Professor of Pathology at the new Flemish section of the Université Libre de Bruxelles (ULB), and in 1969 he became head of the Department of Pathology at Brugmann University Hospital. As the number of students in the Flemish section increased, Gepts and a few colleagues took the initiative to create and build an independent Flemish Brussels Free University, the VUB, with its own medical campus—a step that was far from simple in a complex country. Between 1970 and 1980 he started a laboratory of Experimental Pathology committed to the morphological exploration of the human pancreas and relevant experimental models (and not the reverse). His collaborators and students found him a hard worker, a perfectionist, demanding, often difficult, but always honest.
His life progressively became indistinguishable from his work. There was little time left for the family; photographs with his children also show articles, manuscripts or a microscope. He was enormously grateful to his wife, Elizabeth, who managed to combine her role as head of a bacteriology department with that of a caring and available mother of four children, but rarely found the time to tell her so.
Towards the end of his life, Willy Gepts suffered from an overload of clinical and administrative tasks, which limited his time for research. He also realised that his memory, always one of his greatest strengths, was beginning to fail. This was one last diagnosis that he did not fail to make, but he kept it to himself. He became increasingly isolated.
Willy Gepts never sought the spotlight for his work or for himself, and may, therefore, be less well known than he deserves to be. His memory will not dim for those who knew him as a teacher, collaborator, colleague or opponent, representative, head or president. He left behind an enduring legacy of integrity, perfectionism, knowledge and vision.
^ Gepts W (1957) Contribution to the morphological study of the islets of Langerhans in diabetes; study of the quantitative variations of the different insular constituents [Article in French]. Ann Soc R Sci Med Nat Brux 5-108
^ LeCompte P (1958) “Insulitis” in early juvenile diabetes. Arch Pathol 450-457
^ Gepts W (1965) Pathologic anatomy of the pancreas in juvenile diabetes mellitus. Diabetes 619-633