Max Samter (March 8, 1909 – February 9, 1999) was a German-American immunologist who first extensively studied the triad between asthma, aspirin allergy, and nasal polyps that became known as Samter's triad, now aspirin-exacerbated respiratory disease.^[1] Samter was a third generation doctor and obtained medical training in Europe.^[2] After fleeing Nazi occupation in Germany, Samter had a long career in medical research in the United States.^[2] He is a pioneer in the field of immunology, having written many of the foundational textbooks of the field.^[3] Samter founded The Max Samter Institute for Immunology Research at Grant Hospital in Chicago (now closed),^[4] and after his death it was renamed in his honor.^[5]

Samter was born in what is now the eastern part of Berlin in 1908.^[3] Both his father and grandfather were medical doctors, and he was advised to attend multiple medical schools to gain knowledge and experience.^[2] Thus, he studied at Freiburg in the German Countryside, Innsbruck in Austria, and Berlin.^[2] He obtained his medical degree from the University of Berlin in 1933.^[5]

After he earned his Medical Degree, Samter started working as an intern doing research at Charite Hospital in Berlin.^[2] During his time there, he discovered an inventive design for the inhalational challenge of those with asthma using histamine and allergens.^[2] Inhalational challenge is exposing patients to a stressor to desensitize their lungs and allow them to breathe better in the presence of this stressor and in general.^[6] During Hitler's Regime, Jewish doctors were no longer allowed to work in major Universities.^[2] Thus, he had to open a medical clinic and worked as a general practitioner outside of Berlin for the next four years.^[2] Samter commuted to housecalls using his BMW motorcycle.^[2] It became dangerous for Samter to be in Germany as not only was he Jewish, but he had also written satirical articles speaking out against the Nazis.^[2] Samter used the increased mobility afforded to him by his motorcycle to help ensure his safety. In an interview, Samter stated his motorcycle facilitated a friendship with German military officers:  “Whenever the Gestapo decided to raid my office, one of my storm troopers [Acquaintances] would call and tell me that it might be unhealthy for me to stay in town. I would hide in Bavaria until the air had cleared.”^[3]

Hiding out in Bavaria only worked for so long, however, and it became clear Samter would have to leave Germany permanently.^[3] In 1937, he left Germany with the help of a formal medical school appointment orchestrated by benefactors at Johns Hopkins University.^[2] His inability to speak English restricted him to a research role because he could not effectively interact with patients.^[2] He worked for the next six years as an unpaid research assistant, including a year and a half in the hematology department at Johns Hopkins and later researching lymphocytes at the University of Pennsylvania.^[2][3]

After his six years as a research assistant, he opened up a private practice in New Jersey to obtain the resources to move his parents to the United States.^[2] His parents ended up moving to the US and he then enlisted in the US Army.^[3] He was a medic during WWII and even landed at Omaha on D-Day.^[2] He later became a military governor in Germany because he spoke German and the US Army needed German speakers.^[2] He stated of his time as a military governor, “I don't think that any country has been governed, by an amateur, as effectively as mine.”^[3] After the war, he was again limited to a research role due to both his lack of experience speaking English and damage to his hearing obtained during his service that stopped him from communicating with patients well.^[2]

Samter was offered a biochemist fellowship at the University of Illinois in Chicago and became full Professor at the College of Medicine in 1961.^[7] He then spent the last 28 years of his career working there in a variety of positions.^[3] He served as Chief of Staff and, in 1975, was appointed Associate Dean for Clinical Affairs of the Abraham Lincoln School of Medicine.^[7] He also became Director of the Institute of Allergy and Immunology and Clinical Immunology at Grant Hospital of Chicago in 1975.^[7] It was there that he made his most notable discovery- now known as Samter's Triad or aspirin-exacerbated respiratory disease.^[2]

Samter became interested in allergies during his time at the University of Illinois and noted a connection between asthma, sinusitis with nasal polyps, and aspirin sensitivity.^[2] Samter noticed that those with asthma and sinusitis are more likely to develop an allergy to non-steroidal painkillers like aspirin, ibuprofen, or naproxen.^[8] He found that people with one or more of these three factors are inclined to develop the others.^[1] This condition is called Samter's Triad, Samter's Syndrome, or, most commonly, aspirin-exacerbated respiratory disease.^[9] While the first publication discussing the link between asthma, nasal polyps and aspirin sensitivity was made by Georges-Fernand Widal in 1922,^[10] it was Samter who fully characterized the condition and brought widespread study and acknowledgement.^[11] It is a chronic disease meaning it has no known cure and does not go away.^[9] Its symptoms include nasal congestion, headache, sinus pain, sneezing, a stuffy or runny nose, loss of smell or taste, wheezing, coughing, chest tightness, difficulty breathing, chronic sinus infections, and recurrent nasal polyps.^[12] As evidenced by its wide range of symptoms and status as a chronic disease, Samter's Syndrome impacts quality of life, and can be life-threatening.^[12]

The Samter's Society is a patient advocacy group dedicated to raising awareness for the disease Samter discovered.^[9] Samter was one of the first researchers in the growing and new field of immunology and founded a research institute at the University of Illinois.^[7][2] After his death, it was renamed the Max Samter Institute for Immunology Research at Grant Hospital in his honor.^[7] The book Samter’s Immunological Diseases, originally titled Immunological Diseases, was republished and renamed in his honor.^[13] He is survived by his three children, all of whom followed in his footsteps and became doctors.^[5]

Samter was instrumental in writing many of the essential books in his field, including Regional Allergy (1954), Classics in Allergy (1969), Immunological Diseases (1965), and Hypersensitivity to Drugs (1971).^[2] He also wrote a variety of journal articles detailing his immunological discoveries, such as “Concerning the nature of intolerance to aspirin,” “The Acetyl- in Aspirin,” and “Asthma bronchiale and Histaminempfindlichkeit”.^[3][14][15]

• Max Samter papers at the University of Illinois at Chicago University Archives