Neuro-oncologist Josep Dalmau, group leader at the CaixaResearch Institute and a global expert in the study of autoimmune encephalitis, has dedicated his career to understanding how the immune system can attack the brain, and to translating that knowledge into advances that have changed clinical practice. His pioneering work has earned him the 2025 National Research Award in the field of Medicine and Health Sciences, granted by the Spanish Ministry of Science, Innovation and Universities. We spoke with him about his career and the significance of this recognition.

QUESTION: What does receiving this award mean to you?

ANSWER: Obviously, it is a great honour. Honestly, I did not expect it, and when I was informed, I was very surprised. I always like to look at who has received the award in previous editions, because I think it is a good way to appreciate its importance. For me, it is truly an honour to share the list with those who have received it before.

Q: The jury highlighted the originality of your research, which combines neurology, oncology and immunology. How did the idea of uniting these three fields come about?

A: This began when I was very young. I have always been very interested in oncology—in fact, I was tempted to choose it instead of neurology. In the end, I opted for neurology and trained here in Barcelona. However, during my residency I had the opportunity to take part in cases of patients with cancer who presented neurological problems, which reawakened and reinforced my interest in both fields. This led me to go to the United States to train as a neuro-oncologist. I went to New York to work at the Memorial Sloan-Kettering Cancer Centre with Jerome B. Posner, considered the father of neuro-oncology, who at that time was studying neuroimmunological complications in patients with cancer. That is how the combination of neurology, oncology and immunology arose, back in 1988.

Q: The jury also highlighted the transformative role of your research “in clinical practice”. Could you explain how your work has changed the way neurological diseases are approached?

A: Studying these cancer-associated diseases led us to identify a whole new category of conditions, previously unknown, that are mediated by antibodies directed against brain proteins. At that time, I was in Philadelphia, at the University of Pennsylvania. There, our laboratory discovered a disease that is now the best known in this group: anti-NMDA receptor encephalitis. However, we soon realised that this was only the tip of the iceberg.

Q: Did you then identify more related diseases?

A: Yes, there were many other similar conditions that, due to lack of knowledge, were sometimes attributed to viral infections —even when no virus was found—, to a possible cancer —even when none was identified—, or they were considered idiopathic, meaning of unknown cause. At that time, no one suspected that all of them —today we know there are at least 18— could have an immune origin.

In addition, we developed diagnostic tests for blood and cerebrospinal fluid, which are now used worldwide. I believe that is where the real impact of our work lies: in identifying a new group of diseases and developing the diagnostic tests that allow them to be detected.

Q: Your research group at IDIBAPS works with multiple approaches, from basic research to a more clinical focus. What added value does integrating research with clinical practice provide?

A: It can happen, for example, that a patient arrives with an unknown disease, and is attended by colleagues in neurology who —if they consider it necessary— call me to discuss the case, or I may even be able to go and see the patient personally. Sometimes the symptoms point to a known disease, but at other times they do not, and that is when our research work in the laboratory truly begins. In this way, we can move directly from the clinic to research.

Q: It must be very motivating to know that your research can help patients.

A: Yes, for me it is essential to work while maintaining both approaches; in fact, I have always combined them, and I would not know how to do it any other way. From my office I can see the hospital and knowing that I have the possibility to attend to patients is something that deeply motivates me in my work.

Starting from a small group of patients with unusual and difficult-to-interpret symptoms, we were able to identify an unknown disease and develop a diagnostic test that made it possible to recognise similar cases more quickly and accurately. This possibility of connecting clinical work and research is something I find fascinating, and it is what has always kept me in this translational field.

Q: What advances and challenges exist today in the treatment of autoimmune encephalitis?

A: Many of the treatments already exist and are currently accessible, but the relatively recent discovery of these diseases means that formal clinical trials with many of them have not yet been conducted. In many autoimmune encephalitis cases, treatment focuses on temporarily eliminating B lymphocytes. I believe this approach will become a relatively standard treatment, as there is considerable clinical experience, but its efficacy must be demonstrated clearly and rigorously through clinical trials.

Q: Are there other treatment options?

A: Yes, other therapeutic strategies that act on regulatory molecules of the immune system are currently being explored in order to suppress autoimmunity. In addition, there is an emerging innovative option: CAR-T cell therapy. These therapies have normally been used in the oncology context, and now their potential in autoimmunity is being explored; in fact, we have already treated one patient with this therapy here. CAR-T cells can eliminate the cells in the body that, under certain circumstances, become dysregulated and start producing antibodies against the nervous system. Although publications on these cases already exist, for now they refer only to isolated patients and, as with other strategies, it will be essential to study them in detail and validate them through clinical trials.

Q: After having lived and worked for many years in the United States, how do you view the future of medical research in Spain?

A: In both countries there are positive and negative aspects. In the United States, very high-quality basic and translational research is carried out—however, from a care and clinical perspective, the system has significant shortcomings. There are people who cannot cover the cost of treatment, or who end up selling their house to pay for medical expenses; and this is not an exaggeration, it is something that happens frequently. Fortunately, in Spain this situation does not occur, but on the other hand, research funding here leaves much to be desired.

Q: What do you attribute this lack of support to?

A: In my opinion, Spain has never shown an interest in research comparable to that of other countries. I believe greater effort should be made to promote scientific research in general, and especially in neuroscience, given the importance that diseases such as Alzheimer’s and other degenerative disorders will have in an increasingly ageing population. Funding from Europe is often expected to solve these deficiencies, but it is essential that Spain increase its own support for research. In other countries, such as France, state-funded grants are much more substantial than those offered here. European projects and investments must of course continue and grow, but national support must also increase.

Q: In this context, what role do you think the CaixaResearch Institute may play in the scientific research landscape in Spain?

A: I believe the CaixaResearch Institute will have a very significant impact. It will be a centre that will host a considerable number of principal investigators, both from Spain and from abroad, who will arrive with their teams and expand over time. This will make the CaixaResearch Institute a reference centre in Spain dedicated to immunological research in all its dimensions. Overall, I believe it will become a key space for advancing biomedical research in our country.

Q: What advice would you give to young researchers beginning their careers in the biomedical field?

A: Personally, I have always been guided by interest in what inspires me, sometimes even making somewhat impulsive decisions. I think the most important thing is that they dedicate themselves to what they truly enjoy, not necessarily what is easiest, most profitable, or allows faster publication. My main advice is that if they cannot do what they want in one place, they should look for another, even in another country if necessary. If they want to develop a particular line of research, they should pursue it and not settle. Ultimately, I would recommend that they always follow what truly motivates them.