Seeking Solutions, Delivering Hope
Researcher’s passion for science and
compassion for people drive MS research
Thomas Forsthuber was a
medical student in his first
neurology course when the
plight of multiple sclerosis
patients struck him. Of all the diseases
that he studied, this one seemed especially
unkind. It arose mysteriously in
the prime of life, causing the body’s
own immune system to turn hostile and
wage war on the delicate protective
layers that surround brain cells. And
it seemed there was little that doctors
could do as this stealth attack began
to fray the circuits in the brain, causing
vision problems, muscle weakness, loss
of coordination, pain and numbness. In
the most serious cases, the disease stole
away patients’ ability to walk or speak.
"I vividly remember that lecture,"
Forsthuber said of the class he attended
two decades ago at the University of
Tubingen, Germany, where he received
his M.D. and Ph.D. "They had no idea
why this happened; why did the body
turn against its own protective cells?"
Six years ago, Forsthuber relocated
from Case Western Reserve University
in Cleveland and brought those questions
to UTSA, where he now is a professor
of immunology. Here, his passion
for science and compassion for
people drive a research program that
is delving into the immune system for
clues about what goes wrong and what
can be done to stop the devastating
damage that follows.
"My weak spot is ill people, but MS
patients have a special spot with me,"
he said. "If you have the flu, we know
what we can do for you. But if you have
multiple sclerosis, we don’t have a lot
that we can do. Most patients go slowly
downhill for 20 or 30 years. They lose
their vision, their muscle control; some
of them lose their families because they
"On the outside, they look OK, but
on the inside, they are ill and suffering."
The program has been a boost to
multiple sclerosis patients in the South
Texas area, not just scientifically but
emotionally as well. Forsthuber invites
groups of them to his laboratory and he
attends their fundraising functions.
"He holds out hope to a group of
people who are looking for any kind of
hope," said Tony Ralf, regional vice president
for the Lone Star and Rio Grande
chapters of the Multiple Sclerosis Society.
"This is not like the scientist you see on
TV who is removed from society."
Even after years of scientific probing,
much about multiple sclerosis remains
an enigma. Research has shown that
people with a specific gene, called HLADR2,
have a higher risk of developing MS.
Other clues suggest there is an outside
event–an injury, infection or toxic exposure—that actually brings on the disease.
"You need the perfect storm," said
Forsthuber. "If you have the gene, your
immune system is ready to cause this
assault on your brain. But then something
has to trigger it."
The insult causes the myelin sheath,
an insulating layer of fat that encases
the neurons, to release an antigen. The
antigen somehow activates a hostile reaction
in select immune cells. The body
then mounts an attack, producing more
and more immune cells devoted to the
destruction of its own healthy tissue.
"They mistake the brain for something
that is infectious," Forsthuber said.
With damaged myelin, brain cells
misfire like faulty electrical wiring. In
most patients, symptoms come and go,
causing pain, numbness, fatigue, blurry
or double vision and loss of muscle
coordination. But the more serious forms
of the disease can leave people unable
to walk or talk. About 400,000 people
in the United States have MS; 18,000 of
them live in Texas. It usually is diagnosed
between the ages of 20 and 40, and is
more common in women.
For years, the only available treatments
were steroid medications to
suppress the immune reaction. More
recently, researchers have developed
drugs that work by blocking the action
of specific immune cells. These are
not effective in all patients, however,
and some of them have potentially
dangerous side effects.
Forsthuber’s work focuses on T-cell
lymphocytes, a type of white blood
cell that is a crucial component of the
immune system attack. Using laboratory
mice that have been bred to carry
the human form of the HLA gene,
Forsthuber has identified what piece
of the myelin is vulnerable to the T-cell
attack. Now he is working with a drug
company to test an experimental medication
that blocks the pathogenic T-cells
from reaching that vulnerable spot.
He also is working to identify biomarkers—proteins circulating in the
blood that can tell doctors how patients
are responding to their therapy and whether
some are developing resistance to the
steroid medications they are taking. This
is the emerging field of proteomics, or
the detailed study of proteins, a research
field that got a giant boost last year when
UTSA landed a key federal grant.
The funding came from the National
Institutes of Health, via the Research
Centers in Minority Institutions (RCMI)
program, which helps build research
capacity at universities that serve
minority student populations. UTSA
is getting a $12 million infusion of capital
over the next five years, much of
it earmarked for the state-of-the-art
equipment needed to enable cutting-edge
research projects, like the ones
Forsthuber is undertaking. Faculty members
have access to the Proteomics and
Protein Biomarkers cores, laboratories
dedicated specifically to this type of
research, where advanced techniques
like mass spectrometry and chromatography
help them identify and characterize
This investment gives Forsthuber’s
team in San Antonio the same opportunity
for discovery as scientists at
any top-tier biomedical research university.
"I can do everything here that
I would at Case Western or Harvard,"
However, this is not a research project
confined to the walls of a laboratory.
Forsthuber, his staff and students shed
lab coats and donned sneakers in
February when the Multiple Sclerosis
Society Lone Star Chapter held its annual
fundraising walk at the AT&T Center.
The chapter also brings groups of
MS patients and prospective donors to
Forsthuber’s lab to learn first-hand about
the work that goes on there.
"We have pretty much open access
to his lab," said Ralf. "That is almost
unheard of in research. He really wants
to have that personal contact with the
people he is trying to help."
Forsthuber thrives on the contact.
The patients remind the scientists and
students in his lab about the human need
that drives their work, Forsthuber said.
"I love the process of discovery," he
said. "But I also have a big soft spot for
people who are ill."