Finding a Cause and a Cure
Benjamin Greenberg, MD
Johns Hopkins TM Center

On March 24, 1882 a German physician named Robert Koch stood in front of a stunned audience and articulated his discovery of Mycobacterium tuberculosis as the cause of tuberculosis. In detail, he explained how his careful science and novel techniques had identified the microscopic organism responsible for this human scourge. This lecture is considered by many to be one of the most important scientific lectures in history. The science practiced by Koch was clear, concise, controlled and structured. His model exemplified how to test scientific theories about cause and effect in human disease. What followed his work was a myriad of excellent science that has helped us advance our understanding of a variety of diseases in just the last century.

Today, however, our challenges have become greater as we address rare diseases with more complex presentations and causes. Neuroimmunology is at the frontier of this undiscovered country trying to determine the causes of diseases such as multiple sclerosis, transverse myelitis, acute disseminated encephalomyelitis (ADEM) and neuromyelitis optica. These disorders tend to strike people in the prime of their life and can cause significant disability, both physically and emotionally. One of the greatest tolls on patients and their families is living in the unknown. Is another attack going to occur? When? Will my family be able to care for me? Will I recover? What will life be like in just 5 more years? Finally we ask why. Why do some people get this disease and not others?

Tuberculosis was unfortunately a very common condition caused by an organism that could be seen through a microscope. MS, TM and the other neuroimmunologic conditions are uncommon disorders with a vast complexity that we are just now beginning to grasp. The cause of tuberculosis was defined largely by the work of one scientist. The causes of MS, TM and other neuroimmunologic conditions requires thousands. This battle also requires something special – unparalleled cooperation.

Through the Accelerated Cure Project and the proposed national consortium from the TMA we are now starting to assemble the pieces necessary for getting at the heart of these diseases. Pooling resources, patient information and samples will provide the power necessary to answer the most complex of questions. At Johns Hopkins I have been working on the initial phases of instituting the Cure Project. We have been tackling difficult questions about information collection, specimen collection, handling and processing. I will be the primary investigator here at Johns Hopkins and serving on the scientific advisory board for the Accelerated Cure Project. My goal is to ensure that large numbers of samples are collected and help to advise on the best processing practices and disbursement of these samples for research purposes.

We are now ready to take the first steps into creating a national repository of data and research material so that we can finally look our patients and families in the eyes and answer the ‘why’ question. Also, it was only after Mycobacterium tuberculosis was identified as the cause of tuberculosis that true cures could be created and I suspect that it will only be when the causes of these neurologic conditions are identified that we will be able to create the cure. Knowing the cause is the first step for knowing the cure. I look forward to taking part in the fight to find a cause and a cure.