Robert Lisak, MD
Narrative Bio
Dr Robert P Lisak is Professor Emeritus, Department of Neurology. Before coming to Wayne State University in 1987 he was a faculty member in the Department of Neurology at the University of Pennsylvania in Philadelphia from 1972-1987, serving as Vice Chair of Neurology from 1985-87. He was also a member of the Graduate Group in Immunology and Associate Member of the Neuroscience Institute. Dr Lisak served as Chair of Neurology at Wayne State University from 1987-2012, as Neurologist-in-Chief of the Detroit Medical Center from 1987-2011 and Chief of Neurology at Harper University Hospital and its predecessors from 1987-2012. As a physician scientist Dr Lisak was a recipient of a Teacher Investigator Award from NINDS (1972-1977) and has and has had funding at the University of Pennsylvania and at Wayne State University from NINDS, NIAID, the National MS Society, the Muscular Dystrophy Association, the Myasthenia Gravis Foundation of America, and the Guillain Barre Syndrome/CIDP Foundation, International, as well as from multiple pharmaceutical companies for both preclinical investigator initiated studies and clinical trials. His clinical, basic and translational studies in neuroimmunologic diseases have resulted in 234 peer reviewed papers and reports, 187 reviews, signed editorials, chapters and books (written and edited) and 323 published abstracts from national and international meetings He has given invited talks nationally and internationally. Dr Lisak has served and serves on multiple editorial boards and served as Editor-in-Chief of the Journal of the Neurological Sciences, the journal of the World Federation of Neurology, from 1997-2013. He served and has served on study sections, review committees and policy committees for NIH and multiple voluntary health and scholarly societies as well as international, national and state-wide medical advisory boards. He has served in leadership positions for the American Academy of Neurology, the American Neurologic Association, the International Society of Neuroimmunology, the Neurologic Society of Philadelphia and the Michigan Neurologic Association. Dr Lisak was a Fulbright Scholar in the United Kingdom. Among his other honors are election ‘by distinction’ to the Royal College of Physicians (England), Gold Medal Award for Research Achievements by the Alumni Association of the College of Physicians and Surgeons, Lifetime Achievement Award from the Consortium of MS Centers and Trailblazer Award from Wayne State University School of Medicine. He has won multiple teaching awards the University of Pennsylvania and Wayne State University and one of the annual student research scholarships from the Foundation of the Consortium of MS Centers has been named in his honor.
Research Summary:
Dr Lisak’s research programs are in neuroimmunologic diseases including multiple sclerosis (MS) and related diseases including neuromyelitis optic spectrum disorders (NMOSD) and transverse myelitis (TM), myasthenia gravis (MG), immune-mediated neuropathies including Guillain-Barre Syndrome (GBS), Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and variants as well as other autoimmune neuropathies and inflammatory diseases of muscle. His approach, dating back to the 1960s, has always been translational. These studies encompass basic (wet bench) science and clinical research. The latter include characterization of clinical disorders, clinical trials including many multicenter trials that have lead to approval of several treatments for MS, MG and GBS.
MS is the most common potentially disabling non-traumatic disease of the central nervous system (CNS) of young adults and affects over 400,000 individuals and their families in the USA. In our MS research wet bench research, done in collaboration with Dr Joyce Benjamins, Professor Emerita of Neurology at Wayne State University and others, and look at fundamental interactions of the immune system and the central nervous system in order to better plan new therapies for MS. Until 1993 there were no known treatments that favorably altered the course of MS and basic studies on our laboratories and that of others have lead to the current status of 14 FDA approved treatments with more in the ‘pipeline’. While none of the available agents are cures the change in the outlook for many patients with MS has been remarkable. We have looked at the effect of cytokines and other mediators of inflammation on cells of the nervous system including oligodendrocytes (OL) and their precursors (OPC), astrocytes, microglia (the endogenous inflammatory cells of the central nervous system), and neurons. More recent studies have been focused on the protective and potential reparative effects of therapies already approved for other uses in MS and other diseases. These studies could point the way not only for use of these treatments for protective and reparative effects like enhancing remyelination, but by looking at the mechanisms of protection and repair by these agents, including adrenocortical trophic hormone (ACTH) and dextromethorphan (DM), newer treatments could also be developed that target the receptors for these molecules. In our other studies, done in collaboration with Dr Amit Bar-Or, formerly of McGill University in Montreal and currently at the University of Pennsylvania, we have discovered a somewhat unexpected potential role for B lymphocytes (B-cells) in the pathogenesis of MS, particularly for the cortical gray matter. Gray matter lesions correlate with the degree of permanent disability and begin in the earliest stages of MS. It has always been felt that B cells which mature to become plasma blasts and plasma cells, the antibody producing cells of the body, were involved in MS by producing antibodies (autoantibodies) that attack the CNS particularly myelin and the OL, the cells that produce myelin in the CNS. But newer roles for B cells in the immune system have been discovered and our work suggests that B cells can produce substances, not iimmunoglobulins (Ig) that are directly toxic to OL and neurons. Such B cells resident in the meninges (the covering of the brain and spinal cord) could release these toxic factors and damage the OL/myelin and the neurons and axons in the underlying cortical gray matter. We are currently actively attempting to characterize the toxic factor or factors released by the B cells which could then lead to a more specific therapy rather than simply destroying B cells in patients which is how the newer B cell MS therapies work. Selective blocking of toxic factors would not only be more specific and potentially more effective treatment but also safer.
MG is a disease of the neuromuscular junction (NMJ), which is where the nerves release chemicals that transit a message to the underlying muscle to activate contract resulting in movement. Weakness in acquired autoimmune MG is caused by autoantibodies directed against proteins of the NMJ. In MG our work as been focused on what drives the autoimmune processes in patients to produce autoantibodies that attack components of the neuromuscular junction (NMJ), which leads to the weakness that characterizes MG. We have also been involved in studies, including one funded by the NIH, to identify additional components of the NMJ that serve as targets (antigens) for antibodies and to characterize the clinical picture in patients with these autoantibodies. While we now have therapies that improve weakness in MG patients, many of these treatments effects are incomplete and many have significant side effects. Therefore we are involved in multicenter trials to try to develop additional therapies for MG.
Our work in inflammatory immune-mediated demyelinating and other autoimmune neuropathies focuses on both the interactions of immune system mediators, antibodies as well as products of T cells and monocyte/macrophages, with Schwann cells, the myelin forming cells of the peripheral nervous system (PNS), using in vitro (tissue culture) and in vivo (animal models) experiments, as well as studies of patients including the first study to demonstrate that plasma exchange was an effective treatment for GBS.
Office Address
Wayne State University
Department of Neurology 8D University Health Center
4201 St. Antoine
Detroit, MI 48201
Office Phone: (313) 577-8959
Other Information
New research funding awarded in 2011
Effect of ACTH on Glial Cell Function Proliferation and Effects of Cytokines on Gene Regulation. Sponsor: Questcor Pharmaceuticals, Inc. Robert Lisak, PI, Joyce Benjamins,
Undergraduate
University College of Arts and Sciences, New York University, BA cum laude, with highest honors in history, 1961
Medical
College of Physicians & Surgeons, Columbia University, M.D.,1965
Position Title
Professor Emeritus, Department of Neurology
Internships
PGY1: Mixed Medicine, Montefiore Hospital, Bronx, NY, 1965-1966
PGY2 Internal Medicine: Bronx Municipal Hospital Center, Albert Einstein College of Medicine, Yeshiva University, 1968-69
Residency
Hospital of the University of Pennsylvania, Philadelphia, PA, 1969-72
Specialties
ms-program,neuromuscular-program
Fellowships
University College London and National Institute for Neurologic Diseases, London, UK, 1978-1979 (Fulbright Senior Scholar); Hospital of the University of Pennsylvania, (Allergy and Immunology), Philadelphia, PA, 1971-1972; National Institute of Mental Health (Neurochemistry/Neuroimmunology), 1966-1968
Prior Appointments
University of Pennsylvania, 1972-1987
Interests
Multiple Sclerosis and related diseases, Myasthenia Gravis, inflammatory demyelinating neuropathies, inflammatory myopathies, neurologic complications of collagen-vascular diseases, vasculitis