Hugo Moser (scientist)

Hugo Moser
Born	Hugo Wolfgang Moser October 24, 1924 Berne
Died	January 20, 2007 (aged 82) Baltimore, Maryland
Cause of death	pancreatic cancer
Residence	Baltimore, Maryland
Alma mater	Harvard, Columbia
Occupation	medical researcher
Years active	-2007
Employer	Kennedy-Krieger Institute
Known for	adrenoleukodystrophy research
Home town	Baltimore, Maryland
Board member of	United Leukodystrophy Foundation
Spouse(s)	Monti Lou Brigham, Ann

Hugo Wolfgang Moser, M.D. (1924–2007), was a research scientist and Director of the Neurogenetics Research Center at the Kennedy Krieger Institute. Dr. Moser was also University Professor of Neurology and Pediatrics at Johns Hopkins University. His research on peroxisomal disorders achieved international recognition.

Early life

Moser was born in Berne, Switzerland, the son of Maria and Hugo L. Moser.^[1] He grew up in Berlin.^[2] His father was of Jewish background and a prominent art dealer in Berlin. His mother was Austrian. Within a month of Hitler taking power in Germany the family left Berlin. Hugo spent his high school years in the Netherlands. Three months prior to the invasion of the Netherlands his mother arranged their timely escape from the Nazis. The family fled via Italy and Spain to Cuba.

In 1940 the family arrived in United States of America, first living in Baltimore, where the family owned paintings exhibited in the Baltimore Museum of Art, then moved to New York City. Survivor guilt plagued Hugo for having escaped the Holocaust without harm. His aunt and uncle, who were not able to leave the Netherlands, died in a German concentration camp. He devoted his life to working for the less privileged and disenfranchised.

Education

Hugo Moser in Korea

Hugo Moser attended Harvard as a pre-med student until he was drafted into the army. After discharge he went to medical school at Columbia University. At Columbia Presbyterian he was influenced by the chairman of medicine, Robert F. Loeb. He taught Hugo “two laws of therapeutics: if something doesn’t work, try something else, and if something does work, keep on doing it”. This principle later influenced his work on adrenoleukodystrophy (ALD).

After two years of residency at the Peter Bent Brigham Hospital during the Korean War, he volunteered for the Army. When back in the states, Hugo Moser returned to Harvard to get an advanced degree in biochemistry. He took two years of course work and became the first fellow of the National Multiple Sclerosis Society (NMSS).

Career

Hugo Moser and Staff

Moser worked on lipid chemistry with Dr. Manfred Karnofsky, until becoming a resident in neurology at Massachusetts General Hospital (MGH), where he established a neurochemistry program. Hugo set up the test for urinary sulfatides and compared the composition of urinary lipids with that of brain in metachromatic leukodystrophy.

Moser spent formative years in the research laboratories of the neurochemist Jordi Folch-Pi and Marjorie Lees at McLean Hospital. At McLean Hospital he interviewed Ann Boody for a position in his laboratory. This proved to be the beginning of a long and successful professional and marital partnership between Ann and Hugo. In the early research years, Hugo and Ann worked on lysosomal disorders. They described first the presence of cholesterol sulfate in human brain. They further investigated the role of steroid sulfatases in metachromatic leukodystrophy and multiple sulfatase deficiency, and they identified acid ceramidase as the enzyme deficient in Farber’s disease. In 1964, Hugo returned to the Joseph P. Kennedy research laboratories at MGH, and with Mary Efron and her junior faculty staff, Harvey Levy and Vivian Shih, he started screening programs for amino acid disorders and lysosomal disorders.

When training with other neurologists under Dr. Ray Adams at the Fernald State School in Waltham, Massachusetts, Hugo Moser became interested in providing better services for persons with developmental and physical disabilities. He was appointed research director and later superintendent of the Fernald State School. He also founded and directed the Eunice Kennedy Shriver Center for research and training in mental retardation. During this time he became a Harvard University Professor of Neurology at MGH, and established a model of a close link between clinical practice, training and community services for the developmentally disabled and bench research.

ALD research

In 1976 Hugo Moser accepted the position of president of the Kennedy Krieger Institute and professor of Neurology and Pediatrics at Johns Hopkins in Baltimore. Here he was able to merge areas of service, training and research. Dr. Yasuo Kishimoto, who had helped Kuni Suzuki make the discovery of elevated very long chain fatty acids in Adrenoleukodystrophy brains at Albert Einstein College of Medicine, followed Dr. Moser from the Shriver Center to the Kennedy Inistitute. With Kishimoto’s help, Hugo and Ann Moser developed the first assay for ALD in fibroblasts In 1981, they developed the plasma assay.

Hugo worked with Jim Powers for many years defining the phenotypic variation in ALD. Dr. Jack Griffin, then a fellow at NIH in endocrinology, first described the adult form of ALD. Beyond establishing the diagnostic testing for X-linked adrenoleukodystrophy, Hugo Moser also contributed to the discovery of the gene for X-ALD. During an interview with the American Neurological Association, he recalled how a post-doc by the name of Patrick Aubourg had come from Paris to work in his lab. Dr. Aubourg began working on the gene abnormality at Kennedy Krieger. However, it was Dr. Aubourg’s work with Dr. Jean-Louis Mandel in Strasbourg that finally led to identification and mapping of the gene.

As soon as diagnostic testing was established, Hugo Moser began to fight for treatment of patients with ALD. Together with the parents’ association United Leukodystrophy Foundation he provided support and guidance for families stricken by this devastating illness. Back in 1982, Johns Hopkins performed the first bone marrow transplantation in ALD. However, it wasn't until Patrick Aubourg transplanted a very mildly involved patient with his nonidentical twin as a donor, that bone marrow transplantation had a successful outcome. Hugo went on to collaborate a great deal with the University of Minnesota, where Bill Krivit and Charlie Peters developed a unique method of transplantation of ALD boys.

Dr. Hugo Moser's clinical partner Dr. Gerald Raymond, trained in pediatric neurology at MGH, worked together with him on these clinical trials in ALD patients. Today Dr. Raymond continues Moser's legacy at Kennedy Krieger.

Lorenzo's Oil

One of Dr. Hugo Moser’s longest endeavors was his work on Lorenzo's oil. It began with his relationship with Augusto and Michaela Odone, the parents of Lorenzo Odone, the namesake for Lorenzo’s oil. Hugo had diagnosed their son with the plasma assay. With the boy’s subsequent decline Hugo had suggested immunosuppression, which turned out not to be successful and contributed to frustration and tension between the Odones and Hugo. Together they organized a meeting at Kennedy Krieger where Dr. Bill Rizzo presented data that showed that adding oleic acid (C18 monounsaturated) to fibroblast cultures of ALD patients would reduce their fatty acids. Mr. Odone made an independent intellectual computation – namely that the use of erucic acid, which is C22:1 (C22 monounsaturated), would increase the effectiveness – and Lorenzo’s oil was developed. Controlled studies, however, indicate that Lorenzo's oil is not effective at treating symptomatic ALD,^[3] although it may delay the onset of symptoms if taken before they set in.^[4]

References

1. Jacques Kelly and Dennis O'Brien (January 23, 2007). "Hopkins doctor studied rare disorder ALD". The Baltimore Sun.
2. "Hugo Moser". The Guardian. 2007-02-21. Retrieved June 7, 2009.
3. Auborg, Patrick (1993). "A Two-Year Trial of Oleic and Erucic Acids ("Lorenzo's Oil") as Treatment for Adrenomyeloneuropathy". the New England Journal of Medicine. 329 (11): 745–752. doi:10.1056/NEJM199309093291101. PMID 8350883.
4. Moser, Hugo W. (2005). "Follow-up of 89 Asymptomatic Patients With Adrenoleukodystrophy Treated With Lorenzo's Oil". JAMA Neurology. 62 (7): 1073–1080. doi:10.1001/archneur.62.7.1073. PMID 16009761.

External links

• "In Memoriam: A Tribute to Dr. Hugo Moser (1924 - 2007)". Archived from the original (obituary) on 2011-08-24.
• Holley, Joe (January 26, 2007). "Neurological Authority Hugo Moser". Washington Post. p. B08. Retrieved June 7, 2009.