Dr. Raphael Schneider
Dr. Raphael Schneider, University of Toronto
Dr. Raphael Schneider is a neurologist specializing in the care of people with MS with an interest in identifying biomarkers to improve clinical care. He completed a Ph.D. in neuroscience at the University of Toronto where his research focused on biomarkers in neurological diseases. He then completed a postdoctoral fellow in neuroimmunology at the Université de Montréal. He is now an Assistant Professor at the University of Toronto in the Department of Medicine and the Institute of Medical Science. He sees patients at the BARLO MS Centre. His laboratory is at the Keenan Research Centre for Biomedical Science, where his work focuses on blood and spinal biomarkers discovery. He collaborates closely with Dr. Jiwon Oh on the Canadian Prospective Cohort Study to Understand Progression in MS (CanProCo) and the Radiologically Isolated Syndrome (RIS) cohort study.
Learn more about Dr. Schneider
What is the focus of your research? How did you become interested in MS research?
Despite recent advances, early diagnosis and estimation of prognosis remain important challenges in the MS clinic. There is no blood test for MS, and the diagnosis remains based on classic symptoms and MRI findings. However, many patients present with symptoms atypical for MS. Further, increasing availability and use of MRI has led to more unexpected findings of brain “lesions” in people with no MS symptoms. When MS-like lesions are seen on a brain MRI without MS symptoms, a diagnosis of a radiologically isolated syndrome (RIS) is made. Many people with RIS eventually develop symptoms and meet MS criteria (i.e. convert from RIS to MS). These people may have a more subtle, pre-symptomatic form of MS. Given the variable and possible aggressive disease course in MS, more research is needed to understand the relationship between RIS and MS. We work on developing a blood test for people with RIS. We hypothesize that self-reactive immune cells are already present in the blood of people with RIS, thus conferring risk for MS.
Uncertainty about the future is one of the most common worries of our patients. Therefore, I have always been interested in research that has the potential to clarify what the earliest signs or symptoms of MS may mean for the patients we see in the clinic. I became interested in MS research as a medical student in Germany in the early 2000s. At the time, the concept of the clinically isolated syndrome (CIS) being an early presentation of MS was relatively new. Today, we know much more about CIS than 20 years ago, and we know how to advise people with CIS. As a result, RIS has become the new "prodromal MS" that we need to understand better.
What inspires you to continue advancing research in this field?
Research into the immunological mechanisms that underlie MS has led to the development of new medications that slow down MS. We now see the impact these medications can have on people's lives. As a result, many people diagnosed with MS today will have a better prognosis than those diagnosed just a few years ago. I believe that we are "on a roll" and that many relevant discoveries about MS are just around the corner. It’s an exciting time to be an MS researcher and clinician.
How do you hope to change the lives of people living with MS through your research?
I have always been interested in research that has the potential to clarify what the earliest signs or symptoms of MS may mean for the patients we see in the MS clinic. In addition, I see great opportunities to learn more about MS by studying the blood and spinal fluid of patients. Therefore, I am particularly enthusiastic about translating findings from the lab to the clinic to impact the lives of those living with MS.
What do you enjoy most about your research? What are some of the challenges you face?
It is incredible how much we already know about the immune system, but researchers worldwide still make discoveries every day. To build on the discovery of others, modify the approach to meet the specific needs of your project and use the newest technologies to push the boundaries of what is possible is just thrilling. But unfortunately, there is not enough time and not enough resources to pursue every project idea. Therefore, one has to pick and choose without always knowing which experiment will yield the best results.
How important is the support from the MS Society of Canada in your research?
The MS Society of Canada had already supported me with a postdoctoral fellowship while working in Dr. Nathalie Arbour's lab at the Université de Montréal. The MS Society of Canada’s Discovery Grant will help me establish myself as an independent early career investigator. Moreover, it will lay a foundation for research projects for students and eventually allow me to pay it forward to the next generation of MS researchers.