Jewish Independent Article: "CFHU Stretches Your Mind"

IMRIC chair to share medical science developments

“There is a constant increase in scientific knowledge. The increment is made up of numerous findings, discoveries and advances,” said Dr. David Lichtstein of the potential for medical breakthroughs.

David LichtsteinChair of the Institute for Medical Research Israel-Canada (IMRIC) and professor in the department of physiology at Jerusalem’s Hebrew University-Hadassah Medical School, Lichtstein will visit Vancouver later this month with several other scholars to participate in Canadian Friends of the Hebrew University of Jerusalem’s Best of Hebrew U: Stretch Your Mind series. In an e-mail interview with the Jewish Independent, Lichtstein described the two sessions he will offer at the conference: a presentation on newly discovered molecular mechanisms behind manic-depressive disorder, commonly known as bipolar, and another on what it takes to achieve medical breakthroughs.

Lichtstein was born in Lodz, Poland, in 1949, and emigrated to Israel as an eight-year-old. He studied physiology and neurochemistry at the Hebrew University and then went on to do postdoctoral work in the United States at the Roche Institute for Molecular Biology. Eventually, he returned to Israel and joined the department of physiology at Hebrew University’s medical school, where, his CFHU biography notes, he has “made revolutionary changes in [the] organization of the entire pre-clinical part of the School of Medicine, establishing new departments and research centres.”

“As a young man, I wanted to be engaged in activities that would make a difference, that would affect and improve people’s lives,” Lichtstein told the Independent of his long career. “This, together with my interest in biology and my natural curiosity, led me to focus on the medical research field.”

Lichtstein’s work “focuses on molecular mechanisms responsible for ion transport across cell membranes,” he explained. “The essence of life is cell integrity and function. Each cell in our body is surrounded by a membrane, which is the physical barrier between two solutions, inside and outside the cell. The processes occurring at the cell membrane determine the integrity and function of the entire cell.

“One of the most important processes at the membrane involves machinery known as the sodium-potassium pump, which transports these ions into and out of the cell. I am studying this machinery and its regulation. We have discovered a new family of steroid hormones that regulate it. The activity of the sodium-potassium pump is of crucial importance for many systems functioning in the human body, including the heart, kidney and brain, and has implications in several pathological states, such as heart failure and neurological and psychiatric diseases.”

The issue of what constitutes a medical breakthrough, as opposed to a medical advance, will be explored in some depth in the professor’s first conference presentation.

According to Lichtstein, “Findings, discoveries and advances ... in my view, are not breakthroughs. I believe that, if you look carefully into [the issue], you will see that the increase in knowledge with time is not a smooth curve but, rather, made up of jumps. These jumps, which are relatively rare (unlike advances or achievements that happen every day), are the findings that serve as a milestone in the field. These discoveries completely change our thinking on the system and revolutionize issues that were completely beyond our comprehension. In the past 110 years, these breakthroughs have usually been recognized by a Nobel Prize and other prestigious awards.”

The time, effort and expense that can be involved to achieve a bona fide breakthrough can be extraordinary, explained Lichtstein.

“The cost of scientific work in our field is increasing with time and today is indeed a huge burden on society. Scientists spend a significant amount of their time in obtaining grants from competitive sources in order to be able to do their work, what I call ‘play[ing] the game.’ You probably know that the percentage of funds from the gross national product allocated for research (medical research included) varies among different countries. I take pride in mentioning that Israel ranks first in the world, allocating more than 4.5 percent of its GDP to research.”

Lichtstein’s second presentation of the day will cover the underlying neurobiology of manic-depressive disorder, a mental illness characterized by unusually extreme shifts in mood and behavior. In Canada, approximately one percent of the population is afflicted with the condition; symptoms, which can range from moderate to severe, typically start in adolescence or early adulthood. There are numerous mechanisms at work in any psychological disorder, expressions of a complex interplay between genetics, physiology, environment and other factors, but studying the brain can yield particularly significant etiological clues.

“Psychological or mental disorders are probably the most complicated biological disturbances and ... depend on myriad parameters,” he explained. “We believe that understanding the fundamental processes governing brain function will eventually lead us to an understanding of the pathological states. Unlike the heart or kidney, we do not understand today how the brain works as a system. Our interpretations of the mechanisms of psychiatric disorders come from our knowledge of mechanisms governing neuronal function at the single cell level and those that take place at the connections between neurons (synapses). All the medications for psychological disturbances, mental diseases, neurodegenerative diseases and psychiatric conditions are based on molecular mechanisms taking place in the neurons and in the synapses. There is an enormous amount of work being done these days on what we call ‘high brain function,’ using fMRI and other imaging techniques, although I am not familiar with any drug that has resulted from these studies as yet.

“The hope is that understanding the different functional connections in the brain and, therefore, an understanding of how the brain functions at the system level, will eventually lead to the development of new treatments.”

Given the nature of his work, there is no such thing as a “typical” day for Lichtstein. “Maybe that is one of the advantages of this profession,” he said. “My work consists of research – meeting with my students and colleagues, discussing and planning experiments, analyzing experimental data, writing research proposals and scientific papers – teaching ... [and] administration. As the chairman of [IMRIC], I deal with all the administrative aspects of a relatively large academic unit composed of five departments, seven teaching divisions, five research centres and 10 research hubs, altogether about 800 scientists. With the assistant of the administrative stuff, I deal with the system’s budgetary issues and manpower, and am deeply involved in the foreign affairs of the institute, mainly in our relations with [CFHU].”

The pressures to achieve results and the sometimes-fierce competition for grant money are issues that pervade the high-stakes world of research, and Lichtstein seems to manage these demands with a sense of pragmatism.

“The difficulties in obtaining funds on the one hand and the need for fast publication on the other hand for purposes of promotion are, on many occasions, determinants of the scientific question that is being studied. For example, if a pharmaceutical firm is offering funding to study a particular drug or mechanism, there will be scientists that will go in this direction, when actually their natural curiosity would have made them study other problems. This is a sad situation but, unfortunately, unavoidable in view of the cost of the experimental scientific work.”

It is the results of those inquiries, as well as a broader introduction to his field, that Lichtstein hopes to share with Vancouverites at Stretch Your Mind.

“My first lecture, on medical breakthroughs, belongs more to the realms of philosophy and the history of sciences. I hope that people will walk away from it with a better comprehension of the way scientific work in the medical sciences is being conducted and the difficulties we, the researchers, face,” he explained. “I believe that the audience will stand to gain from the analysis of examples of scientific breakthroughs throughout history. As to the second lecture, on molecular mechanisms of depressive disorders, the audience will learn a lot on the nature of these diseases and become familiar with the cellular mechanisms underlying them. This lecture contains a condensed course in basic neurobiology, which may be of interest to the audience.”

Lichtstein’s work with IMRIC brings together many of his interests and areas of expertise and, as he writes on the institute’s website, “The work that IMRIC scientists do is essential to understanding most of the illnesses that now challenge medical science, including cancer, cardiovascular disease, diabetes, neurodegenerative diseases, infectious diseases and many more.”

The father of three and grandfather to four has spent a lifetime devoted to scientific inquiry, and it’s the rigors of research that has kept him inspired. “I can’t really imagine myself doing anything else,” he concluded.

The Best of Hebrew University: Stretch Your Mind conference will be held the evening of Sept. 17 and during the day on Sept. 18, at Temple Sholom and at King David High School. Visit or call 604-257-5133 for more information or to register.