Professor Emeritus Charles Peter Tilbery [1944-2020]

Professor Emérito Charles Peter Tilbery (1944-2020)

On May 24, 2020, at the age of 76, Professor Charles Peter Tilbery (Figure 1) passed away after a life story marked by sudden and dramatic family losses, a memorable career as a doctor and researcher, and a legacy to neurology with his scientific productions and an entourage of doctors trained by him. His work on multiple sclerosis (MS) made him an internationally renowned researcher.

Figure 1.
Charles P. Tilbery in Jerusalem (2000).

In the last three decades, the name Charles Peter Tilbery has become synonymous with research and treatment of MS in Brazil. Throughout his academic career, he has consistently been at the forefront of clinical research on the disease; his tenacity, together with his questioning spirit, were traits he had from a young age. Born in London, England, in 1944, Charles and his family came to Brazil in 1949 under the shadow of World War II. He graduated in medicine in 1969, as a student of the second medical class at the Faculdade de Ciências Médicas da Santa Casa de São Paulo. In 1970, Charles made his academic debut with a publication in the journal Arquivos de Neuro-Psiquiatria¹. In 1973, he became the first resident trained at the Neurology Service of the Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP), under the coordination of Professor Wilson Luiz Sanvito. At the end of his residency, in 1973, Charles started his teaching career as an Instructor; in 1975, he became Assistant Professor; and in 2006, he was appointed Full Professor at ISCMSP.

In 1974, Charles earned his title of Specialist in Neurology from the Academia Brasileira de Neurologia (ABN), and 40 years later, in 2014, he received the title of Full Emeritus Member of ABN. In the 1980s, Charles taught courses on MS in São Paulo for the newly created Associação Brasileira de Neurologia (ABEM), the first association of MS patients in the country.

In 1983, Charles concluded his Master’s degree with the dissertation “Evaluation of T lymphocytes in patients with MS;” two years later, he finished his Ph.D. with the thesis “Value of variations in lymphocytes and their subpopulations and the finding of anti-lymphocyte antibodies in the blood in the diagnosis of MS.” Both were presented at what is now the Universidade Federal de São Paulo (UNIFESP) under the guidance of Professor José Geraldo de Camargo Lima. This research gave rise to two scientific articles, published by Revista Paulista de Medicina in 1987^2,3.

In 1988, Charles helped found the Working Group (now the Scientific Department) of Neuroimmunology of ABN. In 1995, he collaborated on the Atlântico-Sul project, a research project that analyzed the clinical and evolutionary profile of MS in Brazil⁴. In 1999, he participated in the founding of the Brazilian Committee for Treatment and Research in Multiple Sclerosis (BCTRIMS) in the city of Botucatu, São Paulo. The 1990s were marked by the establishment of the Centro de Atendimento e Tratamento da Esclerose Múltipla (CATEM) in April 1997. Charles stated that the founding of CATEM involved a public-private partnership among the São Paulo State Health Secretariat, ISCMSP, and the pharmaceutical industry with the aim of standardizing the clinical approach, multidisciplinary care, and treatment for MS patients⁵. Based on this model, CATEM was the first reference center for MS in the country. On August 27 and 28, 1998, CATEM's historic 1^st Multiple Sclerosis Workshop brought together more than 200 doctors and researchers from all over Brazil, with theoretical classes and practical workshops, disseminating the idea of ​​creating other reference centers in the country.

In three decades of clinical research, Charles published more than 70 original articles and 27 book chapters. He was also editor of the book “Esclerose Múltipla no Brasil: Aspectos clínicos e terapêuticos” (ISBN 85-7379-714-2) in 2005. In 2012/2013, Charles was editor of the Latin American Multiple Sclerosis Journal (ISSN 2238-3247). He took part in 11 Master's examination committees and eight Ph.D. examination committees; he supervised seven Master's theses and two doctoral dissertations. Among his numerous pioneering contributions to the study of MS, we highlight:

The first articles on the immunology of the disease in Brazil^2,3. The first Brazilian clinical trials and guidelines on the treatment of MS with beta-interferon^6,7.

Studies on specific aspects of MS, from its pathology to its immunology, epidemiology, multidisciplinary approach, and treatment^{8,9,10,11,12,13,14,15,16,17,18}.Collaborative studies on the prevalence of MS in the city of São Paulo^19,20.

Aspects related to the treatment of MS, such as drug migration, treatment failure, and adverse effects of immunomodulatory drugs in Brazilian patients^21,22,23,24.

Charles Peter Tilbery concluded his academic career with the title of Professor Emeritus of Faculdade de Ciências Médicas da Santa Casa de São Paulo on June 19, 2019 - the first former student of that school to receive such a title. To new neurologists, Charles once said, “the suffering we see when we have just graduated simply ennobles us and provides us with new data for future care. Only experience can give us that.” All who knew him well will certainly miss him deeply. His work will continue to be disseminated by his collaborators, disciples, and friends.

References

• ¹
  De Jorge FB, Gagliardi-Ferreira LC, Tilbery CP. Hepatolenticular degeneration: iron and copper contents of tissues of autopsy material. Arq Neuro-Psiquiatr. 1970 Mar;28(1):51-7. https://doi.org/10.1590/S0004-282X1970000100006
  » https://doi.org/https://doi.org/10.1590/S0004-282X1970000100006
• ²
  Tilbery CP, Camargo Lima JG, Scheinberg MA. Immunologic aspects in multiple sclerosis: I. Subpopulations of lymphocytes and antilymphocyte antibodies. Rev Paul Med. 1987 May/Jun;105(3):134-40.
• ³
  Scheinberg MA, Tilbery CP. Immunological aspects in multiple sclerosis: II characterization of antilymphocyte antibodies. Rev Paul Med. 1987 May/Jun;105(3):143-5.
• ⁴
  Papais-Alvarenga RM, Alves SV, Santos CMM, Tilbery CP. [Multiple sclerosis (MS): presentation of a research project to analyze the clinical and evolutionary profile of MS in Brazil - Projeto Atlântico-Sul 1995/1996]. Rev Bras Neurol. 1995 Mar/Apr;31(2):51-9.
• ⁵
  Tilbery CP, Moreira MA, Felipe E, Mendes MF, Balsimelli S, Barão AM, et al. CATEM - Centro de Atendimento e Tratamento da Esclerose Múltipla: um projeto multidisciplinar. In: Reimão R, Gagliardi RJ, Spina-França A. Temas de Neurologia: Associação Paulista de Neurologia. São Paulo: Frôntis Editorial; 1999. p.440.
• ⁶
  Tilbery CP, Felipe E, Moreira MA, Mendes MF, França AS. Interferon beta 1-a in multiple sclerosis: 1-year experience in 62 patients. Arq Neuro-Psiquiatr. 2000 Jun;58(2B):452-9. https://doi.org/10.1590/s0004-282x2000000300009
  » https://doi.org/https://doi.org/10.1590/s0004-282x2000000300009
• ⁷
  Tilbery CP, Moreira MA, Mendes MF, Lana-Peixoto MA, Brazilian Committee for Treatment and Research in Multiple Sclerosis. Recommendations for the use of immunomodulatory drugs in multiple sclerosis: the BCTRIMS consensus. Arq Neuro-Psiquiatr. 2000 Sep;58(3A):769-76. https://doi.org/10.1590/s0004-282x2000000400030
  » https://doi.org/https://doi.org/10.1590/s0004-282x2000000400030
• ⁸
  Lancellotti CLP, Paslar EAL, D'Andretta Neto C, Atra M, Tilbery CP. Multiple sclerosis: clinical and pathological study of a case. Arq Neuro-Psiquiatr. 1989 Dec;47(4):455-60. https://doi.org/10.1590/s0004-282x1989000400012
  » https://doi.org/https://doi.org/10.1590/s0004-282x1989000400012
• ⁹
  Tilbery CP, Felipe E, Mota IM, Scheinberg MA. Increase of interleukin-2 soluble receptors in multiple sclerosis: preliminary study in 26 patients. Arq Neuro-Psiquiatr. 1994 Jun;52(2):216-20. https://doi.org/10.1590/s0004-282x1994000200011
  » https://doi.org/https://doi.org/10.1590/s0004-282x1994000200011
• ¹⁰
  Felipe E, Mendes MF, Moreira MA, Tilbery CP. Comparative analysis of 2 clinical scales for clinical evaluation in multiple sclerosis: review of 302 cases. Arq Neuro-Psiquiatr. 2000 Jun;58(2A):300-3. https://doi.org/10.1590/s0004-282x2000000200016
  » https://doi.org/https://doi.org/10.1590/s0004-282x2000000200016
• ¹¹
  Moreira MA, Felipe E, Mendes MF, Tilbery CP. Multiple sclerosis: descriptive study of its clinical forms in 302 cases. Arq Neuro-Psiquiatr. 2000 Jun;58(2B):460-6. https://doi.org/10.1590/s0004-282x2000000300010
  » https://doi.org/https://doi.org/10.1590/s0004-282x2000000300010
• ¹²
  Mendes MF, Tilbery CP, Felipe E. Fatigue and multiple sclerosis: preliminary study of 15 patients with self-reported scales. Arq Neuro-Psiquiatr. 2000 Jun;58(2B):467-70. https://doi.org/10.1590/s0004-282x2000000300011
  » https://doi.org/https://doi.org/10.1590/s0004-282x2000000300011
• ¹³
  Mendes MF, Tilbery CP, Balsimelli S, Moreira MA, Barão-Cruz AM. Depression in relapsing-remitting multiple sclerosis. Arq Neuro-Psiquiatr. 2003 Sep;61(3A):591-5. https://doi.org/10.1590/s0004-282x2003000400012
  » https://doi.org/https://doi.org/10.1590/s0004-282x2003000400012
• ¹⁴
  Tilbery CP, Mendes MF, Thomaz RB, Oliveira BE, Kelian GL, Busch R, et al. Multiple Sclerosis Functional Composite Measure (MSFC) standardized in the Brazilian population. Arq Neuro-Psiquiatr. 2005 Mar;63(1):127-32. https://doi.org/10.1590/s0004-282x2005000100023
  » https://doi.org/https://doi.org/10.1590/s0004-282x2005000100023
• ¹⁵
  Moreira MA, Tilbery CP, Monteiro LP, Teixeira MM, Teixeira AL. Effect of the treatment with methylprednisolone on the cerebrospinal fluid and serum levels of CCL2 and CXCL10 chemokines in patients with active multiple sclerosis. Acta Neurol Scand. 2006 Aug;114(2):109-13. https://doi.org/10.1111/j.1600-0404.2006.00629.x
  » https://doi.org/https://doi.org/10.1111/j.1600-0404.2006.00629.x
• ¹⁶
  Pavan K, Marangoni BEM, Schmidt KB, Cobe FA, Matuti GS, Nishino LK, et al. Vestibular rehabilitation in patients with relapsing-remitting multiple sclerosis. Arq Neuro-Psiquiatr. 2007 Jun;65(2A):332-5. https://doi.org/10.1590/s0004-282x2007000200027
  » https://doi.org/https://doi.org/10.1590/s0004-282x2007000200027
• ¹⁷
  Fazzito MM, Jordy SS, Tilbery CP. Psychiatric disorders in multiple sclerosis patients. Arq Neuro-Psiquiatr. 2009 Sep;67(3A):664-7. https://doi.org/10.1590/s0004-282x2009000400017
  » https://doi.org/https://doi.org/10.1590/s0004-282x2009000400017
• ¹⁸
  Stievano LP, Olival GS, Silva RA, Toller VB, Carabetta EG, da Cunha ET, et al. Validation survey of the impact of urinary incontinence (IIQ-7) and inventory of distress urogenital (UDI-6) - the short scales - in patients with multiple sclerosis. Arq Neuro-Psiquiatr. 2015 Jan;73(1):46-51. http://doi.org/10.1590/0004-282X20140218
  » https://doi.org/http://doi.org/10.1590/0004-282X20140218
• ¹⁹
  Callegaro D, de Lolio CA, Radvany J, Tilbery CP, Mendonça RA, Paiva Melo AC. Prevalence of multiple sclerosis in the city of São Paulo, Brazil, in 1990. Neuroepidemiology. 1992;11(1):11-4. https://doi.org/10.1159/000110901
  » https://doi.org/https://doi.org/10.1159/000110901
• ²⁰
  Callegaro D, Goldbaum M, Morais L, Tilbery CP, Moreira MA, Gabbai AA, et al. The prevalence of multiple sclerosis in the city of São Paulo, Brazil, 1997. Acta Neurol Scand. 2001 Oct;104(4):208-13. https://doi.org/10.1034/j.1600-0404.2001.00372.x
  » https://doi.org/https://doi.org/10.1034/j.1600-0404.2001.00372.x
• ²¹
  Tilbery CP, Mendes MF, Oliveira BES, Thomaz RB, Kelian GR. Immunomodulatory treatment in multiple sclerosis: experience at a Brazilian center with 390 patients. Arq Neuro-Psiquiatr. 2006 Mar;64(1):51-4. https://doi.org/10.1590/s0004-282x2006000100011
  » https://doi.org/https://doi.org/10.1590/s0004-282x2006000100011
• ²²
  Jordy SS, Tilbery CP, Fazzito MM. Immunomodulator therapy migration in relapsing remitting multiple sclerosis: a study of 152 cases. Arq Neuro-Psiquiatr. 2008 Mar;66(1):11-4. https://doi.org/10.1590/s0004-282x2008000100004
  » https://doi.org/https://doi.org/10.1590/s0004-282x2008000100004
• ²³
  Olival GS, Lima LCP, Lima GPS, Tilbery CP. Clinical predictors of response to immunomodulators for multiple sclerosis. Arq Neuro-Psiquiatr. 2012 Jan;70(1):12-6. https://doi.org/10.1590/s0004-282x2012000100004
  » https://doi.org/https://doi.org/10.1590/s0004-282x2012000100004
• ²⁴
  Olival GS, Cavenaghi VB, Serafim V, Thomaz RB, Tilbery CP. Medication withdrawal may be an option for a select group of patients in relapsing-remitting multiple sclerosis. Arq Neuro-Psiquiatr. 2013 Aug;71(8):516-20. https://doi.org/10.1590/0004-282X20130081
  » https://doi.org/https://doi.org/10.1590/0004-282X20130081

Publication Dates

• Publication in this collection
  21 Aug 2020
• Date of issue
  Aug 2020

History

• Reviewed
  07 June 2020
• Received
  07 June 2020
• Accepted
  10 July 2020