Portrait in Research: Philip L. Cohen, MD

Philip Cohen, MD, is well known in the rheumatology research community for his extensive work in the study of lupus. He is also well known as a teacher and mentor, and in 2002, the Arthritis Foundation honored him as one of its Research Heroes.

Today he is a Professor of Medicine at the University of Pennsylvania School of Medicine and a staff physician at the Philadelphia Veterans Affairs Medical Center. He also co-directs the Rheumatology Training Program at the University of Pennsylvania School of Medicine.

In addition to an already busy schedule, Dr. Cohen has taken on the role of chair of the Arthritis Foundation’s Medical & Scientific (M&S) Council. We talked to Dr. Cohen about his experience as an Arthritis Foundation researcher, what it has meant to him and what his thoughts for the future are.

What role did Arthritis Foundation funding play in your research career?
I owe a tremendous debt to the Arthritis Foundation. At the very onset of my training in rheumatology, I was fortunate enough to be awarded an AF Postdoctoral Fellowship to work with  the late Morris Ziff , PhD, MD, at the University of Texas Southwestern Medical School.  Dr. Ziff was a pioneer in American rheumatology and mentor to many rheumatology investigators around the world.  He was himself the very first Postdoctoral Fellow of the Arthritis Foundation in 1951, so I was a kind of legacy.  The AF provided support and the freedom to pursue projects I thought were worthwhile and important.  I am deeply grateful for the confidence they placed in me.

How has Arthritis Foundation funding impacted the success of your lab?
In 1981,  I received a Senior Investigator Award.  This five-year grant (now superseded by Arthritis Investigator awards) protected my time as a young Assistant Professor and allowed me to explore different areas of science, some of them risky at the time. The Foundation was also kind enough to let me use part of the last year's funding to pay for a sabbatical that served to acquaint me with molecular biological approaches at the National Institutes of Health. And, most importantly, the Foundation has supported a number of talented and productive trainees to work in my laboratory.  These people have themselves gone on to make important contributors to arthritis research.

What has been the main focus of your research (in lay terms)?
We have characterized the immune cells that make autoantibodies: where they are located and how they interact with each other. We also found that abnormalities in cell death and in the disposal of dead cells were important in triggering and perpetuating autoantibodies in lupus.

What key discoveries have come out of your research?
Our laboratory defined the cellular immunology of autoantibody production in animal models of lupus. We showed that T cells are required for autoantibodies to be produced, and that the interactions between T and B cells depend on the major histocompatibility complex and on cytokines, and that this process requires autoantigens. These findings, together with data from other laboratories, established that the ground rules for self-reacitve immune responses are similar to those that govern responses to conventional antigens, such as microbial pathogens, helping to clear the way for therapies targeted to these mechanisms.

How has your research impacted/will impact the lives of people with arthritis now and five years from now?
Our work on the importance of T cells and their interactions with B cells in autoantibody formation has contributed to the development of therapies directed against T cell-B cell activation, such as the recently approved abatecept (Orencia. In the near future, other biological agents that modulate T cells or their cytokine products will reach patients, such as antibodies to certain lymphokines.

Why did you choose rheumatology as a specialty?
Clinical rheumatology appealed to me because it demands broad knowledge and clinical insight. Moreover, caring for rheumatic disease patients is immensely rewarding --  the physician develops warm  and enduring relationships with many remarkable people and their families .  To help them and mitigate their suffering is a privilege. Finally, as an investigator, rheumatology attracted me because of my research interest in immunology. Many of the rheumatic diseases seemed to be problems in disordered immunity, which could be approached by an immunologist.

What is your life like outside the lab? What do you also do?
I have a regular outpatient clinic at the Philadelphia VA Medical Center and precept fellows and residents both at the VA and at the Hospital of the University of Pennsylvania (HUP). I serve as Attending Physician on the Rheumatology Consulting Service at both hospitals, and on the General Medicine Service at the VA Hospital. This year, I taught a seminar course to 16 University of Pennsylvania freshmen on the biology of allergy and autoimmune diseases. I also participate in teaching of medical and graduate students at Penn.

What do you like to do in your free time?
My wife Anne and I are music lovers and enthusiastic amateurs. (Anne plays the violin, I play the piano.) We enjoy the rich musical scene in Philadelphia Anne is a much admired English Professor at Penn whose students enjoy lofty intellectual evenings (and food!) at our house in Center City.

We have four children. Two are in medicine: Lisa is a medical intern at HUP, and her twin brother Andrew is a first year medical student at Penn. Caedmon (amateur singer) is a Stanford classics PhD student, and Heron (talented artist) is a freshman at Columbia.

As the Chair of the M&S Council, what is your view of the direction the AF is taking in research? What are your goals for the M&S Council?

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