- Fritz Köberle
Fritz Köberle (October 1, 1910 – February 20, 1983) was an Austrian-Brazilian
physician ,pathologist andscientist , discoverer of the neurogenic mechanism of the chronic phase ofChagas disease , ahuman parasitic disease caused by "Trypanosoma cruzi ", aprotozoan .Life
Fritz Köberle was born in
Eichgraben ,Austria , and studiedmedicine at theUniversity of Vienna , Austria, graduating "magna cum laude " in 1934. He began to work in the Institute of Pathology while a student and soon after graduation, in 1935, he was admitted as an assistant professor. With the annexation of Austria toGermany ("Anschluss ") byAdolf Hitler , Köberle was drafted into the Army as a medical lieutenant and worked as a pathologist in the Central Army Hospital of Vienna. With the outbreak of theSecond World War hostilities, Köberle was attached as field pathologist to the XII Army Group of theWehrmacht in 1940 and served in the fronts ofFrance ,Belgium ,Poland andRussia . He was able to acquire during this period an enormous experience on the pathology ofinfectious diseases (bacterialdysentery ,typhus ,typhoid fever ,tularemia andmalaria ) as well as war-inflictedwounds , and performing more than four thousand autopsies. After the war, Köberle returned to theUniversity of Münster as "Privatdozent ", continuing his activities as professor and researcher of medical pathology until 1945. He returned shortly to the University of Vienna, and, in 1946, accepted a post as director of the Serological and Pathological Institute of the General Hospital of St. Pölten, Lower Austria.In 1952, he received an invitation which would radically change his personal and scientific life. A new
medical school was being established by theUniversity of São Paulo in the little-known city ofRibeirão Preto , in the hinterland of the state of São Paulo,Brazil . The main objective of the state government was to increase the number of physicians in the rapidly developing hinterland, and its first dean, Dr.Zeferino Vaz , a parasitologist, medical research and professor of the University, wished to create a favorable environment for high qualitymedical research and teaching in the new school. With this in mind, Vaz invited a number of foreign researchers to become chairmen of the basic and clinical departments, and Fritz Köberle had a good recommendation by Prof.Henrique da Rocha Lima , a Brazilian medical researcher who had studied in Germany. Dr. Köberle accepted an invitation and moved with his family to the Medical School of Ribeirão Preto in 1953. He soon organized the Department of Pathology, became its chairman, and began to assemble a small group of Brazilian researchers.Works
While in Ribeirão Preto, Prof. Köberle noted that a promising field of research in pathology for the new department and himself could be
Chagas disease , or American trypanosomiasis, which had been discovered by another Brazilian physician namedCarlos Chagas , in 1910 (coincidentally, the year he was born). Even though 40 years had passed since its discovery, little was known about the peculiar manifestations of the chronic phase of the disease, such asmegaesophagus ,megacolon ,cardiomegaly , heartventricular aneurysm ,achalasia , etc., and the mechanism of the causation of these several pathologies. By making good use of the extensive caseload of fatalities due to Chagas disease in the region of Ribeirão Preto and SouthernMinas Gerais , where it was endemic and widely prevalent at the time, Köberle studied initially the dilation pathologies of thedigestive tract and proved, by extensively quantifying the number ofneurons of theautonomic nervous system in theAuerbach's plexus , that: 1) they were strongly reduced all over the digestive tract; 2) that megacolon and megaesophagus appeared only when there was a reduction of over 80% and 55% of the number of neurons, respectively; 3) these pathologies appeared as a result of the disruption of the neurally integrated control ofperistalsis (muscular annular contraction) in those parts where a strong force is necessary to impel the luminal bolus of food orfeces ; and 4) Europeanidiopathic megaesophagus and Chagas megaesophagus appeared to have the sameetiology , namely thedegeneration of the Auerbach's myoenteric plexus.Studying the typical features of the Chagasic
myocardium pathology, characterized by damage to its electrical conduction pathways, heartarrythmia ,aneurysm of the ventricular apex,cardiomegalia and sudden death byventricular fibrillation , Köberle and his group of collaborators were able to prove that they were caused also by an extensivedenervation of theparasympathetic (55% andsympathetic (35%) intrinsic cardiac nervous networks, leading to a control imbalance of contraction,cardiac failure , cardiomegalia and hypoxia. He named this constellation of effects as "cardiopathia parasympathicopriva". Other less typical phenomena observed in Chagas disease, such asbronchiectasis andmyelopathy were also studied by Köberle under the new prism of hisneurogenic theory.Thus, with his classical and detailed scientific studies, Köberle proposed for the first time a unified and radically different (and polemical) view of the etiopathogeny of Chagas disease, characterizing it as a disease of the autonomic nervous system, which establishes itself during the acute phase and provokes long term and slowly installing denervation. Since the trypanosoma does not seem to damage neurons directly, Köberle and other researchers have hypothesized the action of a
neurotoxin ,cytotoxic factors orautoimmune mechanisms. Dr. Köberle retired from the University of São Paulo in 1976, but soon moved as visiting professor to the Medical School, of theState University of Campinas , inCampinas , São Paulo, where one of his sons,Gottfried Köberle , is a professor ofOrthopedics . He worked there until his death, in 1983, inAmericana . Another son,Roland Köberle , is a professor inPhysics at the University of São Paulo atSão Carlos .Miscellaneous
The square in front of the main entrance to the USP campus at Ribeirão Preto is named in his honor.
Bibliography
* Koeberle, F. Cardiopathia parasympathicopriva. "Munch. Med. Wochenschr.". 1959 Jul 31;101:1308-10.
* Koeberle, F. Enteromegaly and cardiomegaly in Chagas disease. "Gut". 1963 Dec;41:399-405.External links
* Rezende, J.M.: [http://usuarios.cultura.com.br/jmrezende/Koeberle.htm Fritz Köberle and his studies on Chagas Disease] (in Portuguese)
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