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When science reporters look for researchers to profile, we put a premium on the importance of their work, of course, but an ability to spin telling anecdotes (extra points if beer is involved), and friends who can offer up pithy commentary, also count. As I was deciding whether to write about neurologist Robert Moir’s long years of researching Alzheimer’s disease — and repeatedly getting slapped down for his nonconformist approach — however, something else weighed in the balance: Moir was willing to share documents that shine a light on how the science establishment works. It wasn’t a flattering light.

That dedication to scientific truth above careerism — his openness didn’t endear him to the powers that be — defined his professional life. When he died in the early hours of Friday of glioblastoma at only 58, Moir, an assistant professor of neurology at Massachusetts General Hospital and Harvard Medical School, left a legacy of brilliant science: His idea that Alzheimer’s has something to do with microbes in the brain, that amyloid plaques form in defensive response to those pathogens, and that something besides eliminating amyloid is probably our best shot at preventing or treating Alzheimer’s.

Scientists before him had the same hunch, but Moir amassed arguably the strongest evidence for it. That all became part of my 2018 story. But so did his saga of struggling for National Institutes of Health funding and clashing with journal editors scared to publish anything outside the mainstream.

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Moir shared with STAT the score sheets for his NIH grant requests and the rejections from journals. One NIH reviewer panned him for wanting to study something (a microbial origin for Alzheimer’s) that hadn’t been proved; it wasn’t a good look for a process that’s supposed to be all about discovering new knowledge. Another sneered that Moir was a mere assistant professor, as if rank trumped merit in deciding what research to fund. A top journal almost published a key paper of his, but backed down when its Alzheimer’s experts (read: defenders of Alzheimer’s orthodoxy) panned it.

When that research was finally published in 2016, showing that amyloid is part of an immune response to brain microbes, it was voted one of the top five discoveries in neurology that year.

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“It shouldn’t have been so difficult for him to get the support and recognition that he deserves,” Moir’s wife, Julie Alperen, told me soon before his death.

Maybe it was his humble background that gave Moir the courage to follow the science and not the crowd, damn the career consequences. He grew up on a farm in the middle of nowhere in western Australia and didn’t learn to read or write until he was 12. Compared to where he might have wound up, being punished for questioning Alzheimer’s orthodoxy was nothing.

“Rob was always a dogged researcher, meaning like a dog with its bone,” Colin Masters, the distinguished Alzheimer’s researcher at the University of Melbourne who trained Moir, told me for the 2018 story. “He never gives up and has never been one to follow the standard line.” His mentor, Mass. General’s Rudolph Tanzi, called him “the most out-of-the-box thinker I’ve ever met — in any field. He doesn’t even see the box.”

When I asked Moir where he got his anti-establishment streak, he mentioned taking a microbiology course from future Nobel laureate Barry Marshall, who bucked orthodoxy for years by arguing that a bacterial infection (H. pylori) causes ulcers. “Everyone thought he was crazy,” Moir recalled last year. “He was crazy, but he was also right.”

Although Moir was known for the microbial hypothesis of Alzheimer’s, he was sort of a Forrest Gump of Alzheimer’s, at the center of some of the field’s key moments. A 2005 study he led identified natural antibodies against the Alzheimer’s-defining protein fragment beta-amyloid; a similar lab-made antibody, aducanumab, might become the first successful anti-amyloid Alzheimer’s drug. And while the consensus of Alzheimer’s researchers is that a protein called apoE acts by clearing amyloid or failing to do so, Moir believed apoE seeds amyloid.

“He was the first person to suggest that,” Tanzi said. “I guarantee you, that idea will be rediscovered” and inspire Alzheimer’s treatments.

Harvard took the boy out of Australia, but it couldn’t keep Australia out of the Mass. General lab. Moir regularly had colleagues in hysterics over his off-color jokes (many involving sheep) and tales of growing up in his country’s desolate west (such as when he saved a pet duck from becoming dinner). One day, to illustrate what he meant by apoE seeding amyloid, he pulled out his ratty old leather wallet and its patina of salt crystals. To explain how it mimics amyloidosis, he began by telling his colleagues, “Dude, the sweat from my butt is hitting the leather, and then …”

Just as STAT’s profile of Moir was about to run, he called to say he’d heard from NIH. The agency had found some extra money in its budget. Would he please respond to the last round of reviewers, who had rejected his grant proposal, and resubmit it? He did. He received $3.2 million in 2019 to support research in mice and in human neurons growing on lab plates (“Alzheimer’s in a dish”) examining whether herpes or other viruses in the brain can exacerbate the buildup of both amyloid and tau, a neuron-killing protein fragment that’s also found in Alzheimer’s brains.

His lab has continued to function during his illness and the research will be completed by his students, overseen by Tanzi.

  • Thank you for focusing on what Dr Moir went through to be taken seriously. A similar dismissive attitude exists towards those who research and study a low carb diet approach to diabetes rather than focus their research on developing lucrative medications. Documentation exists but their research is panned. See Dr.Ted Naiman,Dr. Richard Bernstein, Dr. Sarah Halberg.

  • Orthodoxy can be the enemy of progress. Whether his theories are validated or not, if the fundamentals are valid, they deserve exploration. There are no negative data, since no matter the results, future research will have been further informed. Godspeed.

  • Dear Rob, never fear, you’ve lit the spark they can’t put out! Thanks for being the funny and straight man at Judith Miklossky’s Crans Montana meeting. I’ll miss you and keep on working til we win. XO Sue

  • Brilliant,kind and funny man. His contributions to science were immense. I hope his vision and insight as to the cause, cure and prevention of this hideous disease continues. The world suffered a great loss.

  • But will the NIH learn anything from this? Or will they continue down the well trodden path that leads to contented researchers, happy universities, but no overarching insights that may change a field.

  • Thank you for this wonderful piece and story of intellectual courage, creativity and tenacity. Happy to hear his lab and work will carry on.

  • Our community has lost a gifted, kind and brilliant man. He had the courage to pursue science the way it should be pursued- without respect for fashion or conformity. I knew him since we were PhD students together. Over the last 30 years, his have been some of the most important ideas in Alzheimer’s research. His approach to discovery in this beleaguered field should be an inspiration to those who follow. Vale Boston Bunyip

  • I concur with mr. Moir in regard to amyloid and alzheimer disease. My sister in law passed away at 63 of amyloidosis and my wife has been diagnosed at 63 with Alzheimers.
    We were told there was no connection but it seems very odd. I think he was on to something regarding the amyloid buildup and addressing that as drug research evolves in the disease.

  • We will miss Rob’s brilliance, humor, creativity and drive. We won’t forget you or your contributions to science.

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