Spotlight on science
Reproduced from Issue 127 of Arthritis Today
Dr Sam Webster and Dr Maresa Carulli explain their work in an ongoing series of questions and answers with arc-funded researchers
Dr Sam Webster
About Sam
I was an avid rock climber until my son was born. Now my spare time is family time. I still climb rocks and mountains occasionally, and will do more in the future. I'm a member of the Cardiff Triathletes whose website I maintain, amongst others.
What does your work involve?
I'm a lecturer at the University of Wales Swansea, teaching anatomy and embryology to students of a new post-graduate medicine degree, and researching the possible uses of a cartilage stem cell in cartilage repair. I have been implanting these cells into cartilage wounds in a lab environment, and comparing their responses with those of “normal” chondrocytes. I'm interested in whether they're as good as (or better than) the cells used routinely in autologous chondrocyte implantation (ACI). One advantage of these stem cells is that you would need very few to repair damaged cartilage. It is likely that they are the same cells that originally made the articular cartilage and are lost when the cartilage is damaged.
How long has arc been funding you?
This study began in April 2003.
What's the most important thing you have found out in the past 12 months? And why?
It seems that under the right conditions the cartilage stem (or progenitor) cells will fill a wound very rapidly – far more rapidly than other cartilage cells. The cartilage they produce is similar to the cartilage produced following ACI.
What do you hope or expect to achieve as a result of your arc funding?
During this project we have already found out more about this new cell type, and are looking forward to possible future clinical applications. By the end of the project we would hope to have begun to learn how to get the best from these stem cells within the wound environment.
What do you do in a typical day?
A large part of my day is spent preparing for teaching for the next few weeks or months. The medicine course in Swansea is in its first year, so we have a lot of work to do. I moved from Cardiff University to Swansea earlier this year, and we are still in the process of setting up new laboratories. At the moment I'm working with an engineering PhD student with which we are collaborating on a new project. I often meet other researchers with diverse interests with which we hope to find common ground for future cartilage research. The Swansea Clinical School is an excellent environment for this, as it has brought together people from many science and medical backgrounds to teach, and we have strong ties with the NHS Trust hospitals.
What is your greatest research achievement?
This year I presented my work at the International Cartilage Repair Society meeting in Belgium, and was a runner-up for a research excellence award, which was a big surprise.
Why did you choose to do this work?
My degree introduced me to research and science as a job, and I've never looked back. I worked with cartilage during my PhD, and since then I've seen articular cartilage repair as an area in which science has yet to produce definitive solutions for the range of joint diseases prevalent in the world.
Do you ever think about how your work can help people with arthritis?
Often. I know many people with joint diseases: my father now has a prosthetic hip (which has helped his golf no end), for example. I've seen the pain and the problems in mobility that result from these diseases, and I'm aware of how common they are. I see real problems for younger patients for whom joint replacement is not a solution, and particularly in athletes in the triathlon and cycling clubs that I am a member of. They have been through multiple surgical operations with variable success.
What would you do if you weren't a scientist?
I'd probably have a go at being a full-time mountaineer.
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Dr Sam Webster is a lecturer in anatomy at the Swansea Clinical School at the University of Wales in Swansea.
Dr Maresa Carulli
About Maresa
I am an Italian in love with London. I have lived here for 10 years, but I still enjoy making the most of what the city has to offer from restaurants to theatres although my favourite places now are those which are most children friendly so I can go with my two year old son James!!! At weekends, if I am not playing with him I will be busy buying antique (or just old) furniture for the house that my husband Andrew and I have finally finished renovating, or cooking a meal for a large group of friends or family.
What does your work involve?
My research is based at the Royal Free Hospital within the Centre for Rheumatology. Here clinical activity and research have focused for the last fifteen years on improving the treatment of patients with scleroderma and understanding the mechanisms that initiate and perpetuate the disease, making this an unique place where to study this uncommon rheumatic disease. In particular my research project aims to understand the role of a protein called MCP-1 in the development of Scleroderma.
How long has arc been funding you?
I was granted an arc Clinical Research Fellowship which started in February 2003 and will finish in March 2005.
What's the most important thing you have found out in the past 12 months? And why?
MCP-1 protein is expressed in high levels in skin and blood of patients with diffuse scleroderma very early on the disease and those with higher levels have a tendency to develop serious internal organ involvement and have more aggressive disease in general. This is an important preliminary observation as it suggests that MCP-1 is involved in the development of the disease and also that it may be an useful marker to tell us which patients need aggressive treatment very early on.
What do you hope or expect to achieve as a result of your arc funding?
I hope that my own work will help us gain some understanding of the complex processes involved in scleroderma and that in particular it will answer whether blocking this protein or its receptor could be useful in treating the disease.
What do you do in a typical day?
On a typical day I spend most of my time in the laboratory carrying out different types of experiments. Writing research articles is also an important activity that takes up a lot of the time. One day a week I join in the scleroderma clinic and see patients with scleroderma associated pulmonary hypertension and scleroderma in general, seeing the problems that scleroderma patients experience brings home to me the difficulty of managing this disease . Teaching the medical students on the basics of rheumatology is also a regular challenge!
What is your greatest research achievement?
Our research focuses on fibroblasts – the cells which are responsible for making too much collagen in scleroderma and causing fibrosis (thickening of the connective tissue in the body). So far my work has shown for the first time that scleroderma fibroblasts express a receptor specific for MCP-1, called CCR2. This receptor is a special protein positioned on the surface of the cells, which is activated by MCP-1, and following its activation transmits signals into the cell. This observation suggests that MCP-1 may be involved in the development of fibrosis via its receptor CCR2, and that there may be an advantage in blocking it.
Why did you choose to do this work?
To study a complex disease for which there is still no satisfactory therapy is very stimulating and exciting. It is challenging also to face and try to solve the burden of problems that scleroderma patients carry. I consider myself very fortunate because I can combine my research work with the clinical activity.
Do you ever think about how your work can help people with arthritis?
As a clinician I value research that ultimately results in an improvement in the care of patients. I would like to think that my research project will lead to further studies to assess if blocking MCP-1 can be used as treatment of scleroderma and perhaps also the many commoner rheumatic diseases in which fibrosis occurs.
What would you do if you weren't a scientist?
I'd love the idea of being and architect and build stunning innovative buildings, perhaps even beautiful hospitals!
- Dr Maresa Carulli is a specialist registrar and an arc clinical research fellow at the Royal Free and University College Medical School, London.
