Dr Frances Hall
Dr Frances Hall is an Arthritis Research UK rheumatology lecturer at the University of Cambridge and an honorary consultant rheumatologist at Addenbrooke’s Hospital in Cambridge.
What does your work involve?
I divide my time between clinical work, research and teaching. My clinical work focuses on connective tissue diseases. My research activity includes a study of T-cell function in patients with lupus (with Dr Christine Bryson) and an interest in the interaction of inflammatory and cardiovascular disease. Today’s clinical students are, of course, the next generation of clinicians and scientists, and I teach the undergraduates at Sidney Sussex College, Cambridge, and groups of clinical students. Recently we've developed a new clinical course with increased exposure to rheumatology; we hope this will translate into greater rheumatological awareness and expertise.
How long has Arthritis Research UK been funding you?
Arthritis Research UK has funded me since 1997.
What’s the most important thing you've found out in the past 12 months? Why?
The cholesterol-lowering drugs, statins, are anti-inflammatory, an effect which has been attributed to effects of statins on pathways within immune cells. In collaboration with Ms Kaisa Maki-Petaja and Dr Ian Wilkinson in clinical pharmacology and Susan Fairchild and Michael Schenk in my group, we've observed that cholesterol-reduction in rheumatoid arthritis patients, either by statins or ezetimibe (a drug which reduces cholesterol absorption from the gut) has similar anti-inflammatory effects. These observations suggest that the concentration of cholesterol in the serum may itself contribute to the severity of disease in rheumatoid arthritis.
What do you hope or expect to achieve as a result of your Arthritis Research UK funding?
I hope to continue to build research capacity to focus on current interests in T-cell biology and vascular disease in connective tissue diseases.
What do you do in a typical day?
An account of a couple of days will give a flavour of the week. Thursday starts at 8 am, answering emails, followed by the laboratory meeting together with Professor Hill Gaston’s group in which research activities and problems are discussed. At 10:30 am, I teach a group of clinical students. The afternoon is divided between writing, administration and meetings. During term, Thursday evenings are spent teaching immunology to the undergraduates at Sidney Sussex College.
Friday has a very different tempo. The connective tissue disease clinic officially starts at 9 am but usually opens earlier to accommodate urgent appointments. If all goes to plan, the clinic finishes by 2 pm and the afternoon is spent dictating and signing clinic letters and, often, negotiating for permission/funding to use biological therapies (e.g. rituximab). I sometimes have the chance to do some bench work myself during the evening.
What's your greatest research achievement?
Using an inflammatory model in the laboratory, Nicola Dalbeth (now a consultant rheumatologist in New Zealand) and I were excited to find that certain drugs which are used to treat hypertension also had potent beneficial effects on arthritis. We're currently conducting a clinical trial in patients with rheumatoid arthritis.
Why did you choose to do this work?
I've always been interested in form and function in biology, but I also enjoy working with and for people. Clinics simultaneously provoke scientific questions and emphasise the importance that doctors engage both with the medical and the psychosocial needs of their patients.
Do you ever think about how your work can help people with arthritis?
Yes, frequently! The work, described above, by Nicola Dalbeth and myself using the anti-hypertensive drugs provides a topical example. We're currently assessing the relevance of this work in a clinical trial called TRALIS. Nicola and I also appreciated the importance of reducing cardiovascular risk in patients with connective tissue diseases and, last year, published a guideline for use in rheumatology clinics. Furthermore, a senior research fellow and I are investigating a technique which will enable blood vessel disease (including Raynaud’s phenomenon and atherosclerosis) to be monitored by blood test.
Read more about the TRALIS trial.
What would you do if you weren’t a clinician/scientist?
I'd have been a zoologist and probably an entymologist, so I might have been studying exotic butterflies or dragonflies!
I live with my husband Rob, an engineer turned author and amateur brewer. We both enjoy hillwalking (although clearly not in Cambridgeshire) and gardening. Reflecting my interest in natural history, the garden is stocked with a range of native plants, which attract an impressive cast of invertebrates and birds. There are few pleasures in life better than finishing a warm summer evening with a glass of wine (or beer!), listening to crickets and watching the changing of the guard as the swifts and swallows give way to the bats.
This article first appeared in Arthritis Today Winter 2007, issue 135.