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Dr Kiran Nistala

Kiran NistalaDr Kiran Nistala is an Arthritis Research UK clinical research fellow.

What does your work involve?

I've just started work on an Arthritis Research UK-funded PhD in Dr Lucy Wedderburn’s laboratory, based at the Institute of Child Health (ICH) in London. ICH is the largest research centre into childhood illnesses outside the US and is closely linked with Great Ormond Street Hospital. Our group is studying two main conditions: juvenile idiopathic arthritis (JIA), which is the most common form of childhood arthritis, and juvenile dermatomyositis, a condition which damages the muscles and skin of children and young people. The focus for my PhD is a newly discovered type of white blood cell called Th17, which may play a significant role in damaging the joints of children with JIA.

How long has Arthritis Research UK been funding you?

In 2006, I was lucky enough to be awarded a Barbara Ansell Fellowship, which gave me a great opportunity to try my hand at laboratory work for 12 months. Barbara Ansell, a rheumatologist working at Taplow and then at Northwick Park, was unique in recognising that children with arthritis differed from adult patients. She set up the first centre that specialised in treating children with arthritis, and through her work and support in training others she raised the profile of paediatric rheumatology in the UK. Her legacy is helping fund a series of Arthritis Research UK fellowships to encourage more researchers to find a cure for childhood arthritis.

What’s the most important thing you have found out in the past 12 months? Why?

I've shown that Th17 cells are found in high numbers in the joints of children with arthritis and particularly those with more severe arthritis. The presence of these cells in the joint might explain why some patients don’t respond to current treatments, such as anti-TNF drugs.

What do you hope or expect to achieve as a result of your Arthritis Research UK funding?

I hope to understand how the body naturally switches off these abnormal cells and hopefully see if this could be used to inform future treatments in arthritis. The Arthritis Research UK fellowship also gives me a chance to learn new scientific techniques, which I'll be able to use when designing new studies in the future.

What do you do in a typical day?

I see children with arthritis and lupus in clinic once a week, but most of my time is spent either planning and carrying out experiments or meeting to discuss my results with the rest of the researchers in our group. I’ve really enjoyed working with the team of scientists studying childhood arthritis at Great Ormond Street Hospital. They're great fun and very passionate about their work, and this does make our lab discussions pretty lively at times. Having a young family, I find that my time is much more flexible as a researcher than a doctor. I get to come home in time to put the kids to bed but then have to finish my work.

What's your greatest research achievement?

I’m hoping it’s still to come!

Why did you choose to do this work?

It was only after I started training as a paediatric rheumatologist that I realised that I wanted to study the immune system. I'd be asked by parents why their children got arthritis and when their arthritis would finally 'burn out'. Sadly we often don’t know the answer to these questions. But this made me want to know more about how the immune system goes wrong in arthritis. I wanted to know how the treatments we used really worked, and more importantly why they didn’t work in some patients.

Do you ever think about how your work can help people with arthritis?

Yes! One of the first things that I learnt when I started in the laboratory was how long things take in science. I still find this frustrating, and I’m sure many patients do too – but when I see how good new treatments can be, like anti-TNF drugs, I think it's worth the wait.

What would you do if you weren’t a clinician/scientist?

Tricky – either a professional restaurant critic or full-time cycle tourist, or perhaps both to burn off the calories.

About Kiran

I'm married and have two kids, aged three and five, who are wild! Apart from constantly ferrying my children to their friends’ birthday parties, in my spare time I enjoy cycling, cooking, music (Arcade Fire are my latest fad) and mastering barbecues.

This article first appeared in Arthritis Today Autumn 2007, issue 138.

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