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For more information, go to www.arthritisresearchuk.org

Dr Michelle Fernando

Michelle FernandoDr Michelle Fernando is an Arthritis Research UK clinical research fellow at Imperial College London.

What does your work involve?

My research involves finding genes that cause lupus. The cause of lupus isn't known, but we do know that genes play a significant role in predisposition to this disease. Therefore, studying the genetic material or DNA (which contains our genes) of people who have lupus is essential in discovering and understanding what causes the condition. By studying lupus DNA, I (along with other researchers in this field) also hope to identify genes that could be the target for future treatments in lupus and other autoimmune diseases.

I undertook my 3-year PhD in Professor Tim Vyse’s laboratory at the Hammersmith Hospital campus of Imperial College London. Professor Vyse has the largest collection of lupus DNA samples in the United Kingdom and collaborates with other lupus researchers in the UK, Europe, America and Canada.

I'm particularly interested in a group of genes on chromosome 6, many of which are involved in the regulation of the immune system. Studies have shown strong association with lupus and this region on chromosome 6, which is called the major histocompatibility complex (MHC). We know that this region contains the genes with the strongest effect on lupus susceptibility. However, the identity of the actual gene(s) within the MHC that cause lupus has remained elusive. With new advances in technology, I hope to make real headway in the hunt for these disease-causing genes.

How long has Arthritis Research UK been funding you?

Arthritis Research UK funded my PhD in the form of a clinical research fellowship from 2004 to 2007. I'm currently finishing my training as a rheumatologist at a busy district general hospital in London while trying to publish my research findings to date and finalising my PhD thesis. I was recently successful in obtaining a clinician scientist fellowship from Arthritis Research UK, which will begin in June in Professor Vyse’s lab. This funding will enable me to continue research in the field of lupus genetics.

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

The most important thing that we've discovered in the last 12 months is that there are at least two separate groups of genes within the MHC that are involved in lupus in UK families. This is the first time that this has been shown and is an important step in identifying what the actual genes are. One group of genes affects the way the body’s immune system may target its own tissues. We're currently studying how the second set of genes predisposes to lupus.

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

I hope to contribute to the understanding of the disease process that underlies predisposition to lupus and other autoimmune diseases. By doing so, I hope to identify markers/molecules that will be helpful in assessing the severity of disease in lupus sufferers and therefore be of help in guiding patients’ treatment more successfully than is presently available. I also hope to identify molecules involved in lupus that could act as targets for better drug treatment in the future.

What do you do in a typical day?

Every day is extremely variable, unpredictable and busy – which is just as well as I get bored easily. Any given day involves a combination of looking after patients with rheumatological and general medical problems in outpatient clinics as well as on the wards. I could also be on call in A+E (I won’t miss that when my 6 months is completed), teaching medical students and junior doctors, attending teaching sessions myself and finalising manuscripts and my thesis and participating in conference calls with collaborators in America and Canada as part of my ongoing research.

What's your greatest research achievement?

As my research career is in its infancy, my greatest research achievement is yet to come. In my PhD work, the most important finding was disentangling the complex genetics of the MHC and lupus and showing that at least two separate genes are involved in the development of lupus from the MHC region.

Why did you choose to do this work?

The fact that lupus can affect any organ in the body and that each patient will have a different constellation of problems caught my attention and interest when I was a medical student.

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

Looking after patients with lupus is challenging and rewarding, and, with recent advances in technology coupled with the pooling of patient samples through collaborations with scientists all over the world, I feel that we're now in a position to make great advances in identifying the different genes, molecules and pathways that contribute to lupus susceptibility. By doing so, this research should be able to help people with lupus and also people with other types of arthritis as we do know that some gene variants are common to different forms of arthritis.

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

I'd be a translator for the United Nations.

About Michelle

I’ll let you know in June when I have some spare time!

This article first appeared in Arthritis Today Winter 2008, issue 139.

For more information, go to www.arthritisresearchuk.org.
Arthritis Research UK fund research into the cause, treatment and cure of arthritis. You can support Arthritis Research UK by volunteering, donating or visiting our shops.