Dr Paul Bowness
Paul Bowness is professor of experimental rheumatology at the Nuffield department of orthopaedics rheumatology and musculoskeletal Science in Oxford.
What does your work involve?
My group studies the immunology of ankylosing spondylitis (AS)
. We largely study white blood cells from patients with AS, in order to understand why these cells are misbehaving to cause arthritis. We also use human cell lines that we grow in culture in the laboratory, and proteins produced artificially again in our laboratory. These include synthetic versions of the natural HLA-B27 protein. HLA stands for human leucocyte antigen, which means it is a protein present on our white blood cells. We all inherit an A and a B gene from each of our parents. The HLA-B27 gene is very commonly found in people with AS (over 90%), and the gene makes the HLA-B27 protein which in turn is very important for the function of the immune system.
How long has Arthritis Research UK been funding you?
For approximately the last 15 years. The experiments are very time-consuming and one scientist can frequently work for several years to answer one or two questions.
What’s the most important thing you have found out in the past 12 months? And why?
In the last year we have found out a lot about the structure and function of another protein that plays a key role in our immune system and is important in determining whether individuals will or will not develop AS. This protein is called ERAP1 (Endoplasmic Reticulum Aminopeptidase 1) and is made by the ERAP1 gene. ERAP1 is the second most important gene involved in causing ankylosing spondylitis (AS). This will now allow us to try and work out how ERAP1 and HLA-B27 – the most important gene – function together in the immune system to cause AS. My belief is that the combination can have both good and bad effects. The good effect might well be extra protection against certain infections. Unfortunately the bad effect is that that some people with this gene combination develop AS.
What do you hope or expect to achieve as a result of your Arthritis Research UK funding?
Our ultimate aim is to develop new treatments for AS but we need a better understanding of the cause to be able to do this. We hope to speed up diagnosis and would also like to be able to ‘tailor’ treatments based upon genetic and immunological characteristics, so that we can offer the best treatments on an individual basis. Currently, the translation from research to usable treatment is estimated at 5-10 years, but technology advances so rapidly it may well be sooner than this.
What do you do in a typical day?
As a consultant rheumatologist I spend half my time doing NHS clinical work at the Nuffield Orthopaedic Centre in Oxford. I do both general rheumatology outpatient and specialist clinics. These include AS clinics with expert physiotherapists and combined clinics with surgical consultants to discuss and plan surgery for our rheumatology patients. I also look after inpatients and see emergency cases, and am involved in hospital safety and medicines management. On my research days I will typically spend half my time meeting with students and post-doctoral scientists, and the remainder writing and reviewing grants or papers or answering emails.
What is your greatest research achievement?
Discovering an abnormal form of HLA-B27 and showing that this can stimulate inflammation in ankylosing spondylitis. This has been very much a team effort with two research scientists, Rachel Allen and Simon Kollnberger, equally involved.
Why did you choose to do this work?
Trying to understand what causes arthritis is an intriguing mystery that I am confronted with every day in my clinical practice. Perhaps more importantly there will hopefully be huge benefits for many arthritis sufferers as progress is made over the next decade.
Do you ever think about how your work can help people with arthritis?
Every day, especially as I spend half my time looking after patients with arthritis.
What would you do if you weren’t a clinician/researcher?
A musician and/or a teacher.
I play bass in a band made up of doctors and scientists. We have played for the medical students, at a paediatric rheumatology conference and even on Desert Island Discs! I enjoy hill walking and running and have done the Three Peaks Challenge and the Great North Run raising money for Arthritis Research UK. I often try to go running with my teenage children but as they have got faster and more enthusiastic I have got slower so now I can’t keep up with them!