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Dr Philippa Hulley

Phillipa HulleyPhilippa Hulley is an RCUK fellow in the Nuffield department of orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford

What does your work involve?

I’m a cell biologist attempting to understand cell damage and repair signalling in bone, cartilage and tendon cells. These cells build and repair tissues damaged by diseases such as osteoporosis and osteoarthritis. Projects in the lab approach these processes from different angles, from analysis of biomarkers in selected patient tissue specimens to detailed molecular studies on cultured human cells. We increasingly work in 3-dimensional culture systems since these are more lifelike, but they're also more technically challenging.

How long has Arthritis Research UK been funding you?

I’ve just completed a 5-year Arthritis Research UK non-clinical career development fellowship, which enabled me to make a permanent move from Cape Town and set up a new research group in Oxford. Arthritis Research UK also helpfully allowed me to combine it with a subsequently awarded Research Councils UK (RCUK) fellowship, which has generated a tenure track post linked to St Hilda’s College.

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

Anti-inflammatory glucocorticoid injections are given to many people with painful joints. Although they seem to help with the pain, these drugs also prevent the natural healing response of the tissues and weaken them. My group has found a very intriguing link between glucocorticoid drugs and free radical damage or oxidative stress in tendon. A class of stress-responsive DNA binding proteins called FOXOs are involved. We've found that both antioxidants (like vitamin C) and growth factors can regulate FOXOs and strongly protect tendon cells from steroid damage. With Keith Willett (professor of orthopaedic trauma surgery at the John Radcliffe Hospital), we're currently running a pilot clinical trial with platelet-rich concentrate to see if this source of growth factors is able to protect stressed tendon cells in ruptured Achilles tendons. This will help us to design a follow-on combination trial in steroid-treated joints. Andy Carr (Nuffield professor of orthopaedic surgery, Oxford) plans to start a rotator cuff co-injection trial with steroid and anti-oxidants once we've secured funding. Our aim is to retain the anti-inflammatory benefit of the steroid but protect the injected tendon from its negative side-effects. Longer term, we're seeking to develop an alternative to glucocorticoid injections in joints.

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

These fellowships are an excellent scheme because they allow one to develop a broad platform of interrelated research rather than being restricted to a single project. Over the last 5 years I’ve been able to establish key collaborations with engineers, clinicians and other basic scientists and explored the interdisciplinary interface with them. Scientifically, it's been an immensely enriching experience that will definitely lead to more effective and better targeted laboratory studies.

What do you do in a typical day?

A nicely varied mixture of laboratory supervision, undergraduate teaching, research admin, writing and still a little time for playing at the bench and developing new technical approaches.

What's your greatest research achievement?

I don’t have one yet! There are so many desperate, unmet clinical needs in our field and basic science progress feels very slow at times. We're making headway though, and I think it’s important to take a creative and curious approach as well as never giving up.

Why did you choose to do this work?

It chooses you, really. Perhaps a combination of wanting to solve problems but doing so by harnessing my particular interests and skills?

I also find training my young researchers both interesting and satisfying (I'm not sure they’d use the same words to describe the experience, though!)

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

I eat lunch most days in the Nuffield Orthopaedic Centre, surrounded by the full spectrum of specialist orthopaedic patients. It’s a regular wake-up call.

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

Probably run a specialist plant nursery growing tricky to propagate plants...tissue culture, smoke primers, how to mimic digestion by an elephant...

About Philippa

I grew up on a farm in the Eastern Highlands of Zimbabwe and spent many years in beautiful Cape Town, so I love spending time outside in mountains, forests and sea. The delightful British obsession with gardening and allotments is something I fully relate to.

This article first appeared in Arthritis Today Autumn 2010, issue 150.

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