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Professor Gabriel Panayi

Gabriel PanayiGabriel Panayi is professor emeritus of rheumatology, King’s College London, and honorary consultant rheumatologist at Guy’s and St Thomas’ Hospital.

What does your work involve?

I teach, see patients with rheumatic disease (especially those with inflammatory arthritis) and carry out research. Unfortunately, and sadly, my research is no longer ‘wet’ – I don’t work at the laboratory bench.

How long has Arthritis Research UK been funding you?

Arthritis Research UK has been funding me for a very long time, starting with a fellowship in Edinburgh. In 1980 I was elected to the Arthritis Research Campaign chair of rheumatology at Guy’s Hospital medical school, which is now incorporated into the medical school of King’s College London. In the ensuing years the charity has funded my research work with a variety of competitive grants. The latest grant is to perform a clinical trial of a human protein called BiP in patients with rheumatoid arthritis.

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

What: we can use a protein purification method to purify BiP that was previously not approved of by the regulatory authorities.

Why: we can produce enough pure BiP for a clinical trial.

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

With my colleague, Dr Valerie Corrigall, we've found that BiP turns on regulatory cells. These cells suppress ongoing inflammation. We've shown this in two ways. First, BiP will suppress ongoing arthritis in an experimental model. The outstanding feature of this suppression is that a single small injection of BiP has an effect that lasts for at least 40 days. This is most unusual. Present-day biological therapies used for the treatment of rheumatoid arthritis don't have such an effect as they require multiple dosing.

Second, human regulatory cells can also be switched on by BiP. As an indirect test of the therapeutic potential of BiP for the treatment of rheumatoid arthritis, we've shown that BiP will suppress inflammation in pieces of joint tissues from patients. These results are the basis of our belief that BiP will be a novel biological therapy for the treatment of rheumatoid arthritis.

We hope to commence a trial by the end of this year. This is somewhat later than we had planned but we had first to develop a robust method of preparing sufficient quantities of pure BiP. We believe that we have now achieved this.

What do you do in a typical day?

This is a tough one as no single day is exactly the same as another. It's best summarised as ‘academic work’: teaching, reading, writing, discussing research work or seeing patients.

What's your greatest research achievement?

It's impossible to say. Over the years I've been fortunate to work with a whole series of intelligent and dedicated researchers, both clinical and non-clinical. Together we've made discoveries in several fields, including the genetics of rheumatoid arthritis, the genetics of drug toxicity, mechanisms of inflammation in rheumatoid arthritis, better application of existing therapies and probably the first randomised placebo controlled trial of a biological therpy in rheumatoid arthritis – an anti-CD7 monoclonal antibody. Unfortunately it didn't work! That trial was motivated by the idea that immunotherapy would be the way forward for the treatment of rheumatoid arthritis in the future. Hence for several years I organised a symposium in Cyprus on this topic which attracted most of the leaders of the subsequent biologic revolution.

Why did you choose to do this work?

I have always wanted to be a doctor and a researcher. When I was a
medical student I saw a patient with Crohn’s disease and arthritis. When I asked Professor Sir Stanley Peart, the Professor of Medicine at St Mary’s Hospital medical school, London, what the mechanism for this was, he told me to go and find out. This led to my first review paper and a life-long interest in arthritis! All these influences inevitably led to my chosen career path.

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

All the time. I have always been interested in the ‘translational’ aspects of my work even when this was not fashionable.

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

I don’t know. Probably an historian.

About Gabriel

I enjoy walking, photography, Roman and Byzantine history, and reading.

This article first appeared in Arthritis Today Spring 2010, issue 148.

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