Collaboration is key

Clinical scientist Professor Iain McInnes is a global leader in the field of arthritis research. Recently appointed CBE for services to medicine he is a Clarivate Analytics Global Highly Cited Researcher for 2018, one of ten Glasgow researchers recognised as being in the top 1% for citations in their academic field.

Tell us a bit about your career this far.

My background is in clinical rheumatology. Along the way, I studied immunology, initially in Glasgow and then during my training in the US, working in the National Institutes of Health. I came back to Glasgow nearly 20 years ago, planning to stay for a “short time”, and I’m happier than ever working here.

What is the focus of your research, and what inspires you?

We are trying to understand why arthritis starts, and when it does start why it doesn’t naturally stop. So, we’re looking for the ‘on’ and ‘off’ buttons in the immune system. There have been two major revolutions in the last 20 years of arthritis management. One is the recognition that treating early is far better than treating late and once recognised that it should be treated aggressively towards a defined target. Second, we have come to recognise that understanding the pathogenesis of arthritis can deliver new and exciting therapies. In Glasgow, we have been part of both elements of this revolution.

This arises because of one remarkable strength in Glasgow namely, our ability to work together as clinicians and scientists - when we get it right, we can achieve global impact.

What drives you to do this research?

The first reason is that I’m a clinician who seeks to do better. I look after people who have chronic diseases that we can’t yet cure. I see the disruption of their quality of life - one of the saddest tasks of a rheumatologist is having to explain to patients when we first meet that we won’t be able to cure their disease. On the other hand, we have had such improvements in treatment in the past 20 years that at least we can offer people with inflammatory arthritis the best possible care to make a difference to their lives, to preserve function and quality as far as possible.

And I’m also intensely curious. I am driven to answer questions such as why does arthritis start and carry on, and how does it mediate its impact on people as it does.

How do you feel about being featured in the Highly Cited list?

A bit embarrassed really. Being highly cited means that you are doing work that others are paying attention to, so that’s very gratifying and great for the whole team. It’s good that the work we are doing is being recognised – it suggests that we are asking relevant questions, and that the answers we are developing are making a meaningful contribution to the body of knowledge that will, in the end, inform new therapies with precision medicine principles. But at the end of the day, this is the work of many in our team and it is they who deserve the recognition! Glasgow is a relatively easy place to capitalise on what we’re good at. We have a very strong collaborative culture in this University.

Tell us about the research that you have been highly cited for.

Over many years we have been studying the immune pathways that initiate and perpetuate inflammation inside the joints, and more recently the pathways that mediate so called co-morbidity, namely the increase in cardiovascular bone and psychological disease that goes with having arthritis. In all of these studies, we have sought partnerships with academia and industry that can be used to develop new medicines or markers of effective treatment – leading to precision medicine in due course.

What keeps you at Glasgow?

I work with amazing people. They are universally committed to what they are trying to do. They want to work with each other and be successful and enjoy each other’s success. I have the privilege of leading them.

Glasgow is a relatively easy place to capitalise on what we’re good at. We have a very strong collaborative culture in this University. We also have a well organised NHS, allowing us to do clinical research, and we work with busy but supportive NHS consultants. We have a team ethic with our NHS colleagues which is very important.

Also, Glasgow is fabulous place to live.

What’s next?

There are very exciting times ahead. Glasgow is working in collaboration with Newcastle University and Birmingham University in the Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence. It is a phenomenal collaboration; we are also hoping to welcome Oxford to the collaboration in the near future. The centre is growing to include psoriatic arthritis and our long-term plan is to have a UK national centre that will focus on inflammatory arthritis in general. I would argue that we are among the most powerful investigative groups in the world. We certainly have an important place globally.

In June 2019 I will become President of the European League Against Rheumatism (EULAR). My first commitment is to create the first European virtual rheumatology research centre. This will take several years but should optimise the way in which we do collaborative research across Europe.

The other area I’m ambitious to develop is investigating the presence and management of arthritis in sub-Saharan Africa. Working with Professor Paul Garside and Professor Andy Waters, we are building the “Blantyre-Blantyre” Centre in Malawi which will form a focus for our work in infectious diseases but increasingly on non-communicable diseases, especially arthritis. Currently there is no rheumatology in the country. In a parallel programme, we have funding to characterise and treat arthritis in Tanzania.

During my presidency of EULAR, I hope that we will create a North American and European taskforce to raise awareness of the management and treatment of arthritis right across sub-Saharan Africa. My vision is that the treatment we take for granted in Europe and North America will become available in sub-Saharan Africa, as medical educational levels and recognition of arthritis improve, and access to medicines becomes possible. It is unacceptable that 1 billion people are currently denied the treatment of the most common cause of disability in Europe.