Dr Gloria Lliso-Ribera, Rheumatology Clinical Research Fellow
22 November 2018
My name is Dr Gloria Lliso-Ribera and I work as an Arthritis Research UK (Versus Arthritis) Clinical Fellow in the Centre for Experimental Medicine and Rheumatology. I am originally from Spain where I completed my medical training in Internal Medicine, but I moved to the UK in 2014 to pursue a special interest in rheumatology where I began a clinical research project and PhD here at the William Harvey in 2016.
My research interests are translational and focused on the identification of novel biomarkers of outcome and therapeutic response in patients with rheumatoid arthritis. I am looking at joint tissue (synovium) taken at disease onset and before therapy and analysing the immune cell infiltration and molecular characteristics of the synovial inflamed tissue (synovitis). The synovial tissue is obtained using a minimally invasive technique which utilises ultrasound images to guide sampling and is a technique that I have been trained in during my PhD. This research aims to allow us to reclassify patients according to prognosis and select appropriate therapy based on likelihood of response which is a huge unmet area in patients suffering from rheumatoid arthritis.
I’m working on a unique dataset collected as part of the MRC-funded Pathobiology of Early Arthritis Cohort (PEAC) which has been recruiting patients since 2007 and at present has over 300 patients with detailed clinical, cellular and molecular data. The aim of my PHD is to integrate these final datasets into prediction models of disease/therapeutic outcome.
Rheumatology is a medical speciality which cares for patients with arthritis, frequently inflammatory and with an autoimmune aetiology. The commonest inflammatory arthritis is rheumatoid arthritis, and, in this condition, the immune system begins to attack the joints which can lead to severe disabilities. Currently there is limited knowledge about why this happens, what signals are activated in the joints and why some patients have more aggressive disease at outcome or a divergent response to the same treatments. Seeing patients in clinic with such bad arthritis or resistant disease drives me on to want to identify clinical tests which will ultimately result in all patients with rheumatoid arthritis having an excellent response to therapy and living without joint destruction or pain.
One of the biggest challenges has been obtaining funding to carry out this project however I was lucky enough to be awarded an ARUK (Versus Arthritis) clinical fellowship this summer which supports not only my salary for 2 years but also funds to perform the experiments on the synovial tissue required to identify biomarkers.
Balancing the clinical and research components of my job is also a continuous challenge. In many ways the clinical aspects are easier as I am more familiar with them whereas learning research language, new research techniques (for example R programming, the process of immunohistochemistry, analysing gene expression data) and academic writing is very different to my previous clinical work (particularly in another language!).
DON'T GIVE UP! When you have never worked in research before it is very challenging to learn new techniques, gain funding etc but at the end of the process, this hard work is highly rewarding. A deeper knowledge of science, at least in Medicine, is extremely useful and motivates your clinical work, in my case this has helped me to understand the pathogenesis of rheumatoid arthritis which ultimately improves my clinical practice, at the end hopefully leading to the patient best care.