Professor Costantino Pitzalis, MD, PhD, FRCP

The Centre for Experimental Medicine and Rheumatology’s mission is to better understand disease pathogenesis in order to develop novel therapeutics and maximise therapeutic utility of existing therapies. The ultimate goal is to find a cure for rheumatoid and osteoarthritis.

To achieve this goal the Centre focuses on a strong basic science programme in the field of immunology & inflammation linked to a clinical translational programme in the following 4 research areas:

1. Breach of Tolerance & Autoimmunity
   
   In this area our efforts focus on:
   
   a) Investigating development of T/B cell autoimmunity in secondary- vs tertiary-lymphoid-structures and in early vs established RA (Bombardieri / Pitzalis); b) Role of FDCs and RASF in auto-antigen retention and breach of B cell tolerance (ElShikh / Pitzalis) and c) analysis of the antigenic specificities of lesional T and B cells (Bombardieri / Pitzalis).
   
   
2. Development and resolution of inflammation & Mechanisms of Tissue Damage and Repair
   
   In this area our effort focus on: a) Mechanisms of T and B cell recruitment and retention using in vivo models (eg. RA/SCID/)(Bombardieri/Pitzalis); b) Resolution-of-inflammation through endogenous anti-inflammatory pathway. This area is investigated/developed through a long-standing collaboration with Prof Perretti and c) Mechanisms of Tissue Damage and Repair with particular emphasis on cartilage homeostasis. This research area is particular competence of Professor Dell’Accio.
   
   
3. Developing new therapies through understanding of pathogenesis
   
   The Centre is actively involved in the development of novel therapeutics both through its own drug development programme (e.g. developing single chain (sc)Fv antibodies, identified by phage display technology, to specifically target joint tissues) and, in collaboration with industry, via the progression of the pharma pipeline. The Centre has been awarded an ARUK Experimental Arthritis Treatment Centres and is part of the National Institute for Health Research Translational Research Partnership.
   
   
4. Patients stratification to understand pathogenesis of disease evolution and response to therapy
   
   The Centre builds on an existing large biomarker discovery and clinical trial programme to identify specific synovial tissue-driven bio-variables and blood correlates of clinical evolution and response to therapy. These include MRC/PEAC, MRC/ABPI and NIHR-EME initiatives. In addition, the ability of targeted biologics (TNF/IL6R/B-cell blockade) to modulate the panoply of RA-associated immune abnormalities will be utilised to better understand and dissect the complex immunological networks in the disease tissue in patients with RA.

Training

To ensure the next generation of Doctors and Scientists is available to translate scientific discoveries into medicine for patient benefit, the Centre provides high-quality research training in musculoskeletal basic and translational sciences. The Centre has a highly successful training record with over 30 PhD/MD successfully completing on time.

Through high-profile translational programmes the Centre provides academic training for Specialist Registrars over and above excellent clinical training to include the use of musculoskeletal ultrasound (US) in the management of rheumatic conditions. In addition, as part of the MRC-funded Pathobiology of Early Arthritis Cohort (PEAC), the Centre provides national/international training in US-guided, minimally invasive, synovial biopsy. The Centre has pioneered the use of this procedure in the UK, which has made possible to incorporate synovial pathobiology in MRC and NIHR clinical trials based on tissue-driven patient stratification.