To coincide with National Arthritis Week, we spoke to Dr Achilleas Floudas, Senior Research Fellow at the Molecular Rheumatology Department, School of Medicine, TCD. Dr Floudas focuses on patient-centred translational studies that harness new technologies to answer questions regarding the pathogenesis of rheumatoid and psoriatic arthritis. Rheumatoid arthritis is the second most common form of arthritis (osteoarthritis being the most common), and patients suffer pain and stiffness as their joints become inflamed. Whist there is no cure, treatment has advanced over the years giving many people a better outlook. Psoriatic arthritis is much less common; it is an autoimmune disease and can cause pain, swelling and damage to any joint in the body. These conditions come with a considerable cost burden. Rheumatic diseases affect up to 60% of the 120 million EU citizens and costs an estimated €240 billion. But the cost to patient wellbeing is even more severe; joint destruction can lead to disability, higher mortality, and are associated with co-morbidities. We spoke to Dr Floudas about his collaborative work and the frustration felt by patients as they await better treatments for joint inflammation.

Tell us about your work and collaborations with others

My approach has been heavily collaborative with the aim of implementing novel technologies, including 3-D bioprinting in collaboration with Professor Daniel Kelly (Professor of Tissue Engineering, Trinity Centre for Biomedical Engineering), metabolic studies in collaboration with Professor Michael Monaghan (Ussher Assistant Professor, School of Biochemistry & Immunology), and single cell RNA sequencing in order to challenge current dogmas in the field of immunology. Particularly, I have identified populations of highly pro-inflammatory T cells in the inflamed joint of patients - importantly these cells correlate with disease progression. We are currently examining the crosstalk between immune and stromal cells in the joint in order to identify novel biomarkers and avenues of therapeutic intervention. I very much value the strong support of our clinical collaborators including Professor Doug Veale, St Vincent’s University Hospital and University College Dublin, my academic mentor Professor Ursula Fearon, Professor of Molecular Rheumatology, School of Medicine, TCD, and our patient partners who, often with a sense of altruism, make these studies possible. By communicating with our patient partners, it has become clear that there is an urgent, unmet need for better treatment of joint inflammation. One comment from a patient representative highlights their difficulties:

I know only too well the frustration of the trial-and-error approach in finding the right treatment. In many cases this entails enduring chronic pain over several years, before a successful drug is stumbled upon!

How did you become interested in this area of research?

I was attracted by the translational opportunities and the potential for real impact to clinical practice. On a more personal level, seeing first-hand the effect of inflammatory arthritis in close family members has increased my passion for this topic.

It is increasingly imperative that we demonstrate impact in our research. How do you see your work impacting health?

The impact of our work has been reflected in our success with fellowships, funding and publications, including the Irish Research Council’s postdoctoral fellowship and the Centre for Arthritis and Rheumatic Diseases postdoctoral innovation award. I am a collaborator on several project grants including from Science Foundation Ireland and the Health Research Board. Our team have published widely, and I currently have published 23 papers with 9 first author papers (a number that will hopefully increase considerably in 2022 with four other papers in various stages of preparation) all approaching key questions in immunology and have high potential for translatability. However, knowledge must be effectively communicated to both the scientific community and the public, so I am grateful for the opportunity to present my work at conferences or as an invited speaker. Most importantly, we place communication and engaging with patients - both formally and informally - at the centre of our work. As a result, there has been real interest from industry partners in the therapeutic and biomarker potential of this work.

What is your proudest achievement?

It is probably a tie between teaching myself bioinformatics analysis during the pandemic when in lockdown (lots of very, very late nights since crèches were closed) and when I got invited to present to Newcastle University, UK at the ‘meet the expert’ seminar series, which I had dreamt of doing when I was attending these seminars as a PhD student.

What is your best advice to early-stage researchers?

Being an early-stage researcher myself my advice is to stay true to the science and don’t give up.

Who are/were your mentors?

I have been fortunate to work with great academic mentors, however, I have to emphasise the impact that Professor Ursula Fearon has (and continues to have) on my development. Her focus on patients, her ability to combine clinical with scientific data, as well as her management and leadership skills, have been an inspiration.

Life is not all about work… When you are not in the lab, where could we find you?

There is little balance at the moment but when not in the lab you will find me playing with my two amazing baby boys or, on the odd occasion, booting on fencing pistes.

Dr Floudas’s work is supported by the Health Research Board, Centre for Arthritis and Rheumatic Disease and Arthritis Ireland, and you can learn more about his work here.

To learn more about National Arthritis Week, visit the Arthritis Ireland website: https://www.arthritisireland.ie

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