Dr. John Esdaile is the national Primary Investigator on one of the nine research teams that received grants under the CIHR Inflammation in Chronic Disease Signature Initiative in 2014. Representatives of the research teams attended an inaugural networking meeting in February, 2015 in Winnipeg, Manitoba, organized by CIHR-IMHA and the CIHR Institute of Infection and Immunity (CIHR-III). One of the meeting’s objectives was to encourage collaboration among researchers studying different aspects of inflammation in chronic disease. At the meeting, Dr. Esdaile kindly took some time to discuss his team’s project and share his thoughts on the collaborative process among health researchers. This is the first in a series of interviews with the Inflammation researchers.
A physician and researcher in Rheumatology at the University of British Columbia, Dr. John Esdaile is the Scientific Director of Arthritis Research Canada. His area of research interest is the study of clinical arthritis with a focus on applied research results, with a main objective of improving the lives of those living with arthritis. The goal of the current project, PRECISION: Preventing complications from inflammatory skin, joint and bowel conditions, is to examine a number of types of arthritis as well as skin disease, psoriasis, and two types of bowel disease: Crohn’s Disease and ulcerative colitis, since the researchers believe these disorders share some very common features. “We think all of these diseases share a number of complications,” Dr. Esdaile explained, “that as we got better and better at controlling the acute problems of these diseases, we’d be left with chronic, low-grade, ongoing inflammation.” These complications now eclipse the original problems that have become treatable with better therapies.
The complications include heart attacks, strokes, lung clots, hip fractures, diabetes, lung disease and hospitalized, serious infections. The PRECISION team will link such complications to the inflammation and look at how to intervene to eliminate and prevent them. “We have some evidence that we might be able to do that,” said Dr. Esdaile, “and we are excited about the prospect of radically altering these bad outcomes.”
The best way to approach the problem is by forming a multidisciplinary team Dr. Esdaile explained, because it was clear to the researchers that one view would not be enough. “We have physiotherapists, occupational therapists, rheumatologists. Biostatisticians are critical to answering some of these questions,” he said. “Epidemiologists and health economists, all of whom are being brought together to focus on getting the answers.” A main concern of the team is knowledge translation, therefore specialists in knowledge translation are also part of the team.“If we did not have that team we would only be able to answer a tiny part of that question,” said Dr. Esdaile.
Further, he expects the techniques the team develops will be widely applicable to many different chronic diseases and questions. “We are expecting the results to be of much greater value not just to the diseases we’re studying but as a method, an approach to studying chronic disease in general,” he said.
Meeting and networking with other research teams is also very beneficial when working in a cross-cutting field such as inflammation in chronic disease. “I think it’s a wonderful opportunity to cross fertilize, hear what other people are doing,” he said of the Winnipeg networking meeting. “They can perhaps see as they develop their models how they could rapidly put them into practice.”
Involving patients in research is another critical component to ensure successful research outcomes. “I think one of the interesting things about our research,” he observed, “is that we’ve had patient involvement from day one.”
Before applying for the grant, Dr. Esdaile’s team first conducted a survey across Canada asking people living with inflammatory diseases what they thought were the important research questions. “The questions we are trying to answer,” Dr. Esdaile explained, “are questions patients across Canada said, “this is what’s really important to me.” And that has made the project very exciting.”