Thursday, January 02, 2020
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I had the pleasure of interviewing Dr. John Harris, a physician-scientist here at UMass and co-director of the autoimmune skin sequencing program. Dr. Harris was my postdoctoral mentor, and I learned a lot from him. John is very talented and charismatic, and I hope you enjoy hearing about the exciting things going on in our department and his vision for the future of Cutaneous Lupus!
1. Please share a little about your career. How did you first get interested in autoimmune skin disease? I entered the MD/PhD program in medical school, which combines medical training with research to prepare students to become physician-scientists. I was always fascinated by science and discovery, and wanted to use this to help fight disease. While in school I became interested in type I diabetes (T1D), an autoimmune disease that attacks the insulin-making cells of the pancreas. My cousin has T1D and I wanted to know why her immune system had turned on her own tissues and cells that were needed to manage her blood sugar. During my research in T1D, I became frustrated that I couldn’t study human cells and tissues because they were so difficult to obtain from diabetic patients (the pancreas is really well-hidden in the abdomen, covered by many other organs). When I had finished my research and reentered medical training, my PhD mentor, a physician-scientist expert in diabetes, introduced me to a patient that changed the course of my career. She had T1D as well as 3 other autoimmune diseases, including Hashimoto’s thyroiditis, pernicious anemia, and vitiligo. The vitiligo caused white spots on the skin of her back, and I quickly realized that the skin was easy to obtain for research studies. It was there and then that I decided to become a dermatologist and do translational research (research on human tissues) in vitiligo, which was one of the best decisions I ever made! I love dermatology and love taking care of my vitiligo patients, they are an awesome group of individuals.
2. Could you briefly describe some similarities and differences between Vitiligo and Cutaneous Lupus? Like vitiligo, cutaneous lupus is an immune-mediated disease of the skin, and so it is just as accessible for translational research studies. They both affect the very top layer of skin called the epidermis, so similar cells are probably involved in the two diseases, and similar tools and approaches can be used to study them both. One big difference between vitiligo and lupus is the effect of the sunlight on the two diseases! Sunlight improves vitiligo, but typically makes lupus worse, so we can’t simply use light therapy as a treatment for lupus the way we do for vitiligo. To me, lupus seems more complicated than vitiligo, which may be why it has been so difficult to understand how it works and to develop new and better treatments for it. But I think after getting a foothold in vitiligo using new research tools, it will make it easier to make significant advances in lupus, and I’m confident you and the other researchers at UMass will accomplish big things for this horrible disease and those who suffer from it.
3. Together with Dr. Manuel Garber, you have made an autoimmune skin sequencing program. This is a very powerful way of examining skin diseases. Could you share a little about that with our readers? Yes, this is one of the tools we developed to study vitiligo that can be used just as easily for lupus to understand what’s going on during the disease in the skin. Older methods to do this had much lower resolution than the newer methods we have developed together, which allow us to see each cell in the skin from healthy individuals and compare those to cells in the skin affected by lupus. We can also see what genes each cell has turned on and therefore what the cells are doing and how they are working together. Therefore, we can design new strategies to interfere with the disease process and develop new treatments for the disease. We are very excited about this, because it represents the type of transformational advance that can really be a game-changer to understand lupus and other skin diseases.
4. What is your vision for the future of Cutaneous Lupus and research in general? I think that dissecting the pathways responsible for causing the disease is the best approach to developing new treatments. Even better if we can do this directly in humans, rather than relying solely on animal models. I believe that it is when using both human data and animal models together that the most significant advances can be made, and so this is my vision for the future of research in cutaneous lupus. If vitiligo is any indication (I think it is), we should be able to obtain new ideas for therapy from the human sequencing data, verify them in mouse models, and then advance them to early proof-of-concept clinical trials in cutaneous lupus patients. We have been able to do this for vitiligo, and it is a very exciting time for patients with the disease! I expect progress in cutaneous lupus at UMass to happen quickly and look forward to watching it unfold over the next few years. Of course, if the public gets involved to provide funding for the work it will make it all go faster, since usually getting the ideas is the easy part, it’s funding the work to test those ideas that becomes the major challenge that makes things go slowly. This is where patients and those who love them can really participate in this important process.
5. Any parting words of wisdom for aspiring physician-scientists? Keep an open mind and follow hunches when you can, while still staying focused on your goal. It’s almost always the unexpected observations that translate to the greatest advances in research, and these become the new treatments of the future. It takes discipline and hard work, but it is truly a privilege to spend your career in such a noble cause. Keep the patients in mind while you do this, because they are the whole reason we do what we do. This helps to keep going when times are difficult and they provide the inspiration that’s such an important part of the process. Oh, and HAVE FUN WHILE YOU’RE DOING IT! I love my job, and wouldn’t change a thing.
