Meet the Scientist - Dr Elizabeth Renzoni

Here at Scleroderma and Raynaud's UK, we invest in research to save lives. The more research we can conduct into both scleroderma and Raynaud's, the closer we get to having better treatments and eventually a cure. Thanks to your support, SRUK is able to work with a number of dedicated, inspiring scientists who all endeavour to further understanding of the two conditions. We do this to improve the quality of people's lives, and ultimately to save lives. Each research scientist has experienced varying journeys to accomplish their many impressive achievements. Here is a little insight into the lives of some of the researchers we fund, what keeps them in the laboratory and the future of research.

Dr Elizabeth Renzoni:

Elizabeth trained in medicine and then in respiratory medicine at the University of Siena, Italy. In 1999, she was awarded a European Respiratory Society research fellowship to study the genetics behind interstitial lung diseases (ILD) at the ILD Unit at Royal Brompton Hospital. She went on to complete a PhD in gene expression analysis in pulmonary fibrosis with Imperial College, London. Since 2006, Elizabeth has been working as a consultant respiratory physician at Royal Brompton Hospital in the ILD Unit and an honorary senior lecturer at Imperial College London. As the oesophagus is so often involved in scleroderma, SRUK have most recently funded a project led by Elizabeth which is assessing the role of chronic microaspiration (movement of small droplets from the stomach into the lungs) in pulmonary fibrosis.

1. What inspired your interest in scleroderma and Raynaud's?

I have been fascinated by connective tissue diseases from the start of my medical journey. The unit where I trained in Siena was a centre for interstitial lung diseases, and there I saw many patients with scleroderma, which instigated my interest with this disease and in looking into mechanisms that might allow us to understand more about the different pathways involved and potential new treatments. I soon became aware of the work being done at the Royal Brompton and Royal Free hospitals, through the collaboration initiated by Dame Margaret Turner Warwick, a pioneer in the field of ILD, and Dame Carol Black, who set up the largest referral centre in the UK for patients with scleroderma. Upon reading about the extensive research being conducted by Dr Ron du Bois and Professor Athol Wells, I decided to come to the Brompton to be involved in research in scleroderma-associated lung disease. Here, I have been fortunate to work in close collaboration with the Royal Free Rheumatology specialists and researchers including Professor Chris Denton, Professor David Abraham, Dr Voon Ong and Dr Xu Shi-Wen. The immune system and how our bodies can recognise the multitude of substances different from our own has always been of huge interest to me. In scleroderma and other connective tissue diseases this fine balance is out of kilter; exactly how this together with other pathways leads to scarring is yet to be discovered.

2. What key areas do you think are going to be really exciting for research over the next 5 years?

Lung fibrosis is a frequent complication of scleroderma, and in a minority of individuals, this fibrosis is progressive. Some features of this symptom are similar to other fibrotic lung diseases, such as idiopathic pulmonary fibrosis (IPF), although it is important to note that patients with scleroderma-associated lung fibrosis tend to do much better than those with IPF. Two drugs have recently been found to be effective in the treatment of IPF, as they can slow down the progression of lung fibrosis, and so these same drugs are also being trialled in scleroderma-associated lung fibrosis, with the first results expected over the next year. I believe in the next five years, there will continue to be interconnections between discoveries and treatment options from the field of IPF to scleroderma-associated lung disease.

Although this is promising, there are also major differences between the two, as the genetics of lung scarring is very different in scleroderma compared to IPF. The immune system plays a much more prominent role in the development and progression of lung fibrosis than in IPF. Immunosuppressive treatments can prevent progression in a substantial number of patients with scleroderma, although there is a small but significant group of patients whose lung fibrosis continues to progress despite currently available treatments. There are promising trials currently ongoing investigating a number of agents that regulate the immune system and we are eagerly awaiting the results.

Finally, for a disease about which we still have so much to learn, it is crucial that we continue to recruit patients into research, and that patients become increasingly involved in the designing and shaping of research to highlight what are the most important aspects and to help guide researchers towards patient-centred outcomes.

3. You get to throw a dream, once in a lifetime, dinner party – who would you invite?

Jane Austen, Mozart, Oscar Wilde, Charles Darwin, Leonardo da Vinci, Roberto Benigni.

4. Finally, what is your one desert island disc?

Mozart's Le Nozze di Figaro

Glossary:

• Pulmonary fibrosis: a respiratory disease, caused by scars forming in the lung tissues which lead to lung stiffening and breathing difficulties.

If you are interested in helping SRUK to fund scientific research, then please visit our donations page here. We rely on the generosity of our community to continue to support groundbreaking research in both scleroderma and Raynaud's.

If you would like information on other treatments for Raynaud's and scleroderma, please visit: Find Support

Information on another piece of new research can be found here: Importance of behaviour change interventions in management of Raynaud's