With the backing of generous donations from UCARF over several years, rheumatic disease research at Monash has built a steady research program aiming to develop better treatments for rheumatoid arthritis and related rheumatic diseases. In 2018, this has taken two major directions.

Firstly, we continue to focus on the harmful effects of steroid drugs, and ways to lessen them by finding molecules that provide their desirably therapeutic effects but lack their side effects. To that end, the group led by Dr Sarah Jones at Monash has pursued the function of a molecule called GILZ, which holds great promise as a way to mimic the good, but not the bad, effects of steroids. Sarah’s group’s work in 2018 has shown firstly that the harmful molecule ‘interferon’ (often called IFN) is resistant to treatment with steroids, potentially explaining why some patients need such high doses, and even more excitingly that GILZ is able to control IFN. This means that a treatment directed at increasing GILZ could have new benefits in arthritis, in which IFN is a molecule of emerging importance.

Alongside this, the group lead by Sarah has studied whether GILZ is indeed free of steroid side effects. To do this, we have treated mice with steroids and measured their development of diabetes and osteoporosis, two of the most common side effects of steroids when used to treat arthritis. This work is not yet complete, but so far it looks as though GILZ may indeed be safer than steroids in terms of these side effects. We hope to continue this work into 2019 and beyond.

The second focus of work that UCARF funding has allowed is on another steroid-related molecule, called MIF. In the group led by Dr Jim Harris, a scientist Dr Nadia Deen has for the first time generated a comprehensive protein map of the ways that MIF works in the immune system. This map confirmed some things we recently proved about MIF, published in a very high profile international publication in 2018 in Nature Communications, and more importantly unveiled new and unexpected functional relationships for MIF that we can now pursue.

These two major directions of work have been directly supported by UCARF. Alongside this, the Monash group continues to be at the cutting edge of research in diseases related to rheumatoid arthritis, like lupus and scleroderma, and have published some major new data in 2018. Publications from outside Australia have proven how much the outlook has improved for rheumatoid arthritis patients in the last 20 years, with long term survival greatly improving, but sadly also how far there is to go in less well-understood diseases where young people still die from the disease.

In addition, we have continued to attract ‘new blood’, in the form of scientists and doctors recruited from around Australia and overseas to work with us, as well as attract local students to come and learn about arthritis research from us – hopefully producing the next generation of arthritis research leaders. Our working environment at Monash, where rheumatology specialists and lab scientists work side by side, contributes to a culture of doing what we do to improve lives for patients. Sometimes we all wish the path from lab to new medicine was faster, but in the meantime we know that continued hard work will provide the answers.

Professor Eric Morand