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Q&A: Dr. Carol Feghali-Bostwick

On the importance of research, her lab's peptide finding, and more...

Dr. Carol Feghali-Bostwick.jpgLast spring, we heard exciting news coming from Carol Feghali-Bostwick’s lab at the University of Pittsburgh. Dr. Feghali-Bostwick and her team identified an essential peptide that could reverse the effects of fibrosis in mice. Fibrosis is an excessive formation of the fibrous connective tissues. More importantly, the peptide also worked on specimens of human tissue. This finding is significant, not only to the scleroderma community, but to the entire world, as tissue fibrosis contributes to 45 percent of all deaths in developed countries, according to Dr. Feghali-Bostwick. We had the opportunity to sit down with the busy researcher after her workshop session at the National Patient Education Conference to discuss how she became involved with scleroderma research, where she sees the field heading in the future, and more.

Q: What prompted you to choose scleroderma as your research focus?

A: It was my own scleroderma diagnosis that prompted me to choose this as a research path. My diagnosis was confirmed by Dr. Dennis Boulware, who was at the time the chief of the division of rheumatology at Tulane Medical School. When I was in graduate school, I had a very supportive mentor, Dr. Laura Levy, who gave me the opportunity to pursue my research interest in scleroderma with her guidance and support. Dr. Boulware generously offered resources and access to patient skin biopsies so that Laura and I could conduct our research.

Q: How did the Scleroderma Foundation’s Research Grant Program help advance your career?

A: The Scleroderma Foundation funded me as a new investigator to conduct a study about twins with scleroderma. Thanks to the Foundation’s support, I transitioned from fellowship to a junior faculty position and was able to complete the only twin study of
scleroderma in the world.

Q: How important are research programs, such as the one that the Scleroderma Foundation oversees, to help advance the field? Additionally, how does it help the careers of upcoming scientists?

A: Young investigators often don’t have the funds and resources to generate enough data to apply for NIH (National Institutes of Health) grants. The Scleroderma Foundation provides them with support to purchase reagents and supplies for their experiments as well as to protect some of their time for research by supporting a percentage of their salary.

With the Scleroderma Foundation New Investigator awards, they are able to focus on their research and generate sufficient data to compete for larger grants available through the NIH. As such, the Scleroderma Foundation facilitates their success and their transition to successful independent investigators.

For established investigators, the Foundation offers the opportunity to receive funding for pursuing a new direction of research that may not be funded by NIH or other sources.

Q: As an established researcher, what would you say to the next generation of scleroderma researchers, or what advice would you pass on to them?

A: First and foremost: “perseverance.” That was the advice my mentor, Dr. Laura Levy, gave me, and it has been the most valuable advice. If experiments don’t work, keep trying; if a grant is not funded, do not give up, apply again. You must persist in order to succeed.

One of my favorite quotes is by Calvin Coolidge: “Persistence and determination alone are omnipotent.” And always remember that, as Winston Churchill said, “Success is not final, failure is not fatal: it is the courage to continue that counts.”

Q: What is the timeline or the next steps in the research with the E4 peptide? How will this discovery affect the scleroderma population and the population in general?

A: We actually have a couple of next steps:

1) To continue to research the mechanisms by which E4 works; and

2) To complete toxicology and other studies required by the FDA (Food and Drug Administration) before filing an IND (Investigational New Drug application) for a clinical trial.

We are currently identifying sources of funding for both of these steps.

E4 may be beneficial for the fibrotic aspect of scleroderma, such as the thickening that affects the skin, lungs and other internal organs. However, we don’t yet know what effects, if any, E4 will have on other aspects of scleroderma, such as the vascular complications.

E4 is likely to benefit patients with other fibrotic conditions, such as idiopathic pulmonary fibrosis and liver
cirrhosis. Since our research showed that it is effective in both skin and lung, we are hoping that it will show efficacy for other organs as well. Dr. Wynn at NIH had reported that organ fibrosis is responsible for almost half of all deaths. Therefore, the discovery of E4 may have broad impact and be helpful for patients with different diseases.

Q: How can people learn the latest about the E4 peptide research, as well as the status of any clinical trials?

A: Hopefully, the research findings will be published in scientific journals. When we reach the stage of a clinical trial, the trial information will become available through the Scleroderma Foundation and Clinicaltrials.gov.

Q: Is there anything else that you would like to add?

A: I would like to emphasize the importance of supporting research. Discoveries such as those of E4 begin at the bench in the laboratories of scientists. Scientists in all disciplines are currently struggling for funding, and the lack of funding hinders research progress and delays the identification of the cause and cure for scleroderma. It also discourages young investigators and jeopardizes the future of research on scleroderma and other diseases.

Thus, it is critical to support research via organizations that promote peer-reviewed research, such as the Scleroderma Foundation, to increase awareness about the importance of research and advocate for increased NIH funding.

Dr. Feghali-Bostwick is an Associate Professor, Division of Pulmonary, Allergy and Critical Care Medicine, and co-director of the Scleroderma Center at the University of Pittsburgh School of Medicine. She also is vice chair of the Scleroderma Foundation’s Board of Directors and chair of the Foundation’s Research Committee.

This article originally appeared in the Fall 2012 issue of "Scleroderma Voice."

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