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Dr. Lillian Barra - Uncovering the link between joints and heart health

Approximately one per cent of the Canadian population has rheumatoid arthritis (RA), an autoimmune disorder that affects the lining of joints, usually in the hands and feet. Those living with the disorder are 50 per cent more likely to die from heart disease.

Dr. Lillian Barra, an Assistant Professor in the Department of Medicine’s Division of Rheumatology and the Department of Immunology and Microbiology, is interested in discovering why there is such an increased risk in affected patients, as well as what the underlying cause and mechanisms might be.

In September, Dr. Barra received $325,000 in funding from The Arthritis Society for a three-year period for her project entitled, “Elucidating the Mechanism of Accelerated Atherosclerosis in Rheumatoid Arthritis: The Role of Citrullination and the Shared Epitope”.

Some patients with RA have anti-citrullinated protein antibodies (ACPA) in their blood produced by their immune system. Dr. Barra’s project will use genetically engineered animal models to help understand how ACPAs are involved in the link between heart disease and RA.

While some of the available treatments for RA are useful at controlling disease activity in the joints, Dr. Barra said it still isn’t clear how well they improve cardiovascular outcomes. The results of her project could potentially help to discover new treatment options, as well as ways to identify those who are at a greater risk of developing heart disease.

Dr. Barra explained she became interested in this line of research while working with patients as a clinician.

“I see patients quite frequently, and rheumatoid arthritis is the most common autoimmune disease that we see in our clinic,” she said. “I was noticing that 40- to 50-year-old patients with RA who didn’t have any other risk factors were dealing with cardiovascular disease — it was something that stood out to me.”

Most people do not realize there is a connection between autoimmune diseases and the heart. Even throughout her medical school training at Schulich Medicine & Dentistry, Dr. Barra said the topic never came up.

She hopes that her research will help to increase awareness and make physicians and patients understand the risk factor.

Since receiving the funding in the fall of 2014, Dr. Barra has mostly been working on the administrative portion of the research project, such as hiring and training staff to work in her lab. However, her team has already begun “under the microscope” work to see how immune cells such as macrophages respond to ACPAs.

“It’s always exciting when someone appreciates your work and values your ideas,” Dr. Barra said. “I was excited to get started when I received the funding, and I am very interested to see what the results of the research project will show.”