Feature: Turning hope into reality for a pain-free future

Photograph of Dr. Tom AppletonBy Jennifer Parraga, BA’93

Dr. Tom Appleton, PhD’07, MD’11, hopes that he can contribute to a future where people with osteoarthritis live a life free of pain and disability. And the clinician-scientist is dedicating his career to turning this hope into reality.
Growing up in Ailsa Craig, a small town in Southwestern Ontario, Appleton says he always felt like he would go to medical school. First inspired by the compassion and commitment of his own family doctor, he got a much bigger view of what was possible from a health career perspective when he arrived at Western.
Those possibilities revealed themselves early, on the football field and in the lab.
A member of the Western Mustangs Football team for three years, Appleton had the opportunity to build a relationship with Dr. Tony Cogliano, the team physician. He also came to appreciate and understand the critical role of sports medicine through the Fowler Kennedy Sport Medicine Clinic; he became intrigued with musculoskeletal health.
That led him to Frank Beier’s lab and his fourth-year honour’s research project. Beier’s supervision brought alive an interest in musculoskeletal biology.
Appleton says that his early research experiences are what shaped his career and research paths. Contributing to that experience was Beier, who now serves as one of Appleton’s collaborators and the Chair of Physiology and Pharmacology.
“Research offers great things and challenges, but with the right mentorship, young scientists can be inspired to succeed. Frank has boundless enthusiasm, makes it seem like anything is possible, and instills the confidence in you as a young scientist that you can succeed,” Appleton said.
Completing his PhD, MD, residency and postdoctoral fellowship at Schulich Medicine & Dentistry, Appleton didn’t hesitate to accept an offer from the School as a rheumatologist in the Department of Medicine.
“Western is national leader in MSK research,” said Appleton of his decision to set up his lab and begin his clinical work in London.
“The expertise and long history of research excellence at the Bone and Joint Institute and in rheumatology are well known. I wanted to work in place where there was a group of expertise, colleagues to collaborate with and mentorship to support my work.”
Appleton points to the Bone and Joint Institute’s graduate training program, the Collaborative Specialization in Musculoskeletal Health Research, as an important factor in establishing such a strong record of musculoskeletal research at the University.
“We have world-class trainees many of whom are participating in the Collaborative Training Program. Cross-disciplinary and integrated, it provides an incredible opportunity for junior researchers to get exposed to things they wouldn’t elsewhere,” he said.
The research environment at the Bone and Joint Institute is what makes Appleton excited to work every day.  
“One of the unique things about translational research is the integration of clinical research with basic science research and all of the experts that it takes to make something happen. This doesn’t exist everywhere and is particularly unique to the Institute.”
Appleton is chief of the Rheumatology service at St. Joseph’s Health Care London where he leads a busy and growing rheumatology clinical practice. In addition, as the founder and director of the Western Early Knee Osteoarthritis program, Appleton collaborates with many experts in orthopedics, sports medicine, physiotherapy, and skeletal biology while leading a translational early osteoarthritis research program focused on understanding the role that the immune system plays in osteoarthritis.
According to Appleton, at this time little is known about this area and treatment for early osteoarthritis is the greatest unmet need in the arthritis field. One main problem caused by osteoarthritis is the failure of joints to heal properly, often resulting in chronic knee inflammation in patients.

Appleton’s research seeks to understand why the immune cells that line joints become dysfunctional in osteoarthritis, with the long-term goal of developing treatments that would restore their function. Recent funding from the Canadian Institutes of Health Research and the Arthritis Society will support this research for the coming years and Appleton says their discoveries could lead to clinical trials.

“I think we have a small but important role to play in the global effort to combat osteoarthritis,” Appleton said.
At the heart of that role are the people he cares for. Patients have informed his research since the beginning, providing advice and feedback on the focus and practicalities of his approaches.
“I’m blessed to be able to work with patients,” he said. “They teach me about what is important, how to look at things in a human way and their influence can be seen in my research program.”