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Professor Flavia Cicuttini on her career in research and rheumatology

Interview by Karen
Med J Aust
Published online: 21 January 2013
Professor Flavia Cicuttini is head of both the Rheumatology Unit at The Alfred hospital and the Musculoskeletal Unit in the School of Public Health and Preventive Medicine at Monash University. Much of her work focuses on using magnetic resonance imaging (MRI) to understand factors that affect joint cartilage. Here, she shares some of highlights of her fulfilling career.
 

I knew that I wanted to be a doctor, but I really didn’t have a clear vision of where I would end up. I suppose I viewed medicine as a journey. The further I travelled, the clearer it all became. I graduated from Monash University in 1982, and then worked as a resident medical officer (RMO) at Prince Henry’s Hospital, Melbourne, which no longer exists. I trained in rheumatology then did a laboratory-based PhD at the Walter and Eliza Hall Institute, which was a very exciting place to work in.

I thoroughly enjoyed my time at the bench but decided to combine clinical and research work. To that end I did my postdoctoral training in London in 1994 and undertook a Master of Science in Epidemiology at the London School of Hygiene and Tropical Medicine. In 1995, I joined Professor John McNeil’s department of epidemiology and preventive medicine at Monash University as a senior lecturer.

I have the privilege of working with really great people at Monash University and at The Alfred. Our successes and supportive spirit mean we attract many students who want to experience both clinical work and research.

Medical students in general are incredibly enthusiastic, intelligent and committed to making the world a better place. They quickly see what a major contribution they can make and, once allocated a task, they are off and running before you know it. I have great confidence that our future is in good hands.

My medical mentors are Professors Geoff Littlejohn and Peter Ryan. They were the heads of rheumatology at The Alfred hospital and Prince Henry’s Hospital respectively when I was a medical student and RMO. They were excellent clinicians, great communicators and highly respected by staff and students alike. They were great role models for rheumatology. Two other people I would like to mention are Professors Gus Nossal and John McNeil. Both are eminent Australian researchers who have achieved great success and who surround themselves with this incredibly positive attitude, particularly in their dealings with staff. This is very infectious and a great way to lead a team.

When I started work measuring cartilage volume from magnetic resonance images, as a more sensitive method for assessing joint damage in osteoarthritis, I was told this would not work. I remember collecting amputated legs from The Alfred operating theatres, getting MRI scans of these and measuring the cartilage from the image. I would take a dissection off the cartilage also to ensure it was in fact cartilage we were measuring. I am very proud that, based on this method, we have now been able to turn around many theories present at the time about the causes of osteoarthritis and what can be done about it. For example, we now know obesity affects joints, such as the knee, not just via loading of the joint but also through meta-inflammatory processes because fat produces chemicals that damage the joint. This, and a lot of other new ideas, emerged from this work.

Rheumatology is fascinating. There are now interesting and effective biological treatments for rheumatoid arthritis and other autoimmune diseases. And in the next 10 years, we are also going to see new treatments and better ways to manage osteoarthritis. Significant inroads are being made in the research of these diseases which will translate into the clinical area.
  • Interview by Karen


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