Granulomatosis with polyangiitis (GPA) is a rare form of vasculitis, a disease that causes blood vessel inflammationInflammation is a normal part of the body’s defense to injury or infection, and, in this way, it is beneficial. But inflammation is damaging when.... This condition primarily affects the ears, nose, sinuses, kidneys, and lungs, often leading to severe complications.
Rennie Rhee, MD, assistant professor of medicine in the Division of Rheumatology at the University of Pennsylvania and her team are working to understand why the inflammationInflammation is a normal part of the body’s defense to injury or infection, and, in this way, it is beneficial. But inflammation is damaging when... that occurs in the nose and sinuses of GPA patients is associated with a higher risk of disease relapse.
Uncovering the Role of Bacteria
“The goal of our project was to delve deeper and characterize the specific types of bacteria that are present in the nasal cavity of GPA patients to understand how these bacteria interact with each other and with the cells lining the nasal cavity.”
Their research has revealed that nasal cells in GPA patients function differently compared to those in individuals without the disease.
“If you take the cells outside of their environment and observe their behavior, they react differently from the start. What we’re finding is that when exposed to various types of inflammatoryInflammation is a normal part of the body’s defense to injury or infection, and, in this way, it is beneficial. But inflammation is damaging when... molecules, their response is also distinct,” Dr. Rhee says.
Her team is now exploring whether GPA patients’ cells react differently to bacteria that are normally present in the body—and whether these differences could play a role in triggering disease relapses.
A Clinician’s Perspective
Dr. Rhee’s interest in GPA began when she was a clinician specializing in the field of vasculitis. Many of her patients reported persistent sinus and nasal symptoms, which often preceded other complications of the disease.
“It’s fascinating to see how patients connect the dots when they learn that their sinus issues were actually part of their GPA from the beginning,” she says. “They look back to their diagnosis and recall experiencing significant sinus symptoms without realizing they were early signs of the disease. That realization really resonates with them.”
Looking to the Future
Rhee hopes her research will not only improve the understanding of GPA but also lead to advancements in predicting flare-ups and even preventing relapses altogether.
“If we identify key bacterial or immune factors in the nasal cavity, we could use nasal swabs or blood tests to predict relapses,” she explains. “This would help clinicians determine whether a patient needs to remain on treatment or if they might be able to taper off while being closely monitored.”
Support from the Foundation
Rhee credits the Rheumatology Research Foundation with playing a crucial role in her career. She has received several grants from the Foundation, including the Innovative Research Award, which has helped support her work.
“As a trainee and early career investigatorIn research, a person who is involved in running a clinical trial or research study. The investigator may help prepare and carry out the protocol..., it’s incredibly difficult to secure the resources and protected time needed to build a research career,” she says. “The Rheumatology Research Foundation was instrumental in allowing me to pursue this path.”