Dr. Nigrovic Puts Research Into Practice | Living An Academic Career

Peter Nigrovic, MD | Lise Nigrovic

Dr. Nigrovic Puts Research Into Practice | Living An Academic Career

Peter A. Nigrovic, MD, is Associate Professor of Medicine at Harvard Medical School and Associate Physician at Brigham and Women’s Hospital. He is a practicing adult and pediatric rheumatologist and director of the Center for Adults with Pediatric Rheumatic Illness (CAPRI) at the Brigham and Women’s Hospital. Dr. Nigrovic received his B.A. in philosophy from Amherst College, including a year of study at Corpus Christi College, Oxford, followed by his medical degree at Harvard Medical School. He completed the Harvard Medicine-Pediatric Residency Program at Brigham and Women’s Hospital and Boston Children’s Hospital, before founding the Nigrovic laboratory in 2010. He was an ANRF grant recipient, class of 2012, and has served on the Scientific Advisory Board of the Arthritis National Research Foundation (ANRF) since 2014.

I always want to know why.

When I was in medical school I had an amazing clinician for a teacher. Her name was Dr. Jean Jackson. As a medical student I was blown away by her insights. I thought she knew everything. She was a remarkable person.

I studied internal medicine and pediatrics because of Dr. Jackson, and went on to complete a fellowship in rheumatology. I thought I would then approach Dr. Jackson in her seeming omniscience.

In fact, what I realized—and what should have been obvious to me as a student too—was that none of us know everything. We know more or less what to do, but we didn’t know unless we knew why something happens, our chances of making real advances in treatment were a lot smaller.

I was a philosophy major as an undergraduate and I try to carry this approach forward in my lab. I wonder why a system should work one way and not another way? These are the questions I find exciting. In our lab, we don’t specialize in a specific technique or focus on trying to develop drugs targeting pathways we suspect may be important. We try to understand the disease better and we believe that this is the best way to better take care of our patients over the long term.

My wife, Lise, is a pediatric emergency medicine doctor at Boston Children’s Hospital and also an associate professor at Harvard Med. She is motivated by what to do for the child in front of her. This is important work and she has made amazing discoveries. Studies in mice or cell culture will not help her answer her questions because she takes care of people, not mice or cells. For me, I need these other tools to get at the why, because they let me explore the basic principles that make the system tick. My hope is that this is where fundamental advances for the treatment of rheumatologic disease will begin.

Science is social.

I’ve had my own lab since 2010 with students, technicians, postdoctoral fellows, and junior faculty colleagues. Each person brings a distinct perspective and fund of knowledge. We teach each other. We learn from each other. When I think of the “good” that springs from my lab, it’s these scientists, as much as the research findings, that make an impact. I see scientists growing up in the lab and I’m very proud of them. It feels a lot like having children (of which Lise and I also have 4, ranging from 9 to 16, of whom I’m also very proud).

Just before I got my first-year ANRF funding in 2009, I wondered if I could stay in an academic position. We had just had our fourth child. My NIH K08 grant was expiring in 2011. The ANRF grant came just at the right time to allow me to continue my work. We were able to generate data that led to new grants, including my first NIH R01 award. I calculated later that the return on the ANRF investment was 15:1. That’s a pretty successful investment!

It’s difficult to predict where science will lead.

ANRF selects its funding target, a group of people who are just beginning their own independent academic careers and who have the potential to make an important contribution. They are like plants that send out their own shoots. I see them sprouting in terms of people, creativity, new ventures, and labs. Funding is often poor at this phase for young scientists, who wonder whether they can survive in academia rather than private practice or industry. Our goal is to help them stay in research, to make the breakthrough and reach the point where it becomes self-sustaining.

ANRF Advisory Board realizes that if the drive is there, the success will follow. It’s hard work at the beginning.  The rewards are substantial, but are often delayed. For example, in the last few month I’ve had the opportunity to give talks in Lisbon, Dubai, and in several cities in the US. We are discovering amazing things in the lab, things I couldn’t have imaged even 5 years ago. This is fun!

There is no cure for arthritis in adults or children.

In my lab, we study the basic mechanisms of inflammatory arthritis, in particular the pathways of joint inflammation. Sometimes our ideas come from the clinic. For example, I treat children with juvenile idiopathic arthritis (JIA), and some of these patients I have followed for almost two decades. Usually only a few joints are involved. Children sometimes go into remission for 10 years, but when the disease flares, it’s in the same joint. Why does arthritis happen over and over in the same joint? Somehow, the joint ‘knows’ it was inflamed before. How can we make the joint ‘forget’ the pattern? This is one of the things we’re studying in a mouse model.

We need a sustained effort to develop an expert arthritis research workforce. ANRF’s niche is bridging the career bottleneck with a funding boost for 10 or 12 new scientists just when they need encouragement most. Think of a big iceberg: You can hack away at it, but it works better if you find a seam or a crack. You eventually break through.

With the support of our generous donors, ANRF is funding the research breakthroughs of the future. No, we haven’t cured arthritis yet. But this is how we get there.

ANRF
Article Author
Arthritis National Research Foundation
derek@curearthritis.org

The Arthritis National Research Foundation's mission is to provide initial research funding to brilliant, investigative scientists with new ideas to cure arthritis and related autoimmune diseases. Writing articles about the patients affected and the science being done to find a cure shows why we need to come together to #CureArthritis!

1 Comment
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    Halima Moncrieffe
    Posted at 12:51h, 10 December Reply

    Congratulations Dr. Nigrovic! Thanks for sharing your perspectives and encouraging the next generation of scientists.

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