Search Begins for a Genetic Link to Vasculitis - Sharon A. Chung, M.D.

By Sharon A. Chung, M.D., April 2007

My story begins in Raleigh, NC, where I was born and raised.  My father is a retired a physics professor from North Carolina State University (NC State) and my mother is an artist.  My sister is 5 years older than me and a pediatric ER doctor in Boston. 

I must say that I was extremely lucky growing up—the schools I went to had a strong emphasis on science, and everyone around me was tremendously supportive of my interests.  One of my most influential experiences was attending the North Carolina School of Science and Mathematics (NCSSM) for my last 2 years of high school.  While at NCSSM, I took a class called “Research in Biology”.  Although it had a very simple name, I cannot underestimate the impact of this class on me.  It introduced me to molecular biology, and allowed me to develop an independent research project on yeast RNA viruses.  The results of the project were definitely not earth shattering—but the project itself jump-started my desire to conduct research studying human diseases. 

After high school, I went to NC State and obtained a degree in Chemical Engineering.  I had an inkling at that time that I wanted to go to medical school, and to continue research exploring medical diseases.  However, I knew that I wasn’t a “pure science” person—that is, that I enjoyed applying science towards something more than the just discovering the science itself.  Therefore, I obtained an applied science degree—engineering.  While at NC State, I became interested in genetics, and began taking classes in this area, with the idea that I may do research in this field in the future.

After graduating from NC State, I went to medical school at Johns Hopkins University in Baltimore, MD, and stayed at Hopkins for my residency in internal medicine.  I realized 2 extremely important things while at Hopkins—First, that I enjoyed seeing patients far more than I enjoyed growing yeast or working a pipette in a lab.  Second, I was introduced to rheumatology, and became fascinated with this area of medicine.  I remember the vasculitis clinics I attended with John Stone and David Hellmann.  I saw such a range of diseases during that time—from Wegener’s granulomatosis to Takayasu’s arteritis to Behçet’s to CNS vasculitis.  I remember asking myself—“How do these diseases start?  We believe that the immune system loses the ability to distinguish itself from foreign cells—but why?  Is there anything that makes it more likely to happen—genetics, environmental exposures, infections?  Why does it affect some, and not others?” Given my previous interest in genetics, I realized that I had found my calling—to study the genetics of autoimmune diseases, and to use genetics to learn how these diseases develop.   

I came to University of California, San Francisco (UCSF) for a rheumatology fellowship, in part, because of the well-developed genetics research program in rheumatology at UCSF.  Dr. Lindsey Criswell, my mentor, has significant experience studying the genetic epidemiology of both rheumatoid arthritis and lupus.  With her, I have developed a research project to identify genes related to autoantibody production in lupus.  These autoantibodies are believed to play a role in starting lupus.  By understanding which genes are involved in producing these autoantibodies, we may gain insight into the genetic causes of lupus.

My research goal is to expand this work in lupus genetics to other autoimmune diseases, such as vasculitis.  In the future, I would like to study how genes, and which genes, influence the risk of developing vasculitis.   This knowledge may help us predict who is at risk for disease, develop potential treatments, identify which treatments may be more effective for a particular patient, or perhaps even prevent disease.  These are definitely long-term goals—we are not close to achieving them currently—but the potential for reaching these goals is growing! 

I don’t want to give the impression that the only thing I think about is research—quite the opposite!  My clinical practice at UCSF is an important and valuable aspect of my rheumatology career.  I currently see a wide variety of patients with different autoimmune diseases, including vasculitis.  However, due to my interests, I am interested in seeing more vasculitis patients in my clinic and developing an expertise in this field.  In addition, I am spending a month this year at the Vasculitis Center at the Cleveland Clinic to expand my experience caring for these patients.

I find it extremely rewarding to care for vasculitis patients.  Often times, I first meet them when they are quite ill—for example, wheelchair bound due to nerve damage, or in the intensive care unit (ICU) due to organ failure.  These patients have shown me the body’s amazing capacity to heal.  My patient who was wheelchair bound is now walking on her own; the patient who was in the ICU is now a college student.  It is uplifting to see my patients make such significant strides in their quality of life.  I’d like to think that I have some impact with medications and a caring ear, but I know that my patients have a significant role on their own recovery.  Their positive outlook, dedication to medical care, attention to physical therapy, self-education, determination to improve—all of these aspects have helped them progress and I am proud of their accomplishments. 

This July, I will finish my rheumatology fellowship and join the faculty at UCSF.  I look forward entering a new stage of my career and developing a stronger relationship with the vasculitis community!