Paul Brogan

Study:  Circulating microparticles as therapeutic targets of plasma exchange in antineutrophil cytoplasmic antibody (ANCA) associated vasculitis
Institution:  UCL Institute of Child Health and Great Ormond Street Hospital NHS Foundation Trust, London, England
Award:  $99,206, two-year study

Inspired by a patient whose Microscopic polyangiitis was diagnosed too late, Brogan began studying ANCA vasculitis and other forms of vasculitis in children in 1997. His work centers on the novel biomarkers contained within the “blood dust”, which could be targets for therapeutic plasma exchange.

“We now know that ANCA cause little pieces of white blood cell ‘shrapnel’ to be released when they bind to neutrophils,” he explains. “In test tube experiments these neutrophil microparticles do bad stuff to endothelium, causing it to be activated and sticky and encouraging more white blood cells to bind, amplifying the vasculitis. We also know that these microparticles may contribute to blood clotting, and are found at higher levels in the blood of children who go on to have thrombotic complications of vasculitis.”

Brogan’s study will determine if this is also true in patients with ANCA vasculitis, and if removing the “shrapnel” by plasma exchange improves patient outcomes. He hopes his study will help identify which blood parameters are most important to remove to achieve disease control.

VF grants help clinician scientists like Brogan who are working at the interface of science and clinical practice for rare diseases.

“It undoubtedly facilitates the flow of knowledge from benchside research to the clinic for patient benefit,” he says. “This sort of support is essential to further our knowledge of such rare diseases.”