Dr. Berti began his work in vasculitis while he was a medical student at Vita-Salute San Raffaele University in Milan, Italy. At the time, Dr. Berti recognized that vasculitis was not very well understood, and being both curious and motivated to further explore this group of diseases, he realized that he wanted to become a researcher in this field.
During his clinical specialty training he moved to Mayo Clinic in Rochester, Minnesota, for a one-year fellowship in 2016-2017, where he worked under the supervision of Ulrich Specks, MD, and in collaboration with Eric Matteson, MD, and Kenneth Warrington, MD. Back in Italy, he finished his clinical fellowship and wanted to pursue another year at Mayo Clinic in 2019-2020 to improve his knowledge and contribute to research in vasculitis.
Dr. Berti officially started the VCRC-VF fellowship in November 2019 because he felt it offered the best program for conducting vasculitis-oriented research. The program allowed him to train with experienced mentors as well as participate in clinical research activities. “The fellowship provides young physicians with a valuable opportunity to enrich their professional experience,” Dr. Berti noted. “I’m grateful to the VCRC-VF for the opportunity and also to my mentor, Dr. Specks, for the support and continuous guidance I received.” Dr. Specks is a consultant in the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine at Mayo Clinic College of Medicine and Science in Rochester, Minnesota, as well as a professor of medicine.
“My contribution to the research in vasculitis aimed to clarify the pathophysiology of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV),” Dr. Berti explained. AAV is a group of autoimmune diseases (granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis [EGPA], and microscopic polyangiitis) that causes blood vessels to swell. The vessels involved in AAV are typically capillaries, arterioles, and venules but small arteries and veins may also be affected.
“We wanted to elucidate the mechanisms by which the antigen-specific B cells, i.e., those cells that produce the ANCAs that trigger the disease, break the immunological tolerance in AAV patients, starting the disease process,” continued Dr. Berti. “These findings might have implications for disease management, i.e., to guide current anti B cell treatment, and potentially for future development of new personalized immunotherapy for AAV.”
Dr. Berti was also involved in more clinical studies, with immediate implications for clinicians and patients. “The clinical research I have done focused on EGPA respiratory manifestations, specifically on severe asthma, a clinical manifestation present in almost 100% of the patients with EGPA that is usually poorly controlled by the immunosuppressive treatment, even after years from the vasculitis diagnosis, an aspect still overlooked of EGPA,” Dr. Berti added.
“The VCRC-VF Vasculitis fellowship has been instrumental for Dr. Berti to extend and complete his already widely quoted studies conducted at Mayo Clinic on the epidemiology and biomarkers of ANCA-associated vasculitis, asthma in EGPA, and most recently the mechanisms of loss of tolerance to PR3 in patients with PR3-ANCA-associated vasculitis (mostly GPA),” Dr. Specks said.
Dr. Berti is currently working as a clinician and researcher in vasculitis in his home country of Italy and is a consultant in the Rheumatology Department at Santa Chiara Regional Hospital in Trento. “I hope to continue to actively collaborate with the VCRC-VF while developing research activity on vasculitis in the center where I’m working,” he said. Dr. Berti is also near completing his PhD in Molecular Biosciences at the University of Trento.
“It has been a true privilege to mentor Dr. Berti on his journey to become an independent clinician-investigator devoted to unraveling the mysteries of the immune system as they lead to the development of ANCA-associated vasculitis and offer opportunities for novel targeted treatment options,” said Dr. Specks.
“Beyond providing support for specific research studies, the VCRC-VF Vasculitis Fellowship has provided Dr. Berti with invaluable networking opportunities that will continue to strengthen the impact of the next generation of vasculitis researchers and clinical experts in Northern Italy and beyond for the benefit of patients with vasculitis. With young investigators like Dr. Berti coming through the ranks, the future for patients with vasculitis is bright, and the Vasculitis Foundation and VCRC need to be commended for paving the way,” Dr. Specks added.
Author: Nina Silberstein