YOUNG RESEARCHER. Cristina Maglio has found the position of her dreams in Gothenburg – where she can combine clinical activities with research on the link between obesity and rheumatic diseases. She is a resident physician in rheumatology, with research time in the Wallenberg Centre for Molecular and Translational Medicine (WCMTM).
In her research Cristina Maglio is examining how obesity surgery affects the risk of patients developing a rheumatic disease, especially rheumatoid arthritis (rheumatism of the joints). It is well known that obesity increases the risk of developing several rheumatic diseases, especially inflammatory arthritis. For people who are severely overweight and who have rheumatoid arthritis, drugs also may not be as effective, and their prognosis is worse.
“There are individual studies indicating that bariatric surgery is a safe obesity treatment for those with rheumatic diseases, too,” says Christina. “But there are no long-term studies of the significance of bariatric surgery and the development of rheumatic diseases.”
Combining different types of studies
Cristina Maglio and her colleagues have recently been able to show that patients who undergo bariatric surgery for their obesity have a lower risk of developing gout. The common denominator here is inflammation, she tells us:
“When obese people lose a substantial amount of weight, there is a decrease in the level of uric acid in their blood, which is the substance that causes gout. It probably is the reduced level of uric acid that is the main reason for the reduced risk of gout, but there are also other possibilities. Obesity is associated with ongoing low-grade inflammation, and gout is characterized by inflammation of the joints. If the inflammation due to obesity is moderated, then it’s likely that inflammation in the joints that is involved in the development of gout is moderated, too,” says Cristina.
May lead to new advice
Italian-born Cristina Maglio has now been a Gothenburg resident for eight years. After completing her medical education and AT in Rome, she had the opportunity to take a doctorate in Stefano Romeo’s team. Her doctoral dissertation concerned bariatric surgery and was based on the famous Swedish Obese Subjects (SOS) study. After the public defense of her dissertation in 2014, she was eager to work with patients as a doctor again.
“I got a job as a resident physician in rheumatology – an area I had not worked with before but that immediately aroused my interest. Getting to do something new was exciting,” Cristina says.
The opportunity to combine her old research field, bariatric surgery, with the new area, rheumatology, opened up through a position as postdoc in Lena Carlsson’s team. Lena heads the SOS study, one of the world’s largest studies of bariatric surgery.
The most common evidence-based advice that physicians can give people who are concerned about the development of rheumatic diseases is that they should avoid smoking. In the future, when the scientific supporting data is stronger, maybe one piece of advice could also be to lose weight, Cristina maintains:
“If we can show that weight loss reduces the risk of rheumatic diseases and that the weight loss will help these patients receive better treatment and a better prognosis, we can also encourage more patients with rheumatism to lose weight.”
Living a dream
Since last year Cristina has been leading one of the teams in the Wallenberg Centre for Molecular and Translational Medicine (WCMTM). WCMTM is funding half her position, which gives her the opportunity to live the dream of combining clinical activities with research. She has a good working relationship with Anna Rudin’s team and plans to establish more research exchanges with other researchers within and outside the Wallenberg Centre.
With the SOS study as a base, she is working now to find methods to determine which patients are likely to develop rheumatoid arthritis in 25 years. She’s working on establishing her group, which up to now consists of herself and a postdoc.
“Among other things, we’re going to investigate whether bariatric surgery affects the levels of various signaling molecules that are present in rheumatic diseases. We are especially interested in arthritic rheumatic diseases. We have a cohort of patients with early rheumatoid arthritis and a control group, which we will use to corroborate results from the SOS study,” says Cristina.
You can read more about Cristina Maglio’s research here: https://wcmtm.gu.se/research-groups/maglio
TEXT AND PHOTO: ELIN LINDSTRÖM CLAESSEN