Meet VF Young Investigator Cecilia Barnini, MD
“The problem with rare diseases like vasculitis,” Cecilia Barnini, MD, said, “is there are not enough doctors and specialists able to recognize the disease, so the people affected by it can’t really get the help they need.” This is why Dr. Barnini is excited to delve into the field of vasculitis research. While her curiosity for science has been with her since childhood, for her, this work will always be about the people behind the science.
Cecilia Barnini, MD, recently received the Vasculitis Foundation’s Young Investigator Grant, an award that provides funds to young researchers at institutions throughout the world to explore or pilot promising studies in vasculitis. The goal? To increase the number of vasculitis researchers by encouraging and training young physicians focused on vasculitis. And, ultimately, to improve the quality of life for people living with the disease and find a cure.
Dr. Barnini isn’t afraid of a challenge. When she did her residency in internal medicine in Italy, the COVID pandemic was raging. “It was hard,” she said. “A really stressful period. But something like that can really give you power. I started to feel like, Okay, we can do this. If you work together, you can really do anything.” It was a lesson in resilience and community—when we pool our talents, our love, our care, and our knowledge, leaps forward are possible.
This lesson prepared her for the ambitious vasculitis project she’ll be undertaking with the support of the Young Investigator Grant. The research project has an international scope, involving two vasculitis centers, one in Austria, at the Medical University of Innsbruck (where she is currently a PhD candidate) and another in the Netherlands at the University Medical Center Groningen (where she’ll spend a period of time working on the project). She’ll be working and learning alongside two senior investigators, Assistant Professor Kronbichler, MD, PhD, and Professor Bajema, MD, PhD. Together, their aim is to “discover something more about the mechanism behind ANCA-associated vasculitis,” with a particular focus on the kidneys.
Essentially, they want to understand the disease process itself: Why is this happening? How is the immune system involved? And how can they take this knowledge and use it to positively transform the trajectory of patients with renal involvement?
To do this, they’ll study the kidney biopsies of patients with ANCA-associated vasculitis. They’ll compare these biopsy reports with reports from patients impacted by other renal diseases. “We know there’s something in common between these diseases,” Dr. Barnini explained. “So we would like to compare the two to understand something more about ANCA-associated vasculitis.” In other words, how can discovering both the similarities and differences between kidney-involved diseases, including vasculitis, deepen their knowledge of what’s really at the root of ANCA-associated vasculitis?
The ultimate goal is for their discoveries to impact treatment protocols for people with vasculitis. “This project is not about merely understanding more about the background of vasculitis,” Dr. Barnini said. It’s not science for science’s sake. Instead she insists it’s about “bringing what we discover to our patients, from the microscope to the bedside.” In ANCA-associated vasculitis, several organs can be impacted, but, she says, “the kidney is often involved and it changes the prognosis of the whole disease and impacts quality of life.” What if they could flip that prognosis on its head? What if the disease-mediated damage could be stopped earlier, thereby limiting its impact on the kidney? The project could have significance for both diagnosis and treatment: a better understanding of the underlying pathological process could impact diagnosis, leading to better patient management.
It also has the potential to lead to tailored responses to the disease. As Dr. Barnini explains, “Nowadays, more and more therapeutic options are available. The inevitable question becomes: Which therapeutic regimen fits each individual patient best? In this sense, our goal is to understand more about the disease process in order to better differentiate between the needs of each patient and provide the best personalized treatment.”
“For both patients and doctors,” Dr. Barnini admitted, “research can seem very theoretical. But what’s important to understand from this project is that the more we discover in our research, the more we’ll be able to address the patient’s needs.”
Dr. Barnini insists that this—addressing a patient’s needs—is why she’s chosen to pursue this research. When you work in clinic, she explained, “you have a really strong connection with the patient, with the human being. And that’s the most powerful thing to me, still. In my research, the people are always my final aim…Science that is not related to that really doesn’t have any value.”
In fact, Dr. Barnini believes that connecting with—and truly listening to people living with vasculitis—is essential to her work and the work of any medical provider. “As a doctor, we can put ourselves in a paternalistic point of view, when you think you know everything that’s going on. That’s not working. Especially for rare diseases like vasculitis, it’s really important to connect with the patient.”
“When you first start studying medicine,” she went on, “you start with a book. You already know the disease because you’re studying the disease…But when you start talking with a human being, you understand that what’s in the book is just the first step in the process of understanding. Sometimes, as a doctor, you can think you know: This is the disease and this is the treatment. But the connection with the patient is very powerful; people can really help you understand what’s their need. That’s the game changer.”
The best medicine is always a collaboration.
Dr. Barnini is “honored” to receive this grant from the Vasculitis Foundation and get the chance to work alongside the project’s designers, Professors Bajema and Kronblicher. She says, “Collaborating with two world experts in the field of vasculitis is very inspiring to me.” She’s also eager to receive support from an organization she respects: “I really see how the Vasculitis Foundation is advocating for vasculitis, how they’re both searching for and supporting new doctors and specialists who are able to treat this disease, and how they’re helping people affected by it to know what’s available to them.” This matters in particular, she said, because “not everywhere in the world is vasculitis care so easily available.”
Her work has the potential to have profound impacts on people living with the disease but, she insists, “I don’t feel myself to be so important. The more you study, the more you realize that you’re just a small drop.” It is the project itself—and the people behind that work—that matter. “I really hope this project will bring the field somewhere. Not just science for science, but science for people.”
Written by Ashley Asti
