Professor Guy Brusselle is the Chair of the European Respiratory Society (ERS) Science Council. We asked him about his work, the opportunities ERS presents its members to further their scientific activities, and why patients should get involved.
Could you start by giving us an overview of your work – what are your key areas of interest?
I am a respiratory doctor at Ghent University Hospital in Belgium. I mainly work with people with conditions like asthma and chronic obstructive pulmonary disease (COPD) on an outpatient basis, and I supervise trainees.
I teach medical students about respiratory medicine and how to design clinical trials. I love teaching and getting difficult questions from students; it is the best way to learn and stay in touch with the latest developments.
I also coordinate translational scientific research. This means getting lab findings into clinical practice to help patients; as well as taking things from the individual to the population level. My main area of activity is severe asthma, in which we have seen huge advances over the last 5 to 10 years. More treatments are becoming available – such as targeted therapies, which are providing huge benefits to the right patients. It is really rewarding to see my work having this impact.
What led to your interest in this field?
I was interested in medicine and wanted to become a doctor as a teenager. I am not from a medical family; my parents are economists. While studying at the University of Ghent, I met the late Professor Romain Pauwels, one of the founders of the Global Initiative for Asthma (GINA), who invited me to do some research on chronic airway inflammation in asthma. It was thanks to him that I decided to become a respiratory physician doing both clinical and translational research.
Within ERS, you are Chair of the Science Council. What does this involve?
ERS has three councils for each of its main pillars: advocacy, education and science. I oversee the Science Council, which is split into four areas of activity, each of which has its own director. Rory Morty is Fellowships and Awards Director, Rachel Chambers is Conferences and Research Seminars Director, Chris Brightling is the Clinical Research Collaboration (CRC) Director and Marc Miravitlles is Guidelines Director. It is a pleasure to work together with four dedicated excellent ERS Directors as well as the outstanding ERS staff.
Could you give an overview of ERS’s scientific activities?
Firstly, the ERS Science and Education councils collaborate on the programme for the ERS International Congress, which delivers over 500 sessions to over 23,000 lung health experts each year. For this year’s Congress in Paris, we have already received over 6,000 abstracts from people who want to present their latest findings in respiratory science, medicine and patient care .
ERS produces independent, trustworthy guidelines and technical standards for doctors and patients on the diagnosis and management of a range of lung conditions. The European Lung Foundation (ELF) is critical in supporting this work by helping to produce simplified versions of these guidelines in a range of languages and making them available to people with lung conditions.
Each year, ERS also gives out over 60 fellowships, enabling clinicians and researchers – usually in the earlier stages of their career – to go abroad and work or train in a different hospital or lab, which is a superb experience for them. International mobility is crucial, and these fellowships often help to lay the ground for longer-term collaborations between centres across Europe and beyond.
We also organise a range of research seminars throughout the year, as well as the Lung Science Conference in Estoril, Portugal each March. This smaller, interactive conference aims to give the next generation of scientists a boost with their research, offering them a platform to meet with leaders in the field.
Finally, ERS currently has 15 Clinical Research Collaborations (CRCs), pan-European networks of researchers and clinicians who are collaborating on specific conditions. These include EMBARC, which focuses on bronchiectasis, and SHARP, on severe asthma. Another CRC is the Global Lung Function Initiative (GLI), which has been doing a superb job in developing reference values for different lung function tests.
There are so many unique opportunities for members to foster and facilitate their scientific activities. I would really recommend visiting the ERS website and reading the newsletter to find out more.
What role do patients currently play within ERS scientific activities?
From the outset of any ERS task force – a group set up to produce a new guideline – ELF is involved and helps bring patient representatives in to take part. Patient involvement at this stage helps ensure that the right questions will be answered and that the guideline will be relevant to a patient’s daily life and how their condition affects them. Once a guideline has been published, ELF also helps disseminate it among people with lung conditions by producing shortened versions, factsheets or other online tools.
Within CRCs, patient involvement is growing, which is great to see. For example, SHARP has two patient chairs on the steering committee, who sit alongside two academics in this key advisory position.
Patient participation is important, and we love working with ELF on our activities – I hope that we can do even more of this. I think we must also remember that we represent all of Europe – and sometimes the whole world. Working only with English-speaking patients can mean that the UK is overrepresented, and that those from other countries who speak English as a second language are often highly educated. However, we know that lung conditions disproportionately affect those of lower socioeconomic status. We should be aware of this selection bias and try to make sure that we involve a wide range of people from many European countries to make sure that our work is as representative as possible.
Could you share an anecdote that shows the value of patient participation?
On the last day of the ERS International Congress in 2016, when delegates are tiring and ready to go home, there was a session on inhalers. There were some superb presentations from worldwide technical experts and also two patient speakers – one was a colour blind patient who talked about the difficulties relating to this and the use of inhalers.
The other patient speaker was a mother of a child with cystic fibrosis who was asked: “what is the best inhaler?” Her answer was “the best inhaler would be the once-weekly inhaler”. She struggled every day with her child to use the inhaler three or four times. This was a superb answer and gave a totally new perspective which could never be given by a physician but only by a patient or carer. Currently we are proud to be releasing a once a day inhaler, which is a step towards the once-weekly inhaler, for which we have a research proposal. It may take 20 years, but we are working towards it.
We know it is challenging for patients to travel to Congress and to speak at sessions, but it is so important – and mind-opening – to add their thoughts and wishes to the conversation.
What would you say to patients that might be considering participating in scientific projects?
Getting involved is so important. Patients can and should be vital partners in shaping a research project and the questions it sets out to answer.
Participation in clinical trials is vital to the development and approval of new treatments – but there are also many more studies that need to be done to learn about the real world effects of a drug, the impacts of long-term use and how the drug compares with other treatments, and patients will need to play a key role in these.
What inspires you most about your work?
The beauty of ERS and of clinical research is that there are no boundaries; we collaborate at the global and pan-European level, and it is totally different from the political world. I am also a Professor at the Erasmus Medical Center in Rotterdam, where we have PhD students from all over the world; it makes for a very stimulating and international environment. I am currently supervising students from the Netherlands, Belgium, Syria and Chile.
I also like that if you combine the clinical work with patients with the scientific research, you get novel insights, which can lead to new treatments. Unfortunately this takes time. For example, my first paper, in 1993, identified a potential treatment target for asthma. A few days ago, a trial on a treatment that uses this target was presented at the American Thoracic Society conference. It took 25 years to develop this drug for severe asthma. We should move faster to make new effective drugs available.
Is there anything else you would like to add?
It is extremely important to thank my family, and especially my wife, who enables me to do this work. My ERS activities are done mostly in my spare time; it is important to meet a partner who supports you in your scientific work or else it is not possible.
I like to ask and answer research questions. The science and research drives me to do this job within ERS. This is the same for many people within ERS, who are ultimately coming together to improve patient outcomes, and help them to live longer and feel better.
