Name
Lorraine Harper
Work Address
Renal Immunobiology
School of Immunity and Infection,
College of Medical and Dental Sciences
University of Birmingham,
Birmingham
B15 2TT
Present employment
10/10-present
4/2001-09/10
10/2006-10/07
Qualifications
Professor of Nephrology
Senior lecturer and honorary consultant (nephrology)
UHB NHS Foundation Trust, Birmingham
Head of Clinical Academic Training, College of
Medical and Dental Sciences, University of Birmingham
Director of Education Wellcome Trust Clinical Research
Facility, UHB NHS Foundation Trust
Immune Tolerance Network Clinical Fellow
Graduated Edinburgh University 1990
MRCP (London) 1993
PhD Birmingham University 2000
Research
I have an international reputation in studying ANCA vasculitis (AV) and its treatment, this
has implications for all autoimmune diseases collectively affecting 5-8% of population.
Mortality in these diseases remains high, primarily due to infection and 20% of patients with
AV will develop end-stage renal failure. Improved outcomes have a large impact on patients
and reduce health service costs.
Clinical studies are aimed at improving treatment and reducing adverse events. Collaborations
include the European Vasculitis study group (EUVAS) to design and undertake clinical trials;
PI on two large multi-centre trials, joint first author CYCLOPS study and anti-TNF paper, coinvestigator IMPROVE. I have developed an immunodeficiency clinic with immunologists to
study infection in immunosuppressed patients. This project follows my work with EUVAS
studying outcome in AV.
Recent laboratory studies have shown that the abnormal T cell phenotype in AV maybe
driven by CMV. This maybe amenable to anti-viral therapy and has implications for other
autoimmune disease, (with Moss, Birmingham). Genetic polymorphisms in AV has been
widely studied (with Smith, Cambridge, Vyse London, Gough Oxford). The role of protease
deficiency in disease has been studied (with Lomas, Cambridge). These studies identify new
targets for novel therapies.
Supervision Post-graduate students
MRes 2004 Neil Holden passed with distinction
Now post-doc on SSVT fellowship
MSc 2005 Saema Kusar passed with merit
Work presented in abstract form at (British) Renal Association Meeting 2006
PhD 2003-2006
Matthew Morgan (Clinical fellow) Health
Now locum senior lecturer in nephrology
PhD 2003-2007
Lavanya Kamesh (Clinical Fellow) NKRF Fellow (part-time)
MD 2003-2008
Alex Richter (Clinical Fellow) UHB NHS Trust (part-time),
MD 2009-2011
Andrew Maclean (clinical Fellow)
PhD 2009-2012
Shazia Shabir (clinical fellow)
Active Research Grants
MRC-CASE studentship - BLyS- a pathogenic role in ANCA-associated vasculitis
award £100000 Oct 11 – Oct 14 PI
UHB Charities – Fatigue in patients with ANCA-associated vasculitis August 09July 11 £68,995 PI
Novartis Research Grant – randomised pilot trial of the treatment of primary
proteinuric glomerulonephritis with myfortic compared with standard care – August
09-July 14 £350,000 PI
Recent Invited International Lectures
European Renal Association – Milan May 24th 09 Treatment of renal vasculitis
Royal College of Physicians – November 09 Treatment of vasculitis
British Transplant Society/Renal Association – April 09 Recurrence of
glomerulonephritis following transplantation
British Renal Society/Renal Association – May 08 CPD Session Glomerular Disease
Treatment of ANCA-associated vasculitis
Selected Publications (original research published in last 2 years)
1. Suppiah R, Judge A, Batra R, Flossmann O, Harper L, Hoglund P, et al. A
model to predict cardiovascular events in patients with newly diagnosed
wegener's granulomatosis and microscopic polyangiitis. Arthritis Care Res
(Hoboken)
2. Morgan MD, Pachnio A, Begum J, Roberts D, Rasmussen N, Neil D, Bajema I, Savage
CO, Moss PA, Harper L. CD4+CD28- T-cell expansion in Wegener’s granulomatosis is
driven by latent CMV and is associated with an increased risk of infection and
mortality. Arthritis Rheum (in press)
3. Arning L, Holle JU, Harper L, Millar DS, Gross WL, Epplen JT, et al. Are there specific
genetic risk factors for the different forms of ANCA-associated vasculitis? Ann
Rheum Dis. Aug 10.
4. Ferro CJ, Edwards NC, Hutchison C, Cockwell P, Steeds RP, Savage CO, et al. Does
immunosuppressant medication lower blood pressure and arterial stiffness in
patients with chronic kidney disease? An observational study. Hypertens Res. Oct
21.
5. Flossmann O, Berden A, de Groot K, Hagen C, Harper L, Heijl C, et al. Long-term
patient survival in ANCA-associated vasculitis. Ann Rheum Dis. Nov 24
6. Hiemstra TF, Walsh M, Mahr A, Savage CO, de Groot K, Harper L, et al.
Mycophenolate Mofetil vs Azathioprine for Remission Maintenance in
Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A Randomized
Controlled Trial. JAMA 2010;304:2381-8
7. Morgan MD, Drayson MT, Savage CO, Harper L. Addition of Infliximab to Standard
Therapy for ANCA-Associated Vasculitis. Nephron Clin Pract. Aug 6;117(2):c89-c97.
8. Wieczorek S, Holle JU, Bremer JP, Wibisono D, Moosig F, Fricke H, et al. Contrasting
association of a non-synonymous leptin receptor gene polymorphism with
Wegener's granulomatosis and Churg-Strauss syndrome. Rheumatology (Oxford).
Feb 25
9. Morgan MD, Day CJ, Piper KP, Khan N, Harper L, Moss PA, et al. Patients with
Wegener's granulomatosis demonstrate a relative deficiency and functional
impairment of T-regulatory cells. Immunology. Jan 27
10. Morgan MD, Ferro CJ, Harper L. An increased risk of ischemic heart disease in
Wegener's granulomatosis: Comment on the article by Faurschou et al. Arthritis
Rheum. Feb;62(2):637-8.
11. Carr EJ, Niederer HA, Williams J, Harper L, Watts RA, Lyons PA, et al. Confirmation of
the genetic association of CTLA4 and PTPN22 with ANCA-associated vasculitis. BMC
Med Genet. 2009;10:121 epub ahead of print IF 2.76
12. Kamesh L, Heward JM, Williams JM, Gough SC, Chavele KM, Salama A, Pusey C,
Savage CO, Harper L. CT60 and +49 polymorphisms of CTLA-4 are associated with
ANCA positive small vessel vasculitis Rheum 2009; 48:1502-5 IF 4.31
13. Morgan M, Turnbull J, Selemet U, Nightingale P, Ferro C, Harper L. Increased
incidence of cardiovascular events in patients with ANCA-associated vasculitis:
matched pair cohort study. Arthritis Rheum 2009;60:3493-500. IF 7.43
14. Little MA, Hassan B, Jacques S, Game D, Salisbury E, Courtney AE, Harper L. Renal
transplantation in systemic vasculitis: when is it safe? Nephrol Dial Transplant. 2009
Oct;24(10):3219-25 IF 3.5
15. Little M, Nightingale P, Hauser T, de Groot K, Savage C, Jayne D, Harper L. Early
mortality in systemic vasculitis: relative contribution of therapy-associated adverse
events and active vasculitis. Ann Rheum Dis 2009 epub ahead of print IF 6.79
16. Richter AG, McKewan S, Harper L, Thickett D. The role of pulmonary infection in
Wegener’s granulomatosis. Thorax 2009 ;64:692-7 IF6.23
17. de Groot* K, Harper L *, Jayne DRW, Gregorini G, Gross WL, Luqmani R, Pusey CD,
Rasmussen N, Sinico RA, Tesar V, Vanhille P, Westman K, Savage COS for the
European Vasculitis Study Group. Pulse versus daily oral cyclophosphamide for
induction of remission in ANCA-associated Systemic Vasculitis. A European,
multicenter randomised controlled trial. Annals Intern Med 2009 150:670-80 IF 15.5