Researcher Spotlight: Dr Kenneth Baillie

Dr Kenneth Baillie is a consultant in critical care medicine at the Intensive Care Unit of Edinburgh Royal Infirmary. He holds Wellcome Trust Intermediate Clinical Fellowship and works at the Roslin Institute at the University of Edinburgh where he is looking into the genetics of why some people are more likely than others to get flu. We asked him to tell us more about his research and the motivation behind it..

What are you working on?

My main interest is trying to find human genes that make people susceptible to flu.

The flu virus mutates so quickly that it evolves resistance to antiviral drugs with terrifying speed, but we know that it depends on our own proteins to replicate. My hope is that the genes that make some people get very sick, or even die, from flu will lead us to drug targets that we can use to make susceptible patients become resistant.

Similar approaches can yield important insights in other diseases too. Ultimately my aim is to exploit the information from genomics to better understand and treat critical illness.

What does your average day involve?

Much of my research is computational, so I spend most of my time sitting in front of a computer. To an observer it would look boring, but when I think I’m onto something good (which is most days, but usually a false positive) I sit at my desk with my heart racing.

I think one of the biggest selling points for a career in science is the freedom to follow whatever ideas you like. I can have an idea on the way to work and then spend a week obsessing over it, and no-one bats an eyelid.

I always have several active projects, and I try to work on whatever is exciting me at a particular moment.

Why is your work important?

I have a lot of statistics to show that flu is a big killer, and that pandemic flu is potentially a very serious threat, but the same argument can be made for many diseases. For me, as I think is the case with most doctors who do research, the importance is more personal. I think the biggest single factor that pushed me to work on this problem was the incredulity of a bereaved relative of one of my patients – how can a young, healthy person die of flu in the 21^st century?

I share that incredulity with respect to many common problems in critical care: we see people deteriorate over days, one organ failing after another, all from the host response to infection. It must be possible to prevent it, but we still haven’t found effective ways to intervene to help people survive.

What do you hope the impact of your work will be?

I want to find new treatments for critical illness, particularly flu.

Probably the surest way for me to do that would be to become a trialist and start resolving some of the many therapeutic questions in critical care medicine, but my work is primarily basic science, where we work on the assumption that understanding disease will one day help us to treat it.

The hope is that we will come up with completely new approaches that will be more effective than the current treatments. In critical care that bar is very low: besides antimicrobials, we have very few treatments that make any direct difference to the progression of disease.

How did you come to be working on this topic/in this field?

I chose to train in critical care medicine because I love the physiology, and the mystery of sepsis and critical illness. There are so many unanswered questions that I can’t imagine ever running out of challenges.

Another reason is that, back in 2003, it seemed like a field that was taking off. Three big studies were published that promised to radically cut mortality: early goal-directed therapy, intensive glycaemic control, and activated protein C. Unfortunately all three were to some extent discredited in the following decade, but by then I was already hooked.

How has Wellcome funding helped you/your research/your career?

It has been completely invaluable.

Wellcome funded my clinical academic training through the Edinburgh Clinical Academic Track (ECAT) scheme. I can’t overstate the impact of this scheme on my progression. In particular it gave me access to the best mentorship I could hope for, and guided me into the field I now work in.

Right now Wellcome funding is enabling me to establish my lab and follow up on some very exciting findings, and to visit Broad Institute, where I am working with some of the most brilliant people in biological science.

What’s the most frequently asked question about your work?

“Can you predict who will get sick from flu?”

People make the assumption that genetics is about prediction. But predicting who will get sick is no use unless you can do something about it.

I don’t want to find a better way to tell which of my patients should write a will. I want to find a way to send them home alive. Genetics is potentially a very powerful way to do that, but it will take a long time.

Which question about your work do you most dread – and why?

“How long will it take to find a cure?”

A perfectly understandable question, but the answer can only be known in retrospect. Also the word “cure” makes it impossible to answer without sounding extremely unrealistic.

Tell us something about you that might surprise us…

It isn’t a world record, but to my knowledge no-one has ever completed the circumnavigation of the Baltic Sea by bicycle relay faster than a team of 15 people, including me, in 2000. (It took 13 days, 10 hours, and 23 minutes, in case you are wondering.)

What keeps you awake at night?

My kids. Particularly when they are ill.

Also since I presumably share genetic susceptibility to viral infections with them, when they get sick, I get sick. A sensible approach would be for all of us to swap children on day one so that we get fewer of the nursery bugs.

What’s the best piece of advice you’ve been given?

Before I chose my PhD project, Derek Angus (University of Pittsburgh) told me: “Find the best scientist in your university, and go work for them”.

The chain reaction question, set by the previous spotlit research Dr Helen Lee is: “What lessons have you learned from doing your research that could help other scientists?”

I’m really just starting out as an independent scientist, so I have a great deal yet to learn. So far I think the biggest lesson has been to tackle important questions.

It is quite daunting to think of how many brilliant people are already working on flu already – it seems almost arrogant to think that I could make any contribution on top of their efforts. But everyone has a different approach, and the more perspectives we have, the better chance we’ll make big advances.

You can find out more about Dr Kenneth Baillie’s work on the Roslin Institute website or by reading his papers on Targeting the host immune response to fight infection and A promoter-level mammalian expression atlas.

Image Credit: Representation of influenza virus, Anna Tanczos, Wellcome Images