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Determined doctor's quest is inspired by patients' battles

THERE are two kinds of people in this world:

the ones who instinctively want to skip to the end of a book and those who meticulously scour every page. By his own admission, Professor Iain McInnes falls firmly into the latter category, which is perhaps just as well given the painstaking nature of his work.

The clinician and Glasgow University academic has spent a decade spearheading research into rheumatoid arthritis with his expertise in high demand around the world. Most recently his time has been devoted to the setting up of a Rheumatoid Arthritis Centre of Excellence (RACE) in Glasgow which it is hoped will see the university become a global leader in the field.

As diseases go, rheumatoid arthritis may not be the sexiest but Professor McInnes isn't in this for glamour. His core impetus, he insists, comes not from the plaudits of his peers but from helping those most affected by the debilitating condition.

"My patients inspire me and in turn they drive me," he says. "To be honest I don't like the word 'patients'. I prefer to use the term 'people with rheumatoid arthritis'. The term 'patients' suggests a state of illness. What I want to try and do is give people as much of their normal life back as possible.

"People may come through the door with a diagnosis, but they still have the same ambitions for life: they want to have families, to love their grandchildren, to go to work - and why shouldn't they?"

His interest in the field was first sparked as an undergraduate when Professor McInnes, 49, took time out from his medical degree to study immunology. He went on to complete a PhD before spending two years honing his skills in rheumatology at the National Institutes of Health in the US.

On return to Scotland in 1999, he took a senior post at Glasgow University where his many hats include director of the Institute for Infection, Immunity and Inflammation, a role which incorporates overseeing the Wellcome Trust Centre for Molecular Parasitology and MRC Centre for Virus Research.

The RACE initiative, which received a £2.5million grant from Arthritis Research UK, will be led by Glasgow University from its Biomedical Research Centre in partnership with the University of Birmingham and Newcastle University.

"There is a long history of rheumatology in Glasgow and next year we will have the 50th anniversary of the Centre of Rheumatic Diseases - it all started almost half a century ago in Baird Street," says Professor McInnes.

"We have a proud track record in the clinical presentation of rheumatic diseases, but over the past decade we've developed a passionate interest in why they occur at a cellular and molecular basis, not least what makes the immune system attack the joint."

His own work has included not only attempting to change the way in which rheumatoid arthritis is widely treated and perceived, but examining a possible link between chronic inflammation and an increased risk of heart attack or stroke as well as conditions such as depression.

"Increasingly we recognise inflammation is one of the things that drive vascular disease," he explains. "We know people are more likely to have heart attacks and strokes if they have a level of inflammation and that's just in the general population. As you can then imagine with rheumatoid arthritis the whole thing is accelerated."

Another key area of interest to Professor McInnes is the associated psychological problems of the disease.

"It may seem self-evident that if you have pain and swelling in your joints you would feel depressed about that," he says.

"But one of the things we are starting to recognise is that it is more than just a response or emotional reaction to having a chronic disease. What we are seeing is that some of the molecules that cause damage to joints can also affect the blood vessels within the brain which can lead to depression, difficulty concentrating and fatigue."

Professor McInnes runs a weekly clinic at the Royal Infirmary in Glasgow where his patients range from teenagers through to those in their late 80s and 90s. "Unfortunately rheumatoid arthritis is not a respecter of age and its impact can be felt in any of those decades of life," he says. "There is great need in the east end of Glasgow - there is no secret about that.

"Very few of our people with arthritis come in with only one problem: they will often have other medical, social or employment challenges. That makes for demanding medicine, but also a great sense of fulfilment when we get it right."

From an early age, Professor McInnes had firm ideas of the path his own life would take. The eldest of three brothers, he grew up in Burnside, near Glasgow. His father John, a mathematician, worked in management at the famed Weir Pumps in Cathcart while his mother Janice is a retired dentist.

"For as long as I remember, I said I was going to be a doctor," he says. "I'm not entirely sure I ever had any other personal ambition so I've been very fortunate in that respect."

Although a keen rugby player and golfer as a youngster, Professor McInnes describes himself as "too boring" to have posters on his bedroom wall.

He took up singing in his senior high school years, a passion that has endured throughout his adult life.

"I'm not in a choir now but I do sing whenever I get the invitation to," he says. "For many years I sang in stage shows, musicals, operetta and oratorio. I would sing around the country for choirs that needed a tenor. Now I sing exclusively for fun - and far less than I would like to."

He and his wife Karin, 50, a nurse, met through work. "Her life ambition was to make sure she never married a doctor - she didn't want to be that cliche," he jokes. Yet, somehow he won her round and the couple have two daughters Megan, 16, and Rebecca, 13.

Both children share their father's love for song as well as playing golf, hockey and going horse riding. "When I'm not working everything is devoted to family," he says. "The kind of things we do for fun is go and watch the girls play hockey. We have tickets for the hockey at the Commonwealth Games this summer. We went to London 2012 and thoroughly enjoyed that.

"The greatest pleasure is seeing my own children are now keen singers. Megan is in the High School of Glasgow Chamber Choir which has done well recently. They won the BBC Songs of Praise Senior School Choir of the Year 2013 and are quite exquisite and a joy to listen to. Becky has a real gift with animals and is a talented horse rider as well as working her way up through the school choirs."

"I often travel for work and a decision we made was that my family would travel with me whenever possible," he adds. "Their most exciting trip was to China recently. My children are actually well-known figures in the rheumatology community because I take them to so many meetings."

Whether his offspring will follow in his footsteps remains to be seen but his own vigour towards his chosen vocation shows few signs of waning.

"A major driving force for me is that I'm intensely curious," he says. "What we do is incredibly interesting and like a fantastic novel where you never quite get to the last chapter. But, as anyone who has ever read good book knows, you don't actually want it to end."

The Rheumatoid Arthritis Centre of Excellence (RACE) will be officially launched in June.

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