“I always thought it would be cool to live abroad,” says Emerson Krock, a Canadian postdoctoral researcher at the Karolinska Institutet (KI) in Stockholm. “I grew up in Canada and went to school in Canada, so that was a big part of it. My PhD supervisor is Swedish and did her PhD in Sweden before coming to Canada. I thought it would be a good thing for my academic career to do an international postdoc. Sweden always seemed to be a feasible option if it wasn’t Canada or the US.”
After finishing his PhD in intervertebral disk degeneration research at McGill University, Emerson decided to shift focus slightly and look for a postdoc in pain research. As luck would have it he found one in Sweden with Camilla Svensson, a researcher whose work he had been interested in for years. The fact that her molecular pain group is at Karolinska Institutet, one of the world’s leading medical universities, helped make it an easy decision. “There are many really good labs that aren’t at prominent institutions, but having a prominent institution on your CV could definitely help in the future,” Emerson adds. “Especially if you aren’t applying for positions within your subdiscipline where everyone will know that really prominent lab at a small institute.”
Emerson’s postdoc research is centred on the mechanisms that cause pain in rheumatoid arthritis patients. Rheumatoid arthritis (RA) is an autoimmune disease, meaning it’s caused by the body’s immune system mistakenly attacking itself. Your immune system usually knows the difference between your own cells and foreign invaders like bacteria or fungus. When something foreign gets in your body, it’s recognized by antibodies which then activate your immune system to go and destroy the foreign invaders. But sometimes the immune system stops registering your own healthy cells, proteins, and tissues as yours and produces autoantibodies to attack them. In the case of RA, the autoantibodies attack the lining of the membranes around your joints and bones. The joints then become inflamed which causes chronic pain and swelling. Eventually, the cartilage in the joints gets destroyed and the bone erodes, warping the alignment of the joints.
At KI, Emerson is looking at how autoantibodies from RA patients lead to joint pain that is not connected to inflammation. In collaboration with rheumatologists at the Karolinska Hospital, the lab has cloned a number of autoantibodies from RA patients called ACPA which they then transferred into mice. While autoantibodies are normally mediators of inflammation, in the mice they lead to pain without the inflammation. This mimics actual RA patients who often experience chronic pain in their joints before they develop inflammation. About 70% of patients also have ACPA autoantibodies in their blood making it a strong indicator (along with joint pain) that they will develop RA. “We’re looking at how ACPA causes pain, but by effect, we’re looking at how you could stop pain or stop autoantibodies from causing pain in the absence of inflammation. If we understand that better when ACPA-positive patients go to physicians with joint pain but don’t have any clinical symptoms of RA, there might be a way to deal with their pain and also prevent the onset of RA,” explains Emerson. “We’re pain focused, but there’s another group at KI that is focused on the joint inflammation and bone destruction side.”
“One of the really neat things about KI is that it’s connected to a hospital so you have access to clinicians and patient samples and a lot of what I do is in collaboration with clinicians and uses patient samples,” he adds. “Collaborating with clinicians was something I did during my PhD and I was looking to continue doing it in some form as a postdoc. There are schools that have health science and life science programs, but they don’t have affiliated hospitals making that kind of collaboration more difficult.”
Through KI, Emerson was also able to quickly settle into life in Sweden and Stockholm. “The whole visa process was simple and KI did some of that legwork for me,” he says. The university also has furnished housing available that incoming international researchers and postdocs can apply for to ease the stress of finding their first place to stay. Each department also has HR representatives who sit down with new international staff and students once in Sweden to help them complete the immigration process and offer advice about setting up bank accounts and cell phones. “Sweden was a very easy place to move to. In a lot of ways, it reminds me of Canada. There are a lot of similarities.”
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