The MAHSC (Manchester Academic Health Science Centre) inaugural lecture series highlights the achievements of distinguished clinical academics across Greater Manchester. This prestigious series recognises individuals who have made significant contributions to research, education, and clinical practice.

This lecture featured Professor Pauline Ho, a Consultant Rheumatologist at the Kellgren Centre for Rheumatology, Manchester University Foundation NHS Trust (MFT), and a leading researcher in psoriatic arthritis.

Her pioneering work in ultrasound diagnostics, genetic research, and clinical trials has transformed patient care and research in rheumatology, earning her a role as a MAHSC Honorary Clinical Chair.

A Journey Across Continents

Professor Ho’s story began in Jiangmen, China, near Hong Kong. Her family’s journey was one of resilience and adaptation—her grandfather was a famous dim sum chef in Hong Kong, and her father followed in his footsteps, moving to Cwmbran, South Wales, to work as a chef. At 13 and a half years old, Pauline arrived in the UK without knowing any English. Armed with a dictionary and determination, she quickly adapted, excelling in her studies despite challenges that came her way.

Attending Llantarnam Comprehensive School, she met a dedicated biology teacher, Mr. Miles, who set up an A-level biology class just for her. With his support and her perseverance, Pauline achieved top grades and secured a place at Cardiff Medical School.

Discovering a Passion for Rheumatology

While studying medicine, Pauline was awarded Medical Research Council (MRC) funding to complete a B.Sc. in intercalated biochemistry before graduating with first-class honours. A top medical student, she secured a competitive house officer rotation in South Wales. It was during this time that she first encountered rheumatology—and immediately knew it was her calling.

However, she faced scepticism from the medical school dean, who advised her to pursue geriatrics or radiology instead. Undeterred, she completed her membership exams and left Wales where she secured a highly sought-after rheumatology training position in Manchester.

Pioneering Research in Psoriatic Arthritis

As a clinical training fellow, Pauline embarked on groundbreaking research in psoriatic arthritis, a complex condition affecting the joints, spine, tendons, skin, and even eyes and gut. Working alongside Professor Anne Barton and Professor Ian Bruce, she led one of the first large-scale genetic studies in psoriatic arthritis, recruiting over 500 patients by personally visiting their homes to collect data and samples.

Her dedication earned her an MRC Clinical Research Training Fellowship, allowing her to complete a PhD in the genetics of psoriatic arthritis at The University of Manchester. Her research has since led to major genetic discoveries, contributing to personalised medicine approaches for psoriatic arthritis treatment.

Transforming Rheumatology Through Ultrasound

Recognising the importance of early diagnosis in preventing irreversible joint damage, Pauline became a pioneer in musculoskeletal ultrasound for rheumatology. With minimal training opportunities, she took matters into her own hands—attending a basic weekend course, then an advanced weekend course, and quickly implementing the technique in clinical practice.

Starting with a fundraised basic ultrasound machine she has since developed a state-of-the-art ultrasound service which she deems is the “Rolls-Royce” version. The technology allows clinicians to visualise inflammation in joints and tendons, distinguishing between active and inactive disease, guiding treatment, and even identifying disease in seemingly unaffected joints.

Her expertise has also been instrumental in major clinical trials, including the APIPPRA study, which investigates preventive immunotherapy for high-risk rheumatoid arthritis patients.

Advancing Personalised Medicine with Biopsy Research

Professor Ho has led the development of synovial biopsy research in Manchester, pioneering the collection of joint tissue samples using ultrasound guidance. This innovative technique has positioned the The Kellgren as the leading centre in the North West for synovial tissue research and enabled participation in cutting-edge clinical trials.

By analysing inflammatory cells and molecular markers in synovial tissue, her work is advancing precision medicine, aiming to match patients with the most effective treatments based on their unique disease profile.

Global Collaborations and Future Directions

As part of The University of Manchester’s Rheumatology Research Group, Professor Ho has collaborated with leading scientists across Europe, co-authoring landmark genetic studies published in Nature Genetics. These high-impact publications have significantly advanced the understanding of the genetic basis of autoimmune rheumatic diseases.

She has also co-supervised research on the microbiome in psoriatic arthritis, exploring the role of gut bacteria in disease development.

Her latest research focuses on multi-omics, integrating data from genes, proteins, and immune cells to gain deeper insights into disease mechanisms. This work is currently being done by her PhD clinical fellow, Dr. Ryan Hum, who has successfully obtained the 4Ward North PhD Fellowship from the Wellcome Trust to apply the cutting-edge techniques to psoriatic arthritis tissue samples, paving the way for new treatments.

Q&A Highlights

Balancing Clinical Work and Research

“You’ve successfully managed to combine a busy clinical career with building a significant research portfolio. What were the biggest challenges you faced along the way?”

Pauline: “Time! But I loved it so much that I made the time. It’s definitely a challenge, but if you have the passion, you just keep going.”

Advice for Aspiring Rheumatologists

“What advice would you give to younger colleagues who want to pursue a similar pathway?”

Pauline: “If you have the passion, no one can stop you—just go for it! Find mentors who support you and take every opportunity that comes your way.”

Manchester as a Hub for Rheumatology Innovation

“Your ultrasound and biopsy work are unique in the North West. Are other sites in the UK doing similar work?”

Pauline Ho: “Yes, there are centres in London, Newcastle, and Edinburgh, but we are the only ones in the North West leading this area. It’s exciting to be at the forefront of innovation here.”