OCTOR

Dr.Lv Liangjing

Deciphering the Secrets of Rheumatology

Dr. Lv Liangjing , a Professor in Rheumatology and Autoimmune Diseases, serves as the Chief Physician of the Rheumatology Department at Renji Hospital. 

    He currently holds the position of Vice Dean at Renji Clinical Medical College of Shanghai Jiao Tong University School of Medicine, Deputy Director of the Rheumatology Department at Renji Hospital, Lead Scientist for the National Key R&D Program “Precision Medicine Research,” Deputy Director of the Shanghai Institute of Rheumatology, and Visiting Scholar at Cedars-Sinai Medical Center in the United States. He is also Vice President of the Rheumatology and Immunology Physician Branch of the Shanghai Medical Doctor Association, Standing Committee Member of the Rheumatology and Immunology Physician Branch of the Chinese Medical Doctor Association, Member of the Vasculitis Group of the Rheumatology Branch of the Chinese Medical Doctor Association, Member of the Rheumatology and Immunology Specialty Branch of the Shanghai Medical Association, Vice Chairman of the Pregnancy Immunology Specialty Branch of the Shanghai Medical Association, and Member of the Rare Diseases Committee of the Shanghai Medical Association.

    Selected as one of the first experts in the National Health Science Popularization Expert Database, he is also an expert for the Shanghai Medical Accident Appraisal Committee, Shanghai Judicial Appraisal Committee, Shanghai Labor Capacity Appraisal Committee (Medical and Health Expert, Work Injury Rehabilitation Medical Expert), and Medical/Preventive Vaccination Appraisal Expert of the Shanghai Medical Association. He serves on the editorial boards of “Chinese Journal of Rheumatology,” “Journal of Diagnostics Concepts & Practice,” “Shanghai Medical Journal,” “Medical Reference News Rheumatology and Immunology Channel,” and “Frontiers in Immunology,” and is a Clinical Consultant for the Chinese edition of UpToDate. He is a member of the Lupus Research Group of the Asia-Pacific League of Associations for Rheumatology (APLAR) and the Asian Lupus Nephritis Network (ALNN).

    He has led over ten projects, including the National Key R&D Program on Precision Medicine and the National Natural Science Foundation of China, and has chaired multiple clinical studies. He has published over 200 academic papers in domestic and international journals such as NEJM, BMJ, Lancet Rheumatology, Annals of the Rheumatic Diseases, Arthritis & Rheumatology, and Rheumatology (150 of which are SCI-indexed). His work has been cited in four international guidelines, and he has contributed to 11 domestic and international guidelines and consensuses (leading two). He holds three patents and has received honors including the First Prize of the Ministry of Education’s Science and Technology Progress Award and the First Prize of the Shanghai Science and Technology Progress Award.

    In the field of early warning and prevention of complications in rheumatic diseases, his major achievements include:

    * Enhancing the predictive ability of infections in rheumatic diseases and effectively distinguishing infections from disease activity. His team has established a series of early warning models for severe infections in SLE and improved early diagnostic methods for fungal lung infections in SLE patients, elucidating risk factors for Pneumocystis jirovecii infection in dermatomyositis. These results have been published in over 10 SCI papers and earned a Shanghai Invention Gold Award, with some findings incorporated into the 2020 “Expert Consensus on Candidiasis Diagnosis and Treatment.”

    * Exploring targeted drug delivery for precision treatment. His team developed a hormone nanocarrier drug to precisely deliver hormones to affected organs, reducing hormone resistance and systemic side effects, and filed a patent. They also constructed and explored the therapeutic effects and clinical application value of nanoparticles encapsulating HIF-1α siRNA in rheumatoid arthritis models.

    * Addressing the severe disease activity and mortality risks in SLE and other autoimmune diseases during pregnancy, as well as adverse pregnancy events such as miscarriage and stillbirth. His team established a prospective cohort for immune-related adverse pregnancies, proposed precision immune intervention strategies to improve pregnancy success rates, and registered and implemented a multicenter clinical study(iLIFE). They successfully explored strategies for preventing neonatal atrioventricular block and preventing hepatitis B virus reactivation in pregnant women with rheumatic diseases. He has been invited to contribute to seven related guidelines and consensuses, helping thousands of patients realize their “motherhood dreams.”

    In the exploration of innovative treatments for rheumatic diseases:

    * He conducted foundational and clinical research on the 1.1-class Chinese innovative drug Iguratimod for RA, publishing six papers and first proving it as a new disease-modifying drug for RA (A&R 2009), leading to its global launch and inclusion in the Asia-Pacific RA treatment guidelines. He later explored its application in SLE.

    * He pioneered the completion of research on adipose-derived mesenchymal stem cell therapy for knee osteoarthritis in China, demonstrating its superior clinical potential. Two SCI papers were published, and the project was included in the first batch of projects filed with the National Health Commission.

    In real-world research and patient management for rheumatic diseases, he has conducted extensive work on the disease burden, intervention evaluation, and quality of life of RA and other rheumatic diseases, establishing the first real-world research model for RA from the perspective of China’s healthcare system. He is also a pioneer in rheumatology internet platforms, having founded the WeChat public account “Rheumatology Doctor-Patient Communication Platform” nine years ago, which now has over 30,000 followers. He has explored new models for standardized management and education of rheumatology patients.

    Research Focus:    His primary research direction focuses on precision strategies for prevention, diagnosis, treatment, and management of major rheumatic diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), as well as clinical and scientific research on rheumatology and pregnancy.

Preface

In the eternal river of time, certain souls radiate with a luminescence all their own, guiding humanity forward through darkness.

Born into a lineage steeped in medicine, his childhood was cradled by the whispers of stethoscopes and the fragrance of antiseptics. A seed—yearning to mend broken lives—took root in his heart. Nurtured by the wisdom of generations, it grew silently, unfurling into a blossom of purpose under the sun of perseverance.

Beacon of Hope. 

Today, he stands as a pillar in China’s field of rheumatology and immunology, his expertise a lighthouse for countless patients adrift in storms of uncertainty.

1.The Path being a doctor

    In Dr. Lv Liangjing's memory, his great-grand-aunt, who was a doctor, always had a neat short haircut, wore a gray robe, and had a serious expression. She led him with dignity and solemnity towards the room filled with bottles and jars. On the way, people would always greet her friendly. They respected and admired this female doctor. "My great-grand-aunt was among the first batch of Western doctors in modern China. People addressed her as 'Master' I could feel the weight that the word 'doctor' carried in people's hearts, and I developed a wonderful impression of this profession from my young age." 

    Dr. Lv Liangjing's family has been engaged in the medical profession for generations. Many of his relatives enjoy great prestige in the local area and are the guardians of the local people's health. Perhaps it was precisely because of being born into such a family and being influenced by it since childhood that the seeds of medicine quietly took root and sprouted in his heart. 

    His father, also a renowned local doctor, had a clear plan for his son's future. "When filling out the college entrance examination application forms, my father filled them out for me by himself. All the majors, from key universities to technical secondary schools, were related to medicine. He hoped that I could make progress in the field of medicine." 

    Dr. Lv Liangjing lived up to his father's expectations. With excellent grades, he was admitted to the key class of Fujian Medical University, his father's alma mater. Here, Dr. Lv Liangjing not only acquired solid medical knowledge but honed his clinical skills through practice. His talent and hard work were recognized by his teachers, and he quickly stood out among his classmates. 

    After graduating from university, with his outstanding academic performance and solid medical foundation, Dr. Lv Liangjing smoothly advanced to study for a master's degree in hematology at the Fujian Institute of Hematology. During his study and work at the institute,Dr.  Lv Liangjing received comprehensive professional training and practical opportunities. He participated in the diagnosis and treatment of various blood diseases, accumulating valuable clinical experience. At the same time, he also participated in the department's scientific research projects, gaining a deeper understanding of the pathogenesis and treatment strategies of blood diseases. 

    However, after witnessing a young patient on the verge of death due to lupus erythematosus, he was deeply touched. He felt that China was still lagging behind the world in the diagnosis and treatment of complex diseases such as rheumatic and immune diseases. This also inspired his determination to further his studies and exploration, and eventually, he decided to change his major to study rheumatic and immune diseases. "I can still remember that during each follow-up visit, she looked more haggard than before, and finally, she passed away." Dr. Lv Liangjing recalled, a trace of sadness flashing in his eyes. "This incident made me deeply realize that as a doctor, I should conduct research on immune diseases and be able to help more patients." This was an important turning point in Dr. Lv Liangjing's life. 

    By chance, he learned that Professor Chen Shunle from Shanghai Renji Hospital was an authority in the field of rheumatic and immune diseases in China. He decided to apply for the postgraduate program under Professor Chen, hoping to explore the mysteries of rheumatic and immune diseases more deeply under the guidance of this master. After arduous efforts and preparations, Dr.  Lv Liangjing was finally admitted to Renji Hospital with excellent grades and became a student of Professor Chen Shunle. 

    "I still clearly remember the day I walked into Renji Hospital for the interview. I met Director Chen Shunle, the legendary leader of the 'Southern School' of rheumatology, for the first time. He nodded with a smile and accepted me. This moment marked my successful transformation from a hematologist to a postgraduate majoring in rheumatology. When following Professor Chen Shunle during outpatient consultations, I witnessed his extremely meticulous inquiry and physical examination, as well as his keen insight into patients' psychology and patient counseling. We attended academic conferences together, and he always spared no effort to introduce us to renowned experts in the international rheumatology field. During the breaks of the conferences, he would take us to have coffee and watch movies... Many of my first experiences and touching moments in life are engraved in my heart." 

    In fact, the conditions at that time were still very difficult. When Dr. Lv Liangjing entered Renji Hospital full of anticipation, the department had just started, with simple facilities, few hospital beds, and a serious shortage of staff. "At that time, our department could be said to be in a state of having nothing."Dr. Lv Liangjing said with a smile, but a glimmer of pride shone in his eyes. "But it was precisely such an environment that inspired our infinite potential and creativity." 

    Under the guidance of Professor Chen Shunle, Dr. Lv Liangjing began his research and exploration in the field of rheumatic and immune diseases. He started from scratch, accumulating experience bit by bit, and gradually formed his own characteristics and advantages. Professor Chen's rigorous academic attitude and deep concern for patients deeply influenced Dr. Lv Liangjing. He gradually understood that as a doctor, one should not only have excellent medical skills but also a heart full of love for patients. 

    As time went by, Dr. Lv Liangjing gradually achieved success in the field of rheumatic and immune diseases. He also became an elder in the academic community and a name card of the hospital. However, he has never forgotten his original intention, which is to use his medical skills to treat more patients and warm every life with his love. "Medicine is not just a science; it is also an art."Dr.Lv Liangjing often said, "We should, like artists, feel the pain of each patient with our hearts and heal their souls with our love."

2.Growth on the land of Renji Rheumatology

    Under the leadership of Professor Chen Shunle and Professor Gu Yueying, the Department of Rheumatology of Renji Hospital has developed step by step. Now it has become a national key clinical specialty, with 120 hospital beds and an annual outpatient volume of nearly 300,000 person-times. This leapfrog development is inseparable from the unremitting efforts and struggles of our team members over decades. 

   
 The Department of Rheumatology of Renji Hospital has played a pioneering and foundational role in the research of systemic lupus erythematosus (SLE) in China. Over the years, the discipline has carried out a series of innovative research projects. Through a large number of clinical observations and studies, the team has proposed a systematic treatment plan for SLE patients. 

    First of all, the team has conducted in-depth research on the pathological mechanism of SLE, clarifying the disease development process and influencing factors. SLE is a complex autoimmune disease, and the fluctuations of its condition are related to the abnormal activation of various immune cells and the imbalance of cytokines. Based on these findings, recently, Dr. Lv Liangjing and his team put forward the concept of immunomodulatory therapy. Through targeted drugs and other treatment methods, they precisely regulate the patients' immune systems, restore immune homeostasis, reduce autoimmune reactions, and thus control the disease condition. 

    In terms of drug treatment, Dr. Lv Liangjing is extremely cautious about the high-dose hormone treatment method that was commonly used in the past, because long-term and large-dose use of hormones will bring serious side effects, such as osteoporosis, diabetes, etc. He advocates the use of an appropriate amount of hormones combined with other immunosuppressants, such as cyclophosphamide and methotrexate, to reduce the side effects of hormones while effectively controlling the disease. 

    In addition, Dr. Lv Liangjing emphasizes the importance of personalized treatment. Since the condition and constitution of each patient are different, the treatment plan needs to be adjusted according to the specific situation of the patient. During the treatment process, doctors need to closely monitor the changes in the patient's condition and adjust the treatment plan in a timely manner to achieve the best treatment effect. 

    In terms of non-drug treatment, Dr.  Lv Liangjing advocates comprehensive treatment, including psychological intervention, nutritional support, physical therapy, etc. He realizes that SLE patients often suffer from psychological problems such as anxiety and depression, which will seriously affect the patients' quality of life and treatment effect. Therefore, it is very necessary to provide psychological counseling and support for patients. 

    Nutritional support is also an important part of Dr. Lv Liangjing's treatment plan. He guides patients to have a reasonable diet to ensure a balanced nutrition, so as to improve the patients' physical quality and resistance. In addition, he has also introduced physical therapy, such as joint exercises and hydrotherapy, to relieve patients' joint pain and muscle stiffness. 

    Systemic lupus erythematosus was once considered a forbidden area for childbearing, and it was almost an impossible task for SLE patients to get pregnant and have children. However, Dr. Lv Liangjing's mentor, Professor Chen Shunle, decided to use his own strength to break this situation. Through a large number of clinical observations and studies, they proposed a systematic treatment plan, which successfully helped many female SLE patients safely pass through their pregnancies and give birth to healthy babies.

    Now, he has taken over the baton from his mentor and continues to be committed to the research of immune-related pregnancies. He has launched a multidisciplinary outpatient clinic and clinical research on rheumatic pregnancies, and provides the most suitable treatment plan for each patient and family. At present, he has helped nearly thousands of patients with rheumatic and immune diseases fulfill their dreams of becoming mothers. Whenever he sees the photos of cute and well-behaved babies sent by the mothers, a sense of accomplishment as a doctor wells up in his heart. 

    "Our goal is not just to treat diseases, but also to help patients rebuild their lives," Dr. Lv Liangjing said. His treatment plan reflects his deep concern for patients and his persistent pursuit of the medical cause. 

    In Dr. Lv Liangjing's office, there are piles of various medical books and research materials. On the wall hang banners presented by SLE patients. Each banner carries the patients' gratitude and respect for him. Here, he is not only a doctor but also an explorer, using knowledge and wisdom to light up the lighthouse of patients' lives. 

    "Whenever I see these banners, I will think of the patients' smiles, which is my greatest happiness." 

    In recent years, Dr. Lv Liangjing has taken the lead and successfully completed the national key research and development plan precision medicine special project of "Precision Prevention, Diagnosis and Treatment Strategies for Major Autoimmune Diseases Based on Systems Biology". Under his leadership, the team has continuously made breakthroughs and innovations. Their research achievements have been published in top domestic and foreign medical journals and have been transformed into practical clinical treatment effects, benefiting thousands of patients. 

    "Research and clinical practice complement each other. We identify problems in research, then solve clinical problems, and summarize the results to guide research. This cycle drives us forward continuously." 

    Dr. Lv Liangjing is well aware that the treatment of rheumatic and immune diseases is a long and complex process that requires the joint efforts of doctors, patients, and all sectors of society. He has not only made outstanding contributions in the medical field but also actively advocated for the attention and support of rheumatic and immune diseases in society. 

    The year 2010 was an important year in the history of the Department of Rheumatology of Renji Hospital. The project "Pathogenesis and Clinical Treatment Technology of Systemic Lupus Erythematosus" hosted by the department won the Second Prize of the National Science and Technology Progress Award. Dr.  Lv Liangjing accompanied Professor Chen Shunle to the Great Hall of the People in Beijing to receive the award. 

    "The capital city of Beijing was covered in silver and the winter was cold and brisk in January of that year. When I held the heavy and brightly red award certificate for him, an indescribable feeling of emotion welled up in my heart. This honor carried his 31 years of painstaking efforts and also embodied the unremitting efforts of all the brothers and sisters in the Department of Rheumatology of Renji Hospital." 

    Although the Department of Rheumatology of Renji Hospital is already a leader in China, Dr. Lv Liangjing feels that what he has done is far from enough. "The research and treatment of rheumatic and immune diseases require more talents, more resources, and more attention. I hope that more people will join our team and bring hope to patients together." 

    As time goes by, Dr. Lv Liangjing now has gray hair quietly appearing on his temples, but his love for medicine and his concern for patients have never changed. He has used his actions to interpret what it means to have a benevolent heart as a doctor and what it means to be a great doctor with sincerity. 

    "The road of medicine is endless. Whenever I see the smiling faces of patients who have recovered, all the efforts and sacrifices become worthwhile."

3."Raise" Talents and Promote Research Progress

    Professor Dr.  Lv Liangjing has always been pondering over the future development trends in the field of rheumatology. He realizes that with the advancement of science and technology and the deepening of the understanding of disease mechanisms, the diagnosis and treatment of rheumatic diseases will become more precise and personalized. At the same time, the exploration of new treatment methods, such as gene editing and cell therapy, will also bring new hope to patients with rheumatic diseases. 

    
    "The future of rheumatology will definitely develop towards a more precise and personalized direction. We need to continuously explore new treatment methods, such as targeted therapy and biological agents. At the same time, we should also pay attention to the overall health of patients and improve their quality of life. I believe that with the development of science and technology, we will definitely be able to bring more blessings to patients." 

    Currently, Dr. Lv Liangjing has established a clinical cohort for systemic sclerosis, a rare rheumatic disease, and has mapped the first single-cell skin atlas of this disease in the East Asian population. The research results have been published in Arthritis & Rheumatology, the official journal of the American College of Rheumatology and a top journal in the field of rheumatology. It has just been rated as one of the top ten research highlights in the field of rheumatology and immunology in China in 2023. 

    Systemic sclerosis is a rheumatic disease with the highest mortality rate, mainly characterized by microvascular lesions and fibrosis of multiple organs such as the skin. It is based on the pathophysiological foundation of the imbalance between the innate immune system and the adaptive immune system. Currently, the treatment mainly focuses on anti-fibrosis treatment, which can relieve the condition to a certain extent, but cannot cure or prevent the progression of the disease in patients. Therefore, the team will focus on further exploring its pathogenic mechanism and looking for new targeted treatment strategies in the future. 

    "Moreover, we will conduct in-depth research on the current clinical challenges in rheumatology - refractory systemic lupus erythematosus (SLE) and the involvement of vital organs in SLE that endanger life, including the diagnosis and treatment strategies for refractory nephritis, pulmonary arterial hypertension, interstitial pneumonia, premature atherosclerosis, pregnancy, infection, and central nervous system lesions. We will search for and discover biomarkers related to disease assessment and prognosis judgment, and ultimately propose new diagnosis and treatment plans to provide a scientific basis for the standardized clinical treatment of SLE. We strive to establish a series of optimized diagnosis and treatment plans. We hope to form diagnosis and treatment norms/guidelines and clinical pathways through various clinical research and promote their application. We will establish early warning and early diagnosis criteria for these complications and build a management platform to improve the treatment rate and the rate of meeting treatment goals, and reduce complications and mortality. We aim to achieve significant landmark achievements in the innovation and promotion of key clinical appropriate technologies, the level of diagnosis and treatment technologies for difficult and complex diseases, and innovative clinical applications." 

    In Professor Dr. Lv Liangjing's future plan, talent cultivation occupies an important position. He is well aware that the development of medicine is inseparable from the inheritance and innovation of generations of medical talents. He hopes that through his words and deeds, he can cultivate more medical talents with ideals and a sense of responsibility to contribute to the development of rheumatology. 

    When cultivating students, Dr.  Lv Liangjing attaches great importance to the following qualities and abilities: First and foremost, a sense of responsibility is the most important. Students should be able to take responsibility for their own studies and behaviors. Secondly, moral character is crucial, including being honest, trustworthy, upright, and kind. Then come learning ability, innovative thinking, problem-solving ability, communication skills, and teamwork ability. 

    "Talent cultivation is the foundation of the development of medicine. I hope that my students can inherit and carry forward our medical spirit and continuously explore the unknown areas of medicine. I will do my best to provide them with the best learning environment and research conditions to help them move forward on the path of medicine." 

    Dr. Lv Liangjing advocates "integrating education into clinical practice". The vast majority of his students will eventually take up clinical positions as doctors. Integrating education into clinical practice can not only ensure the cultivation of students' clinical abilities but also enhance their clinical interest and promote their growth. Through the analysis and discussion of actual cases, especially complex and challenging cases or explorations of innovative clinical treatments, students can experience the real clinical situation and treatment process firsthand. Students should be encouraged to observe, follow up on cases, summarize them, and submit them for publication. He has found that once students can get their work published, it can greatly stimulate their clinical enthusiasm. 

    The presentation of difficult and rare cases, the exploration of innovative clinical treatments, and the sharing of doctors' experiences and insights are medical traditions with a long history. As early as in the era of Hippocrates or even in ancient Egypt, doctors began to record interesting and valuable medical cases. Therefore, their clinical value is beyond doubt, and they are an important part of clinical research, especially having great significance for the cultivation of medical students and young doctors. They can also reflect the clinical strength of the hospital and the discipline. 

    "I have always attached great importance to the diagnosis, treatment, and research of difficult and rare rheumatic diseases. In recent years, my students and I have accumulated a large number of cases during our busy outpatient work. We have published more than 20 reports on case analysis, experience sharing, and explorations of innovative treatments in internationally renowned clinical top journals such as The New England Journal of Medicine (NEJM), British Medical Journal (BMJ), Lancet Rheumatology, Canadian Medical Association Journal (CMAJ), Quarterly Journal of Medicine (QJM), Annals of the Rheumatic Diseases (ARD), Arthritis & Rheumatology (AR), and a sub-journal of the Journal of the American College of Cardiology (JACC). These reports have had a wide impact in relevant fields at home and abroad. They have provided important clues for further research on disease mechanisms, the launch of multicenter randomized controlled trials (RCTs), and even the change of concepts in disease diagnosis and treatment. They have also cultivated a group of excellent medical students with a solid theoretical foundation and rich practical experience." 

    Now, the Department of Rheumatology of Renji Hospital has become a well-known rheumatology research center at home and abroad. Dr. Lv Liangjing hopes that through his own efforts, he can build the department into a world-class rheumatology research and treatment platform and provide the best medical services for rheumatism patients around the globe. 

    "I hope that we can continue to move forward hand in hand, continuously improve our scientific research level and clinical treatment capabilities, and build our department into an internationally renowned rheumatology research center to bring hope to more patients. Medicine is a marathon without an end. We need to keep running and keep surpassing. I believe that as long as we persevere, we will definitely be able to bring more hope and light to patients. This is my dream and also my responsibility."

Interviewed by Gong Zhiwei 

Edited by Chen Qing

If you'd like to contact to Dr. Lv Liangjing, Please contact us with chenqing@ShanghaiDoctor.cn.

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