RA-associated interstitial lung disease (RA-ILD) is one of the most common extra-articular manifestations of RA and is correlated with increased mortality. We recently performed a study investigating disease activity and RA-ILD risk using the Brigham RA Sequential Study (BRASS), which has followed more than 1,500 patients over time, some for up to 15 years, and has generated a wealth of clinical and biomarker data.
Patients with RA and OA all experience chronic pain but safe options for analgesia are limited. While NSAIDs (selective and non-selective) are commonly used in rheumatology, they can cause major toxicity. Improving the risk/benefit ratio requires a more precise understanding of risk. This study, published in Arthritis & Rheumatology, was undertaken to derive and validate a risk score for major toxicity among NSAID users enrolled in a prior randomized controlled trial.
Cardiovascular (CV) disease is a major concern for patients with systemic rheumatic diseases. In a recent study, we examined disease‐modifying antirheumatic drug (DMARD) treatmentsand estimated the risk of a subsequent CV event among patients who experienced a first CV event and had rheumatoid arthritis (RA), psoriatic arthritis (PsA) or psoriasis.
Metabolism is a hot topic in immunology. Immune cells carry out diverse functions by exploiting different pathways of taking in nutrients and generating energy. Accordingly, metabolic processes such as glycolysis and oxidative phosphorylation are now front and center in understanding how cells behave in the context of normal and pathogenic immune responses. Read More
The inflamed joint is a complex place. Many different types of cells must interact with each other to initiate and sustain inflammation and tissue injury. These include both those resident in the joint before inflammation started and cells that were recruited or developed later. To get a handle on this complexity, investigators need methods that can provide highly detailed portraits of individual cells. A major goal of the Joint Biology Consortium’s Cellular Systems Core, directed by Dr. Jim Lederer, is to accelerate research by JBC members through two such methods: cytometry by time of flight (CyTOF) mass cytometry and RNA sequencing (RNA-seq). Read More
A single genetic variant in PTPN22 has been known for over a decade to convey risk for rheumatoid arthritis (RA), but exactly how remains a mystery. Led by rheumatologist and researcher Dr. I-Cheng Ho, investigators at BWH are using the JBC to understand PTPN22 as a regulator of citrullination, the post-translational protein modification of arginine that plays a leading role in RA biology. Read More
Conducting high-quality translational research in rheumatology is increasingly difficult. Major projects often require a range of methods, from patient recruitment to cutting-edge ‘omics technologies to big-data bioinformatics. Most research groups lack the expertise to cover this range, and so must either limit the scope of their work or expend substantial effort working outside their “comfort zone” to achieve their research goals. Neither of these options efficiently advances the science of rheumatology.
Along with inflammatory arthritis, overproduction of autoantibodies is a defining feature of rheumatoid arthritis (RA), particularly autoantibodies against citrullinated proteins (ACPAs). The clinical significance of these ACPAs, other than for diagnosing RA, has been unclear. Previous studies have focused on association studies between a few ACPAs and one or two specific RA phenotypes – for example, an association between anti–citrullinated histone H2B antibodies and coronary artery calcium scores in patients with RA. But such an approach cannot identify potential associations with a wider array of untested phenotypes.
Big data will drive precision medicine in rheumatology. At Brigham and Women’s Hospital (BWH), the combination of massive databases with genomic and clinical data will open new capabilities for the diagnosis, care, and even prevention of rheumatic disease. BWH has invested in large-scale data collection that is now is bearing fruit. The Partners HealthCare Biobank repository of DNA, plasma, and serum samples now has more than 78,000 participants, with 20,000 genotyped samples, as well as survey data with family history, lifestyle and environmental information.