Abdominal Obesity and Risk of Developing Rheumatoid Arthritis in Women

Bing Lu headshot
Bing Lu, MD, DrPH

Individuals with obesity, particularly abdominal obesity, are at an increased risk of hypertension, dyslipidemia, diabetes, coronary heart disease, stroke, cancer, and all-cause mortality. Several studies have observed an association between obesity and increased risk of rheumatoid arthritis (RA). Abdominal obesity is associated with visceral fat and has been a stronger predictor of obesity-related health risk, such as cardiovascular disease, than overall obesity as measured by BMI. We sought to investigate whether abdominal obesity per se predicts RA risk in two large prospective cohorts, the Nurses’ Health Study (NHS) and Nurses’ Health Study II (NHSII).
Read More

Metabolic Pathways in Monocyte Development Identified Using HoxB8 Model Cells

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

Using CyTOF Mass Cytometry and RNA-seq to Identify New Cell Populations in Arthritis

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

Human Subject Recruitment via JBC is Helping to Unravel Role of PTPN22 in RA Development

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

The Joint Biology Consortium: A New Resource for Translational Research in Rheumatology

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.

Read More

Exercise enhancement among Rheumatoid Arthritis patients: Research from the Brigham and Women’s Hospital Rheumatoid Arthritis Sequential Study

Iverson MD, Frits M, von Heideken J, Weinblatt M, Shadick NA.  Physical activity and correlates of physical activity participation over three years in adults with rheumatoid arthritis.  Arthritis Care Res (Hoboken) 2017;69(10):1535-1545. PMCID:PMC5436948

The Brigham and Women’s Hospital Rheumatoid Arthritis Sequential Study (BRASS) was founded 14 years ago by Drs. Nancy A. Shadick and Michael Weinblatt to study genetic and clinical predictors of disease activity, biomarkers of disease response, and the natural history of patients with rheumatoid arthritis (RA) treated in the biologic DMARD era. Over 1,400 patients with either new onset or established RA disease have been recruited from the practices of Brigham and Women’s Hospital rheumatologists.  At annual visits, information is collected on multiple variables, including demographics, disease activity score (DAS), medication use, co-morbidities, and functional status. More than 1,200 clinical variables are collected at each six month timepoint, which allows for the generation of extensive phenotyping and clinical analyses.

Read More

Over 40 Years of Rheumatology Clinical Research at Brigham and Women’s Hospital

Brigham and Women’s Hospital Division of Rheumatology, Immunology and Allergy

In 1977, Dr. Matthew Liang founded the clinical research group in rheumatology at Brigham and Women’s Hospital (BWH).  The original funding for this group derived from the NIH Multipurpose Arthritis Center program.  Dr. Lawren Daltroy, a behavioral scientist, joined Dr Liang in 1982, and they pursued several innovative behavioral trials focusing on lupus, back pain, and Lyme disease. The faculty grew during the 1980s and 1990s with the addition of Drs. Jeffrey Katz, Nancy Shadick, and Elizabeth Karlson.

Read More

Trauma and PTSD May Bring on Systemic Lupus Erythematosus in Women

Andrea L. Roberts, PhD, Susan Malspeis, MS, Laura D. Kubzansky, PhD, Candace H. Feldman, MD, Shun-Chiao Chang, ScD, Karestan C. Koenen, PhD, Karen H. Costenbader, MD, MPH Arthritis & Rheumatology, 2017;69(11):2162-2169.

Systemic lupus erythematosus (SLE) is an enigmatic inflammatory autoimmune disease. A widely-accepted etiologic model for SLE is that environmental exposures “trigger” the disease in genetically-predisposed individuals. The epidemiology of SLE – 80-90% of cases occur in women, and disease severity is much greater in African-American and non-white populations – points to the obvious role of genetics, and genome-wide association studies have identified many genetic factors associated with SLE susceptibility. Meanwhile, there is a growing list of exposures which have also been associated with SLE risk in epidemiologic studies, which include current cigarette smoking, crystalline silica, pesticides, and oral contraceptives and postmenopausal hormones among women. Models for how these and other environmental exposures may contribute to autoimmune disease pathogenesis include elevating concentrations of systemic inflammatory cytokines, increasing oxidative stress, and impairing T-cell function.

Read More

Different Cardiovascular Risks in Gout Patients Initiating Probenecid Versus Allopurinol

Cumulative Incidence Curves of the Composite Endpoint of MI or Stroke

Cardiovascular Risks of Probenecid Versus Allopurinol in Older Patients with Gout. Seoyoung C. Kim, Tuhina Neogi, Eun Ha Kang, Jun Liu, Rishi J. Desai, MaryAnn Zhang, Daniel H. Solomon. Journal of the American College of Cardiology Mar 2018, 71 (9) 994-1004; DOI: 10.1016/j.jacc.2017.12.052

Inflammation plays a critical role in the pathogenesis of both gout and cardiovascular disease (CVD). It is well known that patients with gout are at an increased risk of CVD, including myocardial infarction (MI), stroke, and heart failure (HF). While it remains controversial whether uric acid is causally linked to the development of CVD, beneficial effects have been reported for allopurinol, the most commonly used urate-lowering drug, on lowering blood pressure and improving endothelial function and metabolic profile. Probenecid is another, older drug used for gout. It works as a competitive inhibitor of the organic anion transporter, producing uricosuria, as well as an inhibitor of pannexin 1 channels, an ATP release channel involved in the assembly and activation of the inflammasome. The NLRP3 inflammasome plays a critical role in production of IL-1β, which drives the inflammatory cascade that results in acute gout. Thus, it is possible that probenecid may have positive effect in gout patients not only by lowering serum urate levels, but also by reducing production of IL-1β.

Read More