RhEumatoid Arthritis SynOvial tissue Network (REASON)

类风湿性关节炎滑膜组织网络 (REASON)

基本信息

批准号：
8851790
负责人：
Harris R Perlman
金额：
$ 25万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-26 至 2017-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8851790
关键词：
Address Affect Alabama Anti-Tumor Necrosis Factor Therapy Antirheumatic Agents Biological Markers Biological Response Modifier Therapy Biopsy Blood Cell Separation Cells Clinic Clinical Collaborations Degenerative polyarthritis Diagnosis Disease Disease remission Educational process of instructing Europe European Flow Cytometry Functional disorder Generations Genetic Goals Immunologics Individual Knowledge Link Medical Medical Economics Michigan Molecular Profiling Pathogenesis Pathologic Pathway interactions Patients Pharmacotherapy Phase Population Procedures Process RNA Refractory Replacement Arthroplasty Research Research Personnel Rheumatoid Arthritis Rheumatology Sampling Site Sum Synovial Membrane System TNF gene Techniques Technology Therapeutic Time Tissues Training Ultrasonography United States Universities Washington base clinical remission cost effective therapy insight laser capture microdissection macrophage medically necessary care minimally invasive nano-string novel peripheral blood programs public health relevance response response marker rheumatologist scale up success therapeutic target tool translational study

项目摘要

DESCRIPTION (provided by applicant): Substantial advances have been made in our understanding of the immunologic and genetic mechanisms that contribute to the pathogenesis of rheumatoid arthritis (RA). Although traditional disease modifying anti- rheumatic drugs (DMARDS) are effective, over 65-75% of patients do not respond to these therapies. Even with combination with anti-TNF therapy, no more than 50% of patients achieve remission. As many as 50% of anti-TNF refractory patients are also inadequate responders to second-line therapies. More strikingly, 24% of RA patients do not even demonstrate a minimal level of response to any therapy. Thus, identifying patients that may respond to anti-TNF therapy or other biologic therapies would greatly benefit the patient medically and economically. However, there is a lack of biomarkers in RA to identify the most effective therapy for a given patient due to the fact that few medical practices in the United States examine synovial tissue, as this requires a biopsy, which may not be medically necessary. Over the past several years ultrasound technology has become an important tool in the practice of rheumatology in the United States. Recently, minimally invasive ultrasound guided synovial biopsies have shown great promise, as there are minimal to no complications associated with the procedure. While this procedure is widely accepted throughout Europe, it has not become a common practice for rheumatologists in the United States. To address this unmet need in the United States, we have assembled a consortium of leading academic rheumatology groups which include the University of Alabama Birmingham, Columbia University, Mayo Clinic, Washington University, University of Michigan, and Northwestern University to form the RhEumatoid Arthritis SynOvial tissue Network (REASON). Thus, we will be creating a new generation of rheumatologists in the United States who will perform minimally invasive ultrasound guided synovial biopsies that is critical for obtaining of synovial tissue from patients at all phases of RA (early, established, DMARD or biologic inadequate response). These tissues will be analyzed by researchers at REASON technology sites who will use this material for translational studies to identify novel pathways and potential biomarkers that might predict therapeutic response.

描述（由申请人提供）：尽管传统的疾病缓解抗风湿药物（DMARDS）是有效的，但我们对类风湿关节炎（RA）发病机制的免疫和遗传机制的理解已经取得了实质性进展，但超过65-。 75% 的患者对这些疗法没有反应，即使与抗 TNF 疗法联合使用，也只有不到 50% 的患者达到抗 TNF 缓解。难治性患者对二线治疗的反应也不充分，更引人注目的是，24% 的 RA 患者甚至对任何治疗都没有表现出最低水平的反应，因此，识别可能对抗 TNF 治疗或其他生物治疗有反应的患者。然而，由于 RA 缺乏生物标志物来确定对特定患者最有效的治疗方法，因此在医学上和经济上都使患者受益匪浅。在美国，很少有医疗实践检查滑膜组织，因为这需要进行活检，而这在医学上可能不是必需的。在过去的几年中，超声技术已成为美国风湿病实践中的重要工具。超声引导的滑膜活检显示出巨大的前景，因为该手术的并发症极少甚至没有。虽然该手术在整个欧洲已被广泛接受，但在美国，它尚未成为风湿病学家的常见做法。这在美国，我们组建了一个由领先的风湿病学学术团体组成的联盟，其中包括阿拉巴马大学伯明翰分校、哥伦比亚大学、梅奥诊所、华盛顿大学、密歇根大学和西北大学，形成类风湿性关节炎滑膜组织网络 (REASON)。，我们将在美国培养新一代风湿病学家，他们将进行微创超声引导滑膜活检，这对于从 RA 各个阶段的患者身上获取滑膜组织至关重要（早期、已确定的 DMARD 或生物反应不足）这些组织将由 REASON 技术站点的研究人员进行分析，他们将使用这种材料进行转化研究，以确定可能预测治疗反应的新途径和潜在生物标志物。