Core 1

对风湿病的自然病史的新的理解，在风湿病的自然病史中，疾病前的状态可能是 已确定导致完成了对几种风湿性和自身免疫性疾病(例如1型)的预防研究 糖尿病、类风湿性关节炎)，还有许多其他试验正在进行中。潜在预防措施的出现 风湿性和自身免疫性疾病的治疗策略强调了充分了解 这些疾病发展的潜在机制，从它们的开始到对一种 尚未累及靶器官直到临床显性疾病阶段(S)的预测性生物标志物 和广泛的器官损伤。重要的是，由于过去几年的研究进展， 包括科罗拉多大学(CU)风湿病研究成员的一些数字 资源中心(RDRRC)建议，现在存在一种假设，即慢性炎症和 粘膜免疫系统内的生物失调是早期自我耐受打破的催化剂 无症状的个体以及临床疾病发展和增加目标的持续推动力 器官受损。这一假说在风湿性和自身免疫性疾病中的探索 疾病的演变阶段，以及体内多个部位的整合(例如血液、粘膜部位和 关节)，在研究设计中需要特殊的技能集，评估例如受试者报告的结果(例如，疼痛， 健康)和环境暴露(如饮食摄入量、烟草使用)、生物杀虫剂收集和 加工(包括血液和粘膜样本)和分析。为了解决这些重要问题， RDRRC的资源核心1：人口与数据科学是为高质量的 对风湿病的研究，以及对银行数据和生物制品的独特访问，以及 信息丰富的主题的生物信息库。这些活动将促进对地球自然历史的研究 风湿病周围黏膜突起的作用。重要的是，核心的活动预计也将 通过提供必要的支持和材料来招募新的调查人员进入这一领域，以促进他们的 认识和研究机会。总体而言，这些活动以及RDRRC的其他活动 应在了解疾病的发病机制、诊断和治疗以及 可操作的风湿病预防。

An emerging understanding of the natural history of rheumatic disease where a ‘pre-disease’ state can be identified has led to completed prevention studies in several rheumatic and autoimmune diseases (e.g. type 1 diabetes, rheumatoid arthritis), with many other trials underway. The emergence of potential prevention strategies in rheumatic and autoimmune diseases highlights the importance of fully understanding the mechanisms underlying the development of these diseases, from their initiation with being positive for a predictive biomarker yet without target organ involvement through to the phase(s) of clinically-apparent disease and extensive organ damage. Importantly, as a result of research advances over the past several years, including a number made by members of this University of Colorado (CU) Rheumatic Disease Research Resource Center (RDRRC) proposal, a hypothesis now exists for a key role of chronic inflammation and dysbiosis within the mucosal immune system as a catalyst for both the initial break in self-tolerance in asymptomatic individuals as well as a continued driver to clinical disease development and increasing target organ damage. Exploration of this hypothesis across rheumatic and autoimmune diseases through multiple evolving stages of disease, and the integration of multiple sites within the body (e.g. blood, mucosal sites, and joints), requires special skill sets in study design, assessments such as subject-reported outcomes (e.g. pain, well-being) and environmental exposures (e.g. dietary intake, tobacco use), biospecimen collection and processing (including blood and mucosal samples), and analyses. To address these important issues, the role of the RDRRC Resource Core 1: Population and Data Sciences is to provide advisory support for high-quality studies in rheumatic disease as well as unique access to banked data and biospecimens as well as ‘living biorepositories’ of informative subjects. These activities will facilitate research into the natural history of rheumatic disease around the role of mucosal processes. Importantly, the Core’s activities are also expected to recruit new investigators into this area by providing the support and materials necessary to facilitate their awareness and research opportunities. In aggregate, these activities as well as the other RDRRC activities should advance the field in terms of understanding disease pathogenesis, diagnosis and treatment, as well as actionable prevention of rheumatic disease.