The 'CARDIOvascular-Immune-Mediated Inflammatory Diseases (CARDIO-IMID) UK Network'

目的：通过汇集英国在心血管和IMID研究方面的专业知识、提高认识、改进诊断和监测方法以及增加该领域的研究，改善有心血管(心血管；心脏和血管)受累风险的免疫介导性炎症性疾病(IMID)患者的预后。背景：英国有100多万人受到IMID的影响，免疫系统的异常行为会导致关节、皮肤和内脏发炎。最常见的IMID是类风湿性关节炎，但也包括系统性红斑狼疮和系统性硬化症等罕见疾病。与普通人群相比，IMID患者的死亡风险高出3-4倍，其中心血管疾病是主要原因之一。未得到满足的需求：我们没有标准的方法来诊断IMID患者的心血管疾病，这可能会延误诊断。我们不知道如何识别和监测最有可能患心血管疾病(CVD)的患者。对IMID患者的临床试验不评估CVD，所以我们没有很好的证据来证明哪些治疗方法可以改善心血管疾病的结果。发现脑血管病的关键成像方法是循环伏安磁共振成像(CMR)和PET-CT。CMR是安全和非常准确的，但CMR措施并不是为IMID患者量身定做的。PET-CT是一种有效的识别炎症的工具，但其获得的途径是不同的。目的：我们将建立一个全国性的网络，“心脏IMID英国网络”，并已经在英格兰、苏格兰、威尔士和北爱尔兰确定了29个中心。该网络将把简历和IMID专家聚集在一起，并使我们能够：1.将来自CV和IMID领域的医生和研究人员以及患者群体聚集在一起，以改进教育和培训，并制定国家研究战略。这将导致为IMIDs患者量身定做的护理途径以及更好的诊断和治疗方法。开发一个数据库平台，以安全地存储、管理和分析跨中心的IMID和心血管疾病患者的临床和心脏调查数据，以便我们可以在未来进行研究。建立与IMID和简历有牵连的现有和新人的患者登记。这将是一个宝贵的资源，以更好地了解不同IMID的心血管病变的特征，并为未来的研究提供信息，以改进诊断和测试治疗。引入统一的CMR和PET-CT扫描和诊断方法，这样英国各地的IMID患者的评估方式就可以在不同中心进行比较。将上述登记册与国家倡议联系起来，例如从不同IMID患者那里收集样本的NIHR IMID生物资源4b。开展一项试点研究，在这项研究中，从登记招募的一组患者中获得的临床、影像和血液标记物数据将建立在更大范围内进行这项工作的能力，并为设计提供信息，以发现有助于诊断和开发新治疗方法的标记物。5.与业界建立合作伙伴关系，以便能够在赠款期限之后进行内部投资和伙伴关系的可持续性；并开发针对有心血管疾病风险的IMID人群未得到满足的需求的研究。我们得到了关键合作伙伴小组的重要支持，包括(I)现有的国家IMID网络，将识别患者并制定研究项目(Ii)NIHR-抗关节炎肌肉骨骼翻译研究合作，一个IMID学术专家网络和量身定制疗法的新研究(Iii)NIHR-BHF心血管伙伴关系，一个由心血管研究人员组成的全国性合作组织，它支持召开心脏IMID英国网络社区。

Objective: To improve the outcomes of people with Immune-mediated inflammatory diseases (IMID) who are at risk of/have cardiovascular (CV; heart and vessels) involvement, by bringing together the UK's expertise in CV and IMID research, raising awareness, improving methods of diagnosis and monitoring and increasing research in the field.Background: Over a million people in the UK are affected by IMIDs in which abnormal behaviour of the immune system causes inflammation of the joints, skin and internal organs. The most common IMID is rheumatoid arthritis, but also includes systemic lupus erythematosus and rare diseases such as systemic sclerosis. People with IMIDs are 3-4 times at higher risk of dying compared to the general population, with CV involvement one of the major causes.Unmet needs: We do not have standard methods to diagnose CV involvement in people with IMIDs, which can delay diagnosis. We do not know how to identify and monitor patients most at risk of CV disease (CVD). Clinical trials of people with IMIDs do not evaluate for CVD, so we do not have good evidence on which treatments improve CV outcomes. Key imaging methods that detect CVD are CV magnetic resonance imaging (CMR) and PET-CT. CMR is safe and very accurate but CMR measures have not been tailored to people with IMIDs. PET-CT is an effective tool to identify inflammation, but its access is variable. Also, it is not clear which patients with abnormalities may develop actual problems later.Aims: We will establish a national network, the "CARDIO IMID UK Network" and have already identified 29 centres across England, Scotland, Wales and Northern Ireland. The Network will bring together CV and IMID experts and allow us to:1. Bring together doctors and researchers from the CV and IMID fields and patient groups to improve education and training, and develop a national research strategy. This will lead to pathways of care tailored to people with IMIDs and better methods of diagnosis and treatment.2a. Develop a database platform to securely store, manage and analyse clinical and heart investigation data from people with IMIDs and CV involvement across the centres so that we can conduct studies in the future.3b. Establish a patient registry of existing and new people with IMIDs and CV involvement. This will be an invaluable resource to better understand the features of CV involvements across different IMIDs and inform future studies to improve diagnosis and test therapies.3. Bring in uniform methods for CMR and PET-CT scanning and diagnosis so people with IMID across the UK are assessed in a way that is comparable across centres.4a. Link the above registry with national initiatives such as the NIHR Bioresource for IMID that collects samples from people with different IMIDs4b. Conduct a pilot study in which clinical, imaging and blood marker data obtained from a subgroup of patients recruited to the registry will establish capability to do this on a larger scale and inform the design to discover markers to help diagnose and develop new treatments5.Establish collaboration with industry to enable inward investment and sustainability of the partnership beyond the duration of the grant; and the development of studies to target the unmet needs of this IMID population at risk of CVD. We have crucial support from key partner groups including (i) existing national IMID networks which will identify patients and develop research projects (ii) the NIHR-Versus Arthritis Musculoskeletal Translational Research Collaboration, a network of academic experts in IMIDs and novel research to tailor therapies (iii) the NIHR-BHF Cardiovascular Partnership, a national collaborative of CV researchers, which has supported the convening of the CARDIO IMID UK Network communityIf successful, the MRC-funded 'CARDIO-IMID UK Network' will be one of the largest national interdisciplinary initiatives that will have a major impact on people with IMIDs.