Identification of Early Psoriatic Arthritis

描述（由申请人提供）：银屑病关节炎（PsA）是一种与银屑病相关的慢性、使人衰弱的炎性关节炎。迄今为止，大多数研究仅包括长期存在疾病的患者。我们从类风湿性关节炎（另一种类型的炎性关节炎）中了解到，早期识别和治疗可以改善对治疗的反应，减少关节损伤和残疾。这可能也是PsA的情况，但迄今为止，PsA很难在疾病过程的早期识别。此外，对PsA的早期阶段知之甚少。由于大多数PsA患者首先发展为银屑病， 银屑病代表了研究PsA发展的理想人群。在本申请中，我们提出了两种检测早期疾病的方法：1）确定银屑病患者发生PsA的危险因素，2）使用18 F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描和肌肉骨骼超声来确定银屑病患者的亚临床关节和关节周围炎症，可能是疾病的最早形式。这些研究不仅解决了识别早期疾病的两种潜在方法，而且通过这些创新的研究，我们将深入了解PsA发展的自然史和病理生理学。 候选人是一名风湿病学家和临床研究者，对炎症性关节炎，特别是银屑病关节炎感兴趣，具有非常适合K23指导职业发展奖的科学背景。她的目标是成为一个成功的，独立资助的临床研究者。通过概述的职业发展计划和拟议的研究，Ogdie博士将获得实现独立和实现长期目标所需的技能。宾夕法尼亚大学是进行拟议研究的理想环境。Ogdie博士将利用共同导师指导的两项现有R 01资助的研究来解决研究目标。凭借在风湿病学，皮肤病学，流行病学和放射学以及优秀的指导，设施和设备方面的巨大资源，Ogdie博士将为以患者为导向的临床和转化研究事业奠定坚实的基础。

DESCRIPTION (provided by applicant): Psoriatic arthritis (PsA) is a chronic, debilitating inflammatory arthritis associated with psoriasis. Most studies to date include only patients with long standing disease. We know from rheumatoid arthritis, another type of inflammatory arthritis, that early identification and treatment initiation improves response to therapy and decreases joint damage and disability. It is possible that this is also the case in PsA, but to date, PsA is very difficult to identify early in the course of disease. Furthermore, very little is known about he earliest phases of PsA. As the majority of patients with PsA first develop psoriasis, patients with psoriasis represent an ideal population for studies investigating the development of PsA. In this application, we propose two approaches to detecting early disease: 1) to identify risk factors for development of PsA among patients with psoriasis, and 2) to identify subclinical articular and periarticular inflammation in patients with psoriasis, possibly the earliest form of the disease, using 18F-Flurorodeoxyglucose Positron Emission Tomography/Computed Tomography and musculoskeletal ultrasound. Not only will these studies address two potential approaches for identifying early disease, but through these innovative investigations we will gain insight into th natural history and pathophysiology of PsA development. The candidate is a rheumatologist and clinical investigator with an interest in inflammatory arthritis, particularly psoriatic arthriis, with a scientific background ideally suited for the K23 mentored career development award. Her goal is to become a successful, independently funded clinical investigator. Through the outlined career development plan and the proposed research, Dr. Ogdie will gain the required skills to achieve independence and to address her long-term objectives. The University of Pennsylvania is the ideal environment in which to conduct the proposed studies. Dr. Ogdie will leverage two existing R01 funded studies directed by the co-mentor to address the research Aims. With tremendous resources in rheumatology, dermatology, epidemiology, and radiology as well as outstanding mentorship, facilities, and equipment, Dr. Ogdie will build a strong foundation for career in patient-oriented clinical and translational investigation.