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：
9130014
负责人：
Harris R Perlman
金额：
$ 14.72万
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/9130014
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 Health 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 response response marker rheumatologist scale up success targeted treatment 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（由应用提供）：在我们对有助于类风湿关节炎（RA）发病机理的免疫和遗传机制的理解中，已经取得了重大进展。尽管传统疾病改变了抗毒药（DMARDS）是有效的，但超过65-75％的患者对这些疗法没有反应。即使结合了抗TNF疗法，也不超过50％的患者可以缓解。多达50％的抗TNF难治性患者对二线疗法的反应者也不足。更引人注目的是，有24％的RA患者甚至没有表现出对任何治疗的最低水平。那就确定可能对抗TNF疗法或其他生物治疗的患者在医学和经济上会极大地使患者受益。但是，RA中缺乏生物标志物来确定给定患者的最有效疗法，因为在美国，很少有检查滑膜组织的医学练习，因为这需要活检，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的重要工具。最近，微创超声引导的滑膜活检表现出巨大的希望，因为与该过程没有最小的并发症。尽管该程序在欧洲被广泛接受，但它尚未成为美国风湿病学家的共同做法。为了满足美国的这种未满足的需求，我们组建了一个领先的学术风湿病学集团，其中包括阿拉巴马大学伯明翰大学，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，形成了类风湿关节炎关节炎合成组织的组织网络网络（理由）。这是，我们将在美国创建新一代的风湿病学家，他们将执行微创超声引导的滑膜活检，这对于在RA的所有阶段从患者那里获得滑膜组织至关重要（早期，建立，DMARD或生物学不充分反应）。这些时间将由理性技术站点的研究人员分析，他们将使用此材料进行转化研究，以识别可能预测治疗反应的新型途径和潜在的生物标志物。