Rheumatic and Autoimmune Diseases in Minority Communities

本计画研究在华盛顿大都会区一个服务不足，主要是少数民族社区的风湿性疾病的临床表现。通过NIAMS社区健康中心，对风湿病患者进行评估，并为临床医生提供了解自身免疫性疾病表型种族差异以及护理障碍的第一手经验。该项目支持了以下方面的文化差异研究：理解标准化自我报告结果评估工具、确定类风湿性关节炎的临床重要改善、在有风湿症状的患者中使用补充和替代药物、少数民族个人接受瑜伽作为关节炎治疗方法、以及少数民族对研究过程和知情同意的理解。 此外，研究人员还研究了改善初级保健提供者和专科医生之间转诊过程的干预措施。 目前正在进行血清学研究，以检查类风湿关节炎和系统性红斑狼疮患者的免疫异常。 我们积极参与了一项观察性研究，以描述COVID-19如何调节既往诊断为全身性自身免疫的成人和儿童患者的全身炎症、自身免疫特征和血管病变，以及他们的总体结局，包括对抗病毒治疗或疫苗的反应。 我们在华盛顿特区东北部开设另一个诊所的工作也已进入最后阶段，以改善对患有风湿性疾病的少数族裔社区的服务，并增加我们对他们的宣传。

This project studies the clinical presentation of rheumatic diseases in an underserved, largely ethnic minority community in the Washington, DC metropolitan area. Through the NIAMS Community Health Center, subjects with rheumatic complaints are evaluated and provide clinicians with first-hand experience in understanding ethnic differences in autoimmune disease phenotypes as well as barriers to care. This project has supported research on cultural differences in understanding standardized self-report outcome assessment tools, determination of clinically important improvements in rheumatoid arthritis, use of complementary and alternative medicine in patients with rheumatic symptoms, acceptability of yoga as a treatment for arthritis by minority individuals, and understanding of the research process and informed consent among ethnic minorities. In addition, researchers have examined interventions to improve the referral process between primary care providers and subspecialists. Serological studies are currently underway to examine immune abnormalities in patients with rheumatoid arthritis and systemic lupus erythematosus. We have been actively involved in an observational study to characterize how COVID-19 modulates systemic inflammation, autoimmune features and vasculopathy in adult and pediatric patients with a prior diagnosis of systemic autoimmunity, and their overall outcomes including response to antiviral treatments or vaccines. We are also in final stages of opening an additional clinic site in NorthEast Washington D.C. to improve access and increase our outreach to the minority community with rheumatic diseases.