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

目的：改善患有免疫介导炎症性疾病（IMID）且有心血管疾病风险/患有心血管疾病的患者的预后（心血管;心脏和血管）的参与，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，并增加该领域的研究。背景：英国有超过一百万人受到IMID的影响，其中免疫系统的异常行为导致关节，皮肤和内脏器官的炎症。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罕见疾病，如系统性硬化症。与普通人群相比，IMID患者的死亡风险高出3-4倍，其中CV受累是主要原因之一。未满足的需求：我们没有标准方法来诊断IMID患者的CV受累，这可能会延迟诊断。我们不知道如何识别和监测最易发生心血管疾病（CVD）的患者。IMID患者的临床试验不评估CVD，因此我们没有很好的证据证明哪些治疗可以改善CV结局。检测CVD的关键成像方法是CV磁共振成像（CMR）和PET-CT。CMR是安全和非常准确的，但CMR措施尚未针对IMID患者。PET-CT是识别炎症的有效工具，但其访问是可变的。目标：我们将建立一个全国性的网络，“英国心脏病网络”，并已在英格兰、苏格兰、威尔士和北方爱尔兰确定了29个中心。该网络将汇集简历和IMID专家，使我们能够：1.汇集来自CV和IMID领域的医生和研究人员以及患者群体，以改善教育和培训，并制定国家研究战略。这将导致为IMID患者量身定制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、管理和分析来自各中心IMID和CV参与者的临床和心脏研究数据，以便我们将来可以进行研究。建立IMID和CV受累的现有和新患者的患者登记。这将是一个非常宝贵的资源，可以更好地了解不同IMID中CV受累的特征，并为未来的研究提供信息，以改善诊断和测试治疗。引入统一的CMR和PET-CT扫描和诊断方法，以便以跨中心可比的方式评估英国各地的IMID患者。将上述登记处与国家倡议联系起来，如NIHR的IMID生物资源，该资源从不同IMID患者中收集样本4 b。开展试点研究，从招募到登记处的患者亚组获得的临床，成像和血液标志物数据将建立更大规模的能力，并为设计提供信息，以发现标志物，帮助诊断和开发新的治疗方法5.与行业建立合作，以实现内部投资和伙伴关系的可持续性超过赠款期限;并开展研究，以满足有心血管疾病风险的IMID人群未满足的需求。我们得到了关键合作伙伴团体的重要支持，包括（i）现有的国家IMID网络，将识别患者并开发研究项目（ii）NIHR-Versus关节炎肌肉骨骼转化研究合作，一个IMID和新研究的学术专家网络，以定制治疗（iii）NIHR-BHF心血管合作伙伴关系，CV研究人员的国家合作，如果成功的话，MRC资助的“CARDIO-IMID UK Network”将成为最大的国家跨学科倡议之一，将对IMID患者产生重大影响。

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.