Natural History of Bone Disease and the Impact of Growth Hormone Treatment in MPS

简介（由申请人提供）：Polgreen博士是明尼苏达大学（UM）内分泌科儿科助理教授。自2008年8月开始担任该职位以来，她将75%的时间用于儿科骨病领域的以患者为导向的研究，并将在本次职业发展奖励期间继续这样做。Polgreen博士的长期职业目标是成为一名独立的学术医师研究员，在患有粘多糖病（MPS）的儿童骨和内分泌疾病领域拥有国际公认的专业知识。在此奖励期内完成的具体目标包括：1)提高基础骨生物学、骨评估方法和临床试验管理知识；2)完成一项临床试验和对MPS患者骨骼和内分泌疾病的纵向研究。尽管接受造血细胞移植（HCT）和/或酶替代疗法（ERT）治疗的MPS I、II和VI患儿成年后认知预后良好，但他们的生活质量受到持续骨骼异常、挛缩和严重身材矮小的显著影响。在项目发起人Chester Whitley博士的指导下，Polgreen博士将追求以下具体目标：1)通过2/3期随机对照试验设计，确定24个月重组人生长激素治疗与不治疗对34名患有MPS I、II、VI和身材矮小的儿童骨骼发育和生长的影响；2)采用3年前瞻性研究设计，对MPS I、II和VI患儿的骨发育（骨密度、几何形状和估计强度）和内分泌功能进行登记，并每年进行外周定量计算机断层扫描（pQCT）、双能x线吸收仪（DXA）、骨代谢生物标志物和内分泌功能实验室检查。这些研究项目和职业发展将在以下导师团队的指导下进行：Chester Whitley博士、Antoinette Moran博士、Moira Petit博士和William Thomas博士。该团队在罕见病研究（Whitley）、临床试验管理（Moran）、儿科骨骼评估的理论和方法（Petit）和生物统计学（Thomas）等领域提供专业知识。在MPS和儿童骨病方面的丰富经验，以及在UM随访的大量患有MPS的儿童，为Polgreen博士的研究和职业发展提供了理想的环境，使其成为儿童代谢性骨病的独立研究者。

DESCRIPTION (provided by applicant): Dr. Polgreen is an Assistant Professor in the Department of Pediatrics, Division of Endocrinology, at the University of Minnesota (UM). Since starting in this position in August 2008, she has devoted 75% of her time to patient-oriented research in the field of pediatric bone disease and will continue this during this career development award period. Dr. Polgreen's long-term career goal is to become an independent academic physician researcher, with internationally recognized expertise in the area of pediatric bone and endocrine disease in children with mucopolysaccharidoses (MPS). Specific goals to be accomplished during this award period include: 1) improve knowledge in basic bone biology, bone assessment methodology, and clinical trials management; 2) completion of a clinical trial and a longitudinal study of bone and endocrine disease in MPS. Although children with MPS I, II, and VI who are treated with hematopoietic cell transplantation (HCT) and/or enzyme replacement therapy (ERT) are living into adulthood with good cognitive outcomes, their quality of life is significantly impacted by their persistent skeletal abnormalities, contractures, and severe short stature. Under the guidance of Dr. Chester Whitley, the project sponsor, Dr. Polgreen will pursue the following specific aims: 1) To determine the impact of 24 months of recombinant human growth hormone therapy versus no therapy on bone development and growth in 34 children with MPS I, II, and VI and short stature with a Phase 2/3 randomized controlled trial design; 2) To develop a registry of bone development (bone density, geometry, and estimated strength) and endocrine function in children with MPS I, II, and VI using a 3-year prospective study design with yearly evaluations with peripheral quantitative computer tomography (pQCT), dual energy x- ray absorptiometry (DXA), biomarkers of bone metabolism, and laboratory tests of endocrine function. These research projects and career development will be conducted under the guidance of the following mentorship team: Dr. Chester Whitley, Dr. Antoinette Moran, Dr. Moira Petit, and Dr. William Thomas. This team provides expertise in the areas of the study of rare disease (Whitley), clinical trials management (Moran), theories and methods of bone assessment in pediatrics (Petit), and biostatistics (Thomas). The extensive experience with MPS and pediatric bone disease, and the large cohort of children with MPS followed at UM, make this the ideal environment for Dr. Polgreen's research and career development into an independent investigator of pediatric metabolic bone disease.