Identification of Early Psoriatic Arthritis

描述(申请人提供)：牛皮癣关节炎(PSA)是一种与牛皮癣相关的慢性、衰弱的炎症性关节炎。到目前为止，大多数研究只包括患有长期疾病的患者。我们从类风湿性关节炎(另一种炎症性关节炎)中了解到，及早识别并开始治疗可以提高对治疗的反应，减少关节损伤和残疾。PSA也可能是这种情况，但到目前为止，PSA在病程的早期很难识别。此外，人们对PSA的早期阶段知之甚少。由于大多数PSA患者首先患上牛皮癣， 牛皮癣是研究PSA发展的理想人群。在这项应用中，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的风险因素；2)使用18F-氟代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，识别银屑病患者的亚临床关节和关节周围炎症，银屑病可能是疾病的最早形式。这些研究不仅涉及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发展的自然历史和病理生理学。应聘者是一名风湿学家和临床研究员，对炎症性关节炎，特别是牛皮癣关节炎感兴趣，具有非常适合K23导师职业发展奖的科学背景。她的目标是成为一名成功的、独立出资的临床研究员。通过概述的职业发展计划和拟议的研究，奥格迪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。奥格迪博士将利用由共同导师指导的两项现有的R01资助研究来解决研究目标。凭借在风湿病、皮肤病、流行病学和放射学方面的巨大资源，以及出色的指导、设施和设备，奥格迪博士将为面向患者的临床和转化性研究奠定坚实的基础。

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.