Lupus Omics Cutaneous Kidney Investigative Team (LOCKIT) - Pain Supplement

风湿性疾病的临床疼痛表型和机制还知之甚少。正在加速的 药物伙伴关系自身免疫和免疫介导性疾病(AMP AIM)计划解决共同的 跨越自身免疫性疾病的主题，并描绘了疼痛和分离的复杂性和影响 在患者和医生之间感觉到的疾病负担不一定与未治疗的炎症有关 未得到满足的主要需求。疼痛表型，如伤害性(组织损伤)、伤害性(中枢敏感化)和 神经病理性疼痛及其对治疗无反应的贡献构成了一个关键的知识鸿沟。痛苦就是 从系统性红斑狼疮(SLE)患者的角度来看，影响生活质量的核心领域 银屑病谱系障碍(PSD)、类风湿性关节炎(RA)和干燥病(SJD)。本副刊 将利用SLE和PSD疾病小组在皮肤病患者中获得的皮肤活检来识别 新的疼痛生物标志物。狼疮性肾炎和SJD患者将被包括在内，因为疼痛在 并提供进一步的比较洞察力。治理将在以下领导下进行 Jill Buyon(MPI SLE)和Alexis Ogdie(MPI PSD)与各自的其他成员提供的合作 疾病团队和Yvonne Lee的咨询带来了疼痛表型方面的专业知识。同时，我们将努力 RA和PSD的协调，重点放在滑膜活检上。提出了两个具体目标。《目标1》中的痛苦 将描述SLE、PSD和SJD患者的表型。除了PROMIS 29项措施外， 连续登记的患者将完成2016年纤维肌痛(FM)调查标准和疼痛 灾难性的规模。在两年多的时间里，SLE团队将招募活动性皮肤病患者(N=20)和/或新患者 发作性肾炎(N=40)，PSD团队将招募牛皮癣和/或PSA患者(N=30)，以及 这第三个团队将招募符合SJD(N=20)的不同临床和/或实验室特征。 在目标2中，SLE、PSD和SJD患者之间皮肤生物标记物和脑功能磁共振成像的差异 在没有伴随FM或疼痛敏感化的情况下将进行评估。这一目标利用了计划进行的研究 调查皮肤性LE和PSD患者的皮损和非皮损皮肤，以检验以下假设 局部神经在疼痛敏感化和瘙痒中起作用。在基线调查之后，皮肤患者的一部分 具有不同疼痛表型的活检将接受功能性脑成像。系统地收集了深度的 作为AMP AIM的一部分，表型患者和来自组织的广泛组学，在 疼痛研究正在进行中。

Clinical pain phenotypes and mechanisms in rheumatic diseases are poorly understood. The Accelerating Medicines Partnership Autoimmune and Immune-Mediated Disease (AMP AIM) Program addresses common themes across autoimmune diseases, and delineating the complexity and impact of pain and the dissociation between patient and physician perceived disease burden not necessarily related to untreated inflammation is a major unmet need. Pain phenotypes such as nociceptive (tissue injury), nociplastic (central sensitization), and neuropathic pain and their contribution to therapeutic non-response constitutes a critical knowledge gap. Pain is a core domain affecting quality of life from the perspective of patients with Systemic Lupus Erythematosus (SLE), Psoriatic Spectrum Disorder (PSD), Rheumatoid Arthritis (RA) and Sjögren’s Disease (SjD). This supplement will utilize skin biopsies acquired by the SLE and PSD disease teams in those with cutaneous disease to identify novel pain biomarkers. Patients with lupus nephritis and SjD will be included given the importance of pain in these patients as well and to provide further comparative insights. Governance will be under the leadership of Jill Buyon (mPI SLE) and Alexis Ogdie (mPI PSD) with collaboration provided by other members of the respective disease teams and consultation by Yvonne Lee bringing expertise in pain phenotyping. In parallel, efforts will be harmonized in RA and PSD with a focus on synovial biopsies. Two specific aims are proposed. In Aim 1, pain phenotypes will be delineated in patients with SLE, PSD, and SjD. In addition to the PROMIS 29 measures, patients consecutively enrolled will complete the 2016 Fibromyalgia (FM) Survey Criteria and pain catastrophizing scale. Over 2 years, the SLE team will enroll patients with active skin disease (N=20) and/or new onset nephritis (N=40), the PSD team will enroll patients with psoriasis and/or PSA (N=30), and patients with varying clinical and/or laboratory characteristics consistent with SjD (N=20) will be recruited by this third team. In Aim 2, differences in skin biomarkers and functional brain MRI among patients with SLE, PSD, and SjD with and without concomitant FM or pain sensitization will be assessed. This aim leverages studies planned to investigate lesional and non-lesional skin from patients with cutaneous LE and PSD to test the hypothesis that local nerves play a role in pain sensitization and itch. Following baseline surveys, a subset of patients with skin biopsies with differing pain phenotypes will undergo functional brain imaging. With systematic collection of deeply phenotyped patients and extensive omics derived from tissue as a part of AMP AIM, substantial innovations in pain research are expected.