Recent advances in pre-clinical and clinical research into the rheumatic and allergic diseases have fundamentally changed the practice of rheumatology and allergy and improve the prognosis of patients. The development of TNF blockade as a novel and highly effective treatment for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and inflammatory bowel disease is one of the most exciting discoveries in 21st century medicine. This achievement was made possible by pre-clinical research that identified TNF alpha as a key player in the pathogenesis of inflammatory arthritis in both rodent models and human disease. These basic discoveries were made possible by fundamental advances in the areas of immunology, molecular biology and genetics. Thus, this major clinical advance is the fruit of a coordinated effort involving basic, disease-focused and clinical research. The research programs emphasize techniques and concepts of immunochemistry, immunopharmacology, cell biology, genetics and molecular biology at preclinical levels as well as in clinical applications. The focus of the Division of Rheumatology, Immunology and Allergy includes T-cell biology, especially T-cell receptors and antigen presentation by CD1 and MHC molecules and T cell development and function. In addition, lymphocyte research emphasizes the role of adhesion molecules, autoimmunity in rheumatoid arthritis, mucosal immunity, and immune response to infection. The Allergy and Immunology education program focuses on the molecular and cellular biology of eicosanoid generation, particularly the cysteinyl leukotrienes and PGD2, the lineage development of the mouse and human mast cell, and the particular role of Th2 cytokines in modulating mast-cell effector components of allergic inflammation. Five new mouse strains with targeted disruption of genes central to the allergic asthmatic response have been generated to facilitate physiologic and pathobiologic investigations with relevance to human disease. Basic research also includes laboratories focused on gene expression, intracellular protein and vesicle traffic and regulation, chromatin and cell cell division.
Clinical population sciences research is a well developed field in the rheumatic diseases and includes investigators who emphasize risk factors and outcomes in rheumatoid arthritis (RA) and systemic lupus erythematosus (lupus), orthopedic outcomes, Lyme disease prevention and the pharmacoeconomics of anti-rheumatic drugs. Members of the Center are currently engaged in research on RA, psoriatic and other inflammatory arthritides, lupus and anticardiolipin syndrome, Lyme Disease and other tick borne illness, osteoarthritis, osteoporosis, meniscal disorders, low back pain including spinal stenosis, upper extremity disorders including carpal tunnel syndrome and computer associated overuse syndromes, fibromyalgia, obesity prevention, and ankle and knee injuries arising from youth sports. In addition, the Division has one of the most comprehensive programs for newer therapies in the treatment of RA and related diseases.
In addition to the full development of basic research in areas relevant to rheumatic and allergic diseases, translational research and clinical research at the population level and patient therapeutics, the Division has also organized and integrated much of its research to provide interdisciplinary progress in several key human diseases. Thus, we have developed focused centers in RA, Lupus, and Asthma and Allergic Diseases. In each of these Centers, extensive interaction between basic researchers and clinical research are fostered and include the integration of research in animal models with research in patients and patient registries. The Centers stand as the most developed examples of comprehensive interdisciplinary translational research.