Identifying Key Autoantibody and Inflammatory Factors in the Initiation, Propagation, and Transition to Clinically Apparent Rheumatoid Arthritis

Abstract

Rheumatoid arthritis (RA) is a disease of the immune system that leads to painful and potentially destructive arthritis. It can strike individuals at a young age, and lead to substantial loss of quality of life. Currently there are fairly good therapies for RA; however, a high percentage of people with RA still do not feel “normal” even with modern therapies. As such, finding ways to prevent RA before it strikes could substantially benefit society – including military populations. RA is currently only treated once an individual develops painful joint inflammation. However, several studies over the past few years have demonstrated that there are blood-based markers that can predict with fairly good accuracy who may develop RA in the near future. This finding has led to the development of several preventive studies in RA. If these studies are successful, RA could turn into a disease that is managed in a similar way to how much of heart disease is managed today. For example, typically an individual gets their blood tested for risk factors for heart disease such as high cholesterol when they are in their 30s or 40s. And, if their cholesterol is high, they treat that cholesterol through things like exercise or medications to help prevent a future heart attack. It is hoped that something similar could take place in RA where an individual could find out their risk for RA based on a blood test, then make lifestyle changes, or take a medication, to prevent them from getting RA in the future. This is an exciting advance! However, it is early days, and we still need to learn more about how to predict future RA accurately and to identify effective ways to prevent RA. The Department of Defense has recognized this, and therefore made learning more about preventing RA a Topic Area for the 2019 Expansion Awards. To address this Topic Area, our project will utilize the Department of Defense Serum Repository (DoDSR) to study factors that (a) predict future RA and (b) that may be targeted for prevention. The DoDSR is a unique resource in that it contains blood samples from individuals on active duty military service from the time of enlistment and then regular intervals during active duty. We are able to identify individuals who developed RA in the military, and then go back and study their blood samples from before their RA in order to identify factors that predict future RA. Based on the findings from this study, we hope to improve the accuracy of predicting future RA, as well as identify specific factors that could be targeted for prevention. Importantly, while RA is pretty rare (affecting ~1% of the population), it is a severe enough disease that findings ways to prevent it would be very beneficial. Furthermore, this project is highly applicable to the military because we could use these findings to implement prevention strategies for active duty personnel, or Veterans. This is particularly relevant because the scientists who are performing this study are also directing an RA prevention trial in the United States. Because of their experience with that trial, they could rapidly use the information from this new Expansion study to develop trials that could specifically benefit military personnel and family members, Veterans as well as the non-military population.

Document Details

Document Type
DoD Grant Award
Publication Date
Mar 10, 2021
Source ID
W81XWH2010204

Entities

People

  • Kevin D Deane

Organizations

  • United States Army
  • University of Colorado Denver

Tags

Fields of Study

  • Medicine

Readers

  • Educational Psychology
  • Immunology and Pathology
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