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Study shows that high bone mineral density scores are associated with lower risk of painful hip osteoarthritis (OA)

Despite the growing base of data from arthritis research, there remains a lack of adequate scientific information regarding the relationship between bone mineral density and hip osteoarthritis (OA). A new study shows that while higher bone mineral density may lower the risk of painful hip OA among middle-aged and older adults followed for a median of 6.5 years, having “intermediate” (vs. “low” or “high”) bone mineral density may increase the risk of OA – including OA accompanied by symptoms – in knees. Overall, these results suggest that having high bone mineral density does not increase the risk of hip or knee OA, and may reduce the risk of painful hip OA.

The research relied, in part, on data obtained from study participants in the Johnston County Osteoarthritis Project (JoCoOA), which is based in NC and is one of the largest and longest-lasting OA studies in the U.S.  JoCoOA director and principal investigator Joanne Jordan, MD, MPH, was one of the study authors for the bone mineral density research. 

 

The study findings were recently published in Arthritis Care & Research.  Read more about the study via This Link.

Thurston Arthritis Research Center and Johnston County Osteoarthritis Project Play Key Role in Study that Identifies New Genetic Marker for Osteoarthritis

The study, which combined the results of genetic data analysis from four well-defined population groups identified a new genetic marker associated with knee osteoarthritis (OA) among North American Caucasians. The genetic marker may identify people who are at increased chance of developing OA. The new findings can help scientists better understand the genetic mechanisms behind OA development and its progression, as well find new methods to prevent and treat OA. Importantly, the study also confirmed three other previously identified genetic markers associated with knee OA.

In research of this type, having genetic data from a sufficient number of study participants is very important.  Since the Johnston County Osteoarthritis Project (JoCoOA) is one of the largest and longest-lasting OA studies in the U.S, its contribution of collected genetic data as well the participation of JoCoOA scientists and data analysis specialists played a critical role in this research.  Joanne Jordan, MD, MPH, who is director of the UNC Thurston Arthritis Research Center Director was a study author, and is also the Principal Investigator for JoCoOA. 

The National Institutes of Health (NIH) funded the study, and findings were recently published in Arthritis and Rheumatology.  Read about the study via This Link

Dr. Joanne Jordan Writes "Perspective" Piece Regarding Study Showing Older Adults With Arthritis Can Benefit From Just 45 Minutes of Exercise Weekly

Federal guidelines suggest older adults with osteoarthritis (OA) engage in a total of 150 minutes of moderate-to-vigorous exercise a week, completed in increments of at least 10 minutes. For a variety of reasons, only about 10% of older adults with knee OA meet this goal. The good news, however, is researchers have found that as little as 45 minutes of moderate exercise such as walking weekly (even if not completed in 10-minutes segments) can still provide significant benefits.

The study, says Dr. Jordan, provides important insights regarding how people with knee symptoms and knee OA can set realistic and less intimidating exercise goals to help them begin exercising, with the intention of gradually building up to recommended guidelines.  While the 45-minute threshold provides a very helpful 'minimum' initial goal, it is important to remember that more exercise may provide important additional benefits.  Learn more about study, as well as Dr. Jordan's "Perspective" piece on Healio Rheumatology.     

Doug Phanstiel, PhD, Receives Grant to Research DNA Looping Related to Inflammation and Immune Response

Thurston Arthritis Research Center scientist Doug Phanstiel, PhD, has received a three-year "Independence Award" grant from the National Human Genome Research Institute at the NIH. The research he will conduct under this grant is designed to help scientists better understand a variety of biological processes that play key roles in regulating immune cell development, including DNA looping and regulation of transcription.
Doug Phanstiel, PhD, Receives Grant to Research DNA Looping Related to Inflammation and Immune Response click to enlarge Doug Phanstiel, PhD

Genes make up less than two percent of the human genome.  Scattered throughout the rest of the genome (the complete set of genetic instructions for an organism) are areas that regulate the expression of genes – the process by which genetic instructions are used to create products such as proteins.  Large DNA “loops” bring these regions into close proximity with the genes they are meant to target.  These loops play a major role in regulating human development, health, and disease.  Unfortunately, high-throughput and accurate methods to detect and study DNA loops are still emerging.  The research covered by this grant will involve developing new tools to identify DNA loops, and provide new insights into the role that looping plays related to immune response and inflammation.  Because altered, or incorrect, regulation of transcription is a common cause for many human diseases, this work is likely to inform our understanding of a variety of biological processes and human disease states.   

Dr. Edwin Kim Interviewed by WRAL TV Regarding New Peanut Allergy Guidelines

The National Institutes of Health have issued important new guidelines that are relevant for parents of children with peanut allergy. Thurston Allergist Edwin Kim, MD helps explain the significance of the guidelines, which are a departure from much of the traditional wisdom related to children with food allergies.

The new recommendations are based on research indicating that early exposure is more likely to protect babies from developing peanut allergies than to harm them.  As with any such topic, it is important that parents discuss the matter with their healthcare provider.  View a news story that helps explain the guidelines, and which includes an interview in which Dr. Kim provides helpful perspectives for parents.  {WRAL-TV Link Temporarily Unavailable}  

Dr. Amanda Nelson awarded grant to evaluate feasibility and reliability of using ultrasound technology for study of knee osteoarthritis; also assumes leadership role in national rheumatology association

Amanda Nelson, MD, MSCR, RhMSUS, a rheumatologist at the UNC Thurston Arthritis Research Center, has received the “Innovative Research Award” from the Rheumatology Research Foundation. This grant will enable her to study the association between features of osteoarthritis (OA) that are observable with ultrasound compared to radiographic (X-ray) observations and symptoms, as well as the potential influence of factors such as age, sex, race, obesity and prior injury.
Dr. Amanda Nelson awarded grant to evaluate feasibility and reliability of using ultrasound technology for study of knee osteoarthritis; also assumes leadership role in national rheumatology association click to enlarge Amanda Nelson, MD, MSCR, RhMSUS

While X-rays are frequently used to assess OA for clinical and research purposes, the technology does not correlate well with symptoms, or changes over time.

Ultrasound provides numerous potential advantages for the assessment of OA, as it is cost-effective, widely available, reliable, and can identify OA changes earlier when intervention may be more effective.  The results of the study could assist in planning future studies of knee OA, and will provide insights that may be useful for clinical practice.

Titled “Sonography of OA by Rheumatologists (SOAR),” the study will be integrated into the Johnston County Osteoarthritis Project (JoCoOA), which is a large, population-based research program evaluating the determinants and societal implications of OA.  The JoCoOA Project is managed by the UNC Thurston Arthritis Research Center, and has been continuously funded for over 25 years.

In other ultrasound-related news, Dr. Nelson has been appointed to the American College of Rheumatology’s Oversight Committee for Musculoskeletal Ultrasound Certification (RhMSUS).  In this role she will be actively involved in all aspects of the RhMSUS certification program, with a particular focus on examination development.

As a nationally recognized leader in musculoskeletal ultrasound imaging, Dr. Nelson and a former Thurston Arthritis Research Center Rheumatology fellow, Dr. Jake Ritt, recently co-authored the chapter “Ultrasound of the Knee,” in the book “Musculoskeletal Ultrasound in Rheumatology Review.”  Their chapter focuses on imaging technique, normal joint imaging, and knee pathology visible using ultrasound.

The book is available for physicians who would like to learn more about the use of musculoskeletal ultrasound for rheumatologic conditions. 

TARC Researchers Provide Leadership and New Scientific Findings at 2016 ACR/ARHP Meeting

The American College of Rheumatology (ACR)/Association of Rheumatology Health Professionals (ARHP) annual conference is the world’s premier meeting of its type and provides important research and clinical updates that benefit the scientific community, physicians and patients. At this year’s conference Thurston Arthritis Research Center (TARC) experts played key roles in helping advance research and initiatives that are focused on improving the lives of people affected by rheumatologic diseases.
TARC Researchers Provide Leadership and New Scientific Findings at 2016 ACR/ARHP Meeting click to enlarge Dr. Reshmi Raveendran, a Rheumatology Fellow, was among the TARC representatives presenting at 10 poster sessions during the conference.
TARC Researchers Provide Leadership and New Scientific Findings at 2016 ACR/ARHP Meeting click to enlarge Dr. Saira Sheikh from TARC met with two lead investigators from France; Dr. Loic Guillevin and Dr. Benjamin Terrier.

A few highlights from the meeting:

  • Richard Loeser, MD, served as Chair of the Annual Meeting Planning Committee – which oversees the planning of over 450 sessions that included more than 1,000 expert speakers – and was quoted as an official representative for the meeting.  In his capacity as Chair, Dr. Loeser worked with the ACR staff and played a central role in helping to coordinate the activities of the planning committee responsible for selecting topics to be covered at the meeting, as well as the faculty best able to speak on those topics. The committee was also responsible for reviewing close to 4,000 abstracts that were submitted for presentation under 28 basic and clinical research categories.    
  • Kelli Allen, PhD, received the prestigious “Distinguished Scholar” award from the ARHP – which is a division of the ACR.  The award is presented annually to a member who demonstrates exceptional achievements in scholarly activities related to arthritis and rheumatic diseases.  Dr. Allen received the honor for her innovative research focused on improving the lives of people with osteoarthritis through impactful and practical behavioral – as well as health-system – interventions.  
  • TARC experts led six separate scientific presentations and workshops, and presented at 10 poster sessions with topics ranging from functional genomic screening, to social influences in rheumatic disease and many points in-between.  
  • Thurston researchers and clinicians have a long history of leadership roles with ACR, including TARC director Joanne Jordan, MD, MPH, who serves on the Board of Directors.  TARC researchers and clinicians who served on key committees for the ACR/ARHP meeting included; Leigh Callahan, PhD; Richard Loeser, MD; Kelli Allen, PhD; Beth Jonas, MD; Becki Cleveland, PhD; and Yvonne Golightly, PhD, PT.  Joanne Jordan, MD, MPH, is Director of the Thurston Arthritis Research Center and a member of the ACR Board of Directors.      

Dr. Saira Sheikh and Dr. Mildred Kwan Address Under-Utilization of Critical Immunizations for Patients with Inflammatory Diseases

Patients with chronic inflammatory diseases such as asthma, rheumatoid arthritis and lupus are at a higher risk of infections compared to the general population. Despite the increased risks, too often these patients do not receive the proper vaccinations. Two UNC physicians are taking steps to address this important health issue.
Dr. Saira Sheikh and Dr. Mildred Kwan Address Under-Utilization of Critical Immunizations for Patients with Inflammatory Diseases click to enlarge Saira Sheikh, MD; Mildred Kwan, MD, PhD
Dr. Saira Sheikh and Dr. Mildred Kwan Address Under-Utilization of Critical Immunizations for Patients with Inflammatory Diseases click to enlarge Materials developed by the Thurston Arthritis Research Center highlight current vaccination guidelines.

According to the CDC, the most significant barrier to achieving optimal vaccination rates for patients with chronic inflammatory diseases is lack of awareness about vaccines among adult patients and providers.  Vaccine guidelines can be particularly complex, and must be altered and customized for different types of patients based on their health history, vaccination history, risk factors, age and other variables. 

To address the problem head on, Dr. Saira Sheikh, an allergist/immunologist and rheumatologist, and Dr. Mildred Kwan, an allergist/immunologist, have developed a number of specialized educational tools that will be distributed directly to all board certified allergists, immunologists and rheumatologists throughout the country.  Because of their educational value, the materials will also be provided to fellows-in-training for both subspecialties. 

The two UNC Thurston Arthritis Research Center physicians developed the materials in partnership with the American Academy of Allergy, Asthma and Immunology, which is posting the items on its website.  To further enhance readership among physicians, the materials will count toward CME (Continuing Medical Education).  Dr. Sheikh’s and Dr. Kwan’s work on the educational materials is supported by a Junior Faculty Development Award and the UNC Thurston Arthritis Research Center.

At the conclusion of the program, data gathered to measure its success will be analyzed with the hope that it can be fine-tuned, and expanded for use in primary care and other sub-specialties.

Thurston Team Pitches in for UNC's "Tar Heel Service Day"

When the call came to lend a hand, the Thurston Arthritis Research Center answered. Several dozen employees donated a wide variety of food ranging from soups and canned fruit to pre-packaged meals for “PORCH,” a local hunger relief organization for families in need. In addition, the team donated a selection of dog and cat food for “PAWS4EVER,” a local no-kill animal shelter. Members of the Thurston Arthritis Research Center join forces several times each year to support local and national charities.

2016 Day of Service - TARC Group Picture

Thurston Arthritis Research Center and Osteoarthritis Action Alliance Participate in First "Rheumatologic Disease Awareness Month" Initiatives

The multi-faceted educational program addresses the public's need to better understand the causes, impact and options for managing the broad spectrum of rheumatologic diseases. More than 52 million Americans -- young and old -- live with sometimes painful, and potentially debilitating rheumatic diseases.
Thurston Arthritis Research Center and Osteoarthritis Action Alliance Participate in First "Rheumatologic Disease Awareness Month" Initiatives click to enlarge Providing educational materials and support is essential for patients affected by rheumatic diseases.

Raising disease awareness and supporting patients and their families are core goals for the UNC Thurston Arthritis Research Center (TARC) and the Osteoarthritis Action Alliance (which is managed by TARC).  For that reason, these organizations are participating in the American College of Rheumatology’s (ACR) first annual Rheumatic Disease Awareness Month, which is shedding much-needed light on a broad range of more than 100 diseases, including arthritis, lupus, Sjogren’s syndrome, gout, and many others. 

Unfortunately, the symptoms and treatment of rheumatologic diseases can sometimes be complex and difficult to understand.  The public awareness month addresses these issues via ACR’s ongoing campaign called, “Hundreds of Diseases. One Voice,” which provides educational content, as well as a variety of tools and resources.

Patients and their families who wish to learn more about osteoarthritis – both now and throughout the year – may access the Osteoarthritis Action Alliance’s website to participate in Twitter chats, listen to experts during free Lunch & Learn sessions, receive informative and inspirational emails, and subscribe to educational newsletters.  Meanwhile, the Thurston Arthritis Research Center continues to leverage advanced research to investigate the causes and consequences of arthritis, autoimmune diseases and allergies, as well as care for patients while training tomorrow’s leading healthcare practitioners.  

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