In the UNC Division of Rheumatology, Allergy and Immunology, we integrate collaboratively and seamlessly on a daily basis with our colleagues in the UNC Thurston Arthritis Research Center. In many cases, our teams overlap, providing a unique opportunity to combine deep clinical expertise with cutting edge research as we work to develop new and innovative treatments for patients.
Our research leverages the full breadth and depth of our multi-dimensional scientific resources, in order to develop and test innovative new ways to prevent, diagnose, and treat rheumatologic, allergic, and autoimmune diseases.
Our clinicians and researchers are exploring the underlying mechanisms that promote development and progression of arthritis and autoimmune diseases. We are studying causes and effects of these diseases, while also searching for new and innovative treatments.Osteoarthritis: Basic and Translational
Research includes in vitro (using human joint tissue cells) and in vivo (rodent model) experiments to study topics such as:
- Cell signaling pathways that regulate anabolic and catabolic activity responsible for joint tissue remodeling and destruction, including the role of integrin signaling in response to matrix damage.
- High throughput drug screening to discover small molecules capable of slowing or stopping the progression of osteoarthritis.
- Role of aging, oxidative stress, and cell senescence in the development of osteoarthritis.
- Chondrocyte mechanotransduction studies.
- Use of regenerative medicine technologies such as stem cells, genome editing and tissue engineering to develop model systems that may be used to develop novel, future therapies for osteoarthritis.
- The role of cell signaling by the C-C chemokine receptor 2 (CCR2) in the development of osteoarthritis.
Genomics and the regulation of chondrocyte gene expression.
Additional clinical research related to OA includes:
- New and innovative use of musculoskeletal ultrasound techniques and technologies to improve diagnosis and treatment of OA.
- Determining the prevalence, incidence, and burden of disease from diverse population-based cohorts.
- Applying advanced machine learning methodologies to the study of phenotypes and precision medicine in OA.
- Understanding the contribution of OA and its risk factors to excess morbidity and mortality.
- Assessment of the impact of race/ethnicity, sex, and social determinants of health on OA to reduce health disparities.
- Rigorous observational, translational, and interventional studies to inform and advance clinical care in OA.
- New and innovative use of musculoskeletal ultrasound techniques to improve diagnosis and treatment of OA.
- Contribution to and dissemination of evidence-based guidelines for OA management for a variety of stakeholders.
Our epidemiologists, clinicians and researchers are evaluating the steadily changing demographics of OA, and the subsequent impact related to disease burden, pain, disability, and social isolation.
A few examples of their research focus areas include:
- Changing demographic patterns of OA, and the subsequent impact related to disease burden, pain, disability, and social isolation.
- Large-cohort, longitudinal, community-based studies related to osteoarthritis (OA) and other chronic diseases.
- The disproportionate incidence as well as impact of osteoarthritis on individuals and communities that are largely rural and/or include higher percentages of participants who are African American or Hispanic.
- Disproportionate incidence and impact of OA among specific groups such as members of the military and veterans.
We are studying the molecular mechanisms that drive the transition from monocytes to disease-relevant cell types. This includes DNA looping and kinases signaling, and the role they play in lineage specificity and cell fate decisions. Having a better understanding the various mechanisms involved may help us improve our understanding of rheumatoid arthritis and eventually identify novel therapeutic targets. This research will also inform our understanding of a wide variety of additional biological process and diseases.
The Division is home to a wide range of projects in the area of lupus and autoimmunity. We conduct comprehensive research in the areas of lupus, Sjogren’s & autoimmunity, with a focus on clinical and translational science approaches to answering scientific questions that directly impact the care of patients with complex immunologic diseases in order to advance health and healing.
We are interested in developing diagnostic assays and prognostic markers for autoimmune diseases and incorporate a multi-disciplinary platform that emphasizes team science, as well as a robust clinical trials program. We are also working on a national level to help address racial disparities and promote inclusion and diversity in lupus clinical trials.
Our research interests include:
- Exploring New Treatments: Our team is involved in cutting edge clinical trials that test innovative therapies targeting specific molecular pathways in lupus and arthritis.
- Diversity in Lupus Clinical Trials: Patients of racial and ethnic minorities are underrepresented in clinical trials. We are working on a national level to promote inclusion and diversity in lupus clinical trials.
- Improving Patient Care: Our work focuses on answering research questions that directly impact and enhance the care of patients with complex autoimmune diseases such as lupus and Sjögren’s. We work collaboratively using a multidisciplinary, team-science approach to achieve this goal.
- Studying Autoimmune Diseases: We are interested in the identification of potential diagnostic and prognostic markers for autoimmune diseases and in understanding mechanisms of lupus. With our collaborators, we explore bench-to-bedside approaches to advance the science and improve the care of our patients. Our collaborative research group, Chapel Hill Alliance Promoting Excellence in Lupus (CHAPEL), utilizes a multidisciplinary approach to advance our understanding of the disease and how we can best serve our patients.
- Patients as Partners: Patient involvement is essential to the success of our team and future innovations. We strive to provide opportunities for patient feedback, education, and collaboration in our research endeavors. Members of our lupus patient advisory board provide expertise and advise us on the development of our research projects
Affiliated Investigator: Dr. Saira Sheikh
UNC’s Division of Rheumatology, Allergy and Immunology has a long tradition of being a national leader and innovator in conducting research designed to better understand, prevent, and treat health issues in underrepresented populations.
- Mortality and osteoarthritis in rural and minority populations
- Community-based physical activity and weight loss intervention trials
- Social determinants and health outcomes
- Social influences of physical activity and dietary intake
- Health literacy
- National programs designed to increase enrollment of minority patients in lupus clinical trials
Our Division is the founding home of the Immuno-Oncology Group (IOG) at UNC, which is a collaborative multidisciplinary team of experts from specialties such as rheumatology, oncology, cardiology, dermatology, endocrinology, and others. The goals of the IOG are to:
- Optimize the clinical care of cancer patients who develop immune related adverse events (irAEs) from cancer immunotherapy, specifically immune checkpoint inhibitors.
- Advance clinical, translational and basic research in defining the mechanisms leading to irAEs and identifying potential parallels in mechanisms underlying autoimmune diseases.
Affiliated Investigator: Dr. Rumey Ishizawar
Our leading experts are researching the underlying causes and conditions associated with the full range of allergies, as well as pioneering new means with which to better diagnose and treat these diseases.Alpha-gal meat allergy
UNC is one of the few locations in the U.S. where physician scientists are conducting research to explore the immunologic mechanisms which lead to alpha-gal red meat allergy, which is an allergic response to the carbohydrate galactose-alpha-1, 3-galactose. This allergic syndrome is poorly understood, but rapidly becoming more common throughout the U.S.
We are investigating allergy-related cells in peripheral blood (basophils) and tissues (mast cells) to understand how these important effector cells can be targeted to prevent, manage, and even cure allergies. Increasing our knowledge of fundamental basic science biology is critical to drive innovation in the allergy/immunology field and bring new treatments to patients, regardless of their specific allergic condition.
Our faculty are engaged in multiple leading research efforts in population health. Dr. Kwan has developed a multi-disciplinary approach to penicillin allergy and her team of experts continues to successfully ‘de-label’ patients who may have an incorrect penicillin allergy diagnosis. The efforts of Dr. Kwan and her team have spared numerous patients from receiving broad spectrum antibiotics and saved countless healthcare dollars. In conjunction with the Centers for Disease Control and Prevention, Dr. Commins leads a longitudinal study of participants with alpha-gal allergy to understand the natural history of this unique allergic syndrome, as well as the role of tick bites and environmental exposures in triggering the immune response.
In addition to investigating alpha-gal meat allergy, our investigators are studying the epigenetic regulation of type 2 and regulatory immunity. This includes exploring the role of the histone H3 lysine 27 (H3K27) demethylase UTX in mouse models of allergic sensitization and parasitic helminth infection. Additional research includes exploring the role of this epigenetic factor in immune responses to parenteral vaccination.
Affiliated Investigator: Dr. Onyi Iweala
A Division of Rheumatology, Allergy and Immunology physician-scientist is exploring how epithelial cell barrier dysfunction, known as “leaky gut” contributes to peanut allergy pathogenesis. This research includes defining the peanut allergy-associated IEC regulatory landscape as a mechanism of barrier dysfunction.
Affiliated Investigator: Dr. Erin Steinbach