The Division of Rheumatology and the Center for Autoimmune Genomics and Etiology (CAGE) achieved many milestones this past year.
Work led by Alexei Grom, MD, identified a pathway that is important for the development of the sometimes deadly macrophage activation syndrome. Susan Thompson, PhD, led work that provided deep genetic insight into the variations of DNA that predispose to juvenile onset idiopathic arthritis. Dan Lovell, MD, MPH, Ed Giannini, DrPH, and Hermine Brunner, MD, MSc, have shown that the new biological therapies are spectacularly successful; their critically important work has become the new standard of therapy and is helping many thousands of afflicted children avoid the life-long disability of chronic destructive arthritis.
Esi Morgan DeWitt, MD, MSc, has achieved better compliance and therapeutic outcomes in juvenile onset rheumatoid arthritis by applying quality-improvement interventions. DeWitt and Brunner are co-leading efforts to effectively align research, clinical care and quality improvement to provide high-value care locally and are leading international initiatives to develop quality indicators and benchmarks for pediatric rheumatology care with focus on systemic lupus erythematosus and juvenile idiopathic arthritis.
Biomarker development efforts are synergistic with development of clinical trial outcome measures that set the stage for testing novel medications for children with SLE. John Harley, MD, PhD, has led an effort to identify the genes that cause systemic lupus erythematosus, now numbering more than 40, followed by progress in discovering the mechanisms and pathways through which they cause lupus.
