Research

The varied impact of diet on joint health

Nada Abughazaleh (PhD candidate) and Dr. Walter Herzog, University of Calgary

The finding: An animal study investigating the impact of a high fat/sugar diet on body weight and joint health found that it had different effects on shoulder joints than seen previously in knee joints. Fiber supplementation was also able to protect male rats from obesity, but not in females. This suggests that metabolic osteoarthritis, a type of arthritis linked to obesity, does not affect all joints in the same way.

The future: The differing impact of diet on joint health emphasizes that other factors such as joint biology, sex hormones, gut bacteria, structural differences, immune response, and biomechanics could play significant roles in the onset or progression of metabolic osteoarthritis. This points to promising new directions for more personalized treatment approaches.

Preventing heart disease in people with psoriatic arthritis

Dr. Keith Colaço and Dr. Lihi Eder, Women’s College Hospital and University of Toronto

The finding: A new tool was created to predict heart disease risk for people with psoriatic disease (PsD), a condition that includes psoriatic arthritis and psoriasis. Researchers found that traditional heart disease risk factors – like high blood pressure, cholesterol levels, and smoking – effectively predicted heart problems in patients with PsD, even without including any PsD-specific factors.

The future: As people with PsD and other rheumatic diseases face a higher risk of heart disease, this research confirms that current heart disease risk assessment tools can effectively guide care for PsD patients – but they need to be used. Adopting this approach would encourage more frequent screenings and improve heart disease prevention for people with PsD.

Improved access to rheumatoid arthritis care

Dr. Mark Harrison, University of British Columbia and Arthritis Research Canada

The finding: British Columbia incentivizes rheumatologists to practice using a multidisciplinary care model that integrates nurses into the clinic. For rheumatoid arthritis patients, this model shortened the time from their referral to when they were first prescribed a disease-modifying antirheumatic drug (DMARD) and improved their access to ongoing care.

The future: Since early diagnosis and treatment leads to better arthritis outcomes, this innovation to enhance access to rheumatology care will help to improve lives for many patients. However, further improvements are still needed to ensure equitable access to this promising model of care and expansion to more clinics.

The knee’s fat pad – a complex player in osteoarthritis

Dr. Mohit Kapoor, Schroeder Arthritis Institute, University Health Network

The finding: The full role of the infrapatellar fat pad (IFP) – the largest fat pad in the knee joint – is not well understood. Researchers studied IFP samples from people in unprecedented detail to map out how different cell types are distributed and how they might communicate with each other. They discovered molecular patterns in IFP cells related to knee osteoarthritis, including distinguishing features among female and male patient samples and those from patients who were obese.

The future: This vast, detailed knowledge can be used to pinpoint new targets for the future development of osteoarthritis treatments and how they might be tailored to individual patients for personalized medicine.

Joint damage after a sprained ankle

Dr. Sarah Manske, University of Calgary

The finding: Sport-related ankle sprains are common in teens and young adults and are known to increase the risk of future osteoarthritis. New research using medical imaging of soft tissues and ankle bones in youth with a history of ankle sprains showed that osteoarthritis-like joint changes can start as soon as three to 15 years after the injuries — meaning individuals in their thirties could experience such changes following injuries sustained in their twenties.

The future: Understanding how soon osteoarthritis can begin in young people following an ankle injury highlights the urgency of prioritizing rehabilitation and prevention efforts and the need for further research on how to intervene to avoid the pain of future arthritis.

How seeing green light can reduce joint pain

Dr. Jason McDougall, Dalhousie University

The finding: By studying the effects of green light therapy on joint pain in animal models, researchers found for the first time that visual exposure to low-level green light can reduce osteoarthritis pain. This therapy works by increasing certain natural pain-relieving molecules in the blood, which activate the body’s endocannabinoid system to help manage pain and stress.

The future: Current arthritis pain medications are not always effective and can raise safety concerns. Exploring alternative treatments like green light therapy could open promising new avenues for pain relief, illuminating an exciting new direction for managing osteoarthritis pain.

Using AI to speed up osteoarthritis diagnosis and monitoring

Lead author, Callie Stirling, and Arthritis Society Canada-supported authors, Dr. Nathan Neeteson and Dr. Steven Boyd, University of Calgary

The finding: Traumatic bone marrow lesions (BMLs) are frequently observed in knee MRI scans after a tear and may act as a precursor for post-traumatic osteoarthritis. Researchers developed an AI-powered tool to automate the detection and segmentation of BMLs in MRI scans, greatly reducing the time and effort required in manual assessments by clinicians and researchers.

The future: This approach holds promise for clinical application, offering a reliable, quantitative tool to detect and study bone-related pathology. This approach could allow for faster diagnosis and monitoring of knee injuries and the possible progression of osteoarthritis, making it a potentially useful asset in both diagnostics and early intervention.

Purple Butterfly: A tool to support lupus patients

Dr. Marc Pouliot, Université Laval

The finding: Lupus is a complex autoimmune disease that can affect the whole body, including the joints. To help rheumatologists communicate clinical lupus information with patients and promote self-management, researchers developed a novel tool called the Purple Butterfly to visually represent the health of the patient at each clinic visit and over time. Ninety percent of patients surveyed thought it should be used in routine practice.

The future: Using the Purple Butterfly may improve conversations between doctors and patients, encourage shared decision-making, and support effective self-management to help people with lupus live well.

Joint replacement surgeries in newcomers

Dr. Bheeshma Ravi, Sunnybrook Research Institute

The finding: In Ontario, the proportion of knee replacement surgeries performed for newcomer patients (immigrants and refugees) doubled over 10 years. Researchers found that newcomer patients had better surgical outcomes than Canadian-born patients, but that these surgeries might be underused in this population.

The future: This study reinforces that knee replacements are safe surgeries for newcomers in Canada, but that more research is needed to understand whether barriers in access to care or cultural perceptions of arthritis and pain lead to underutilization of joint replacement surgeries in this community. This will make progress on the path to equitable arthritis care for all people in Canada.

Fatigue – a core concern in childhood arthritis

Naomi Choong (trainee) and Dr. Jaime Guzman, University of British Columbia, and the nationwide Canadian Alliance of Pediatric Rheumatology Investigators (CAPRI)

The finding: Studying hundreds of children with early juvenile idiopathic arthritis (JIA) enrolled in a national registry revealed important links between fatigue, pain interference with activities, and physical disability, and found that fatigue is severe for 15% of children with JIA.

The future: This study validates that fatigue is a key burden for children with early JIA, which may worsen physical disability. It suggests that efforts to prevent disability should include strategies to cope with both fatigue and pain’s interference with daily living.

Improving access to osteoarthritis care for diverse women

Dr. Anna Gagliardi, University Health Network

The finding: Interviews with diverse women with osteoarthritis and healthcare professionals across Canada suggest at least 18 strategies to overcome barriers to accessing equitable, person-centred osteoarthritis care for women in Canada. Recommended strategies respond to gaps in clinical guidelines and consider patients, healthcare providers, and the healthcare system.

The future: This research is closing the knowledge gap to inform clinical guidelines, healthcare professional education, and programs and policies to optimize osteoarthritis care for disadvantaged communities, including diverse women across the country.

Blocking inflammation in gout

Dr. Ali Abdul-Sater, York University

The finding: A protein called TRAF1 protects against inflammation and swelling in gout by blocking the activation of a protein complex called the inflammasome.

The future: TRAF1 can be studied as a new therapeutic target in gout to potentially lead to relief for more than one million Canadians who live with this painful and debilitating disease.

Understanding joint lubrication in osteoarthritis

Dr. Antoine Dufour and Dr. Roman Krawetz, University of Calgary

The finding: An enzyme called Tryptase β may contribute to osteoarthritis by interfering with the anti-inflammatory and joint lubricating activities of a protein called PRG4 in the joint lining.

The future: This research supports the idea of developing a new treatment to slow osteoarthritis by injecting the affected joint with a drug to block the undesired actions of Tryptase β, while also injecting a lab-developed form of PRG4 to boost its protective levels.

A decade of progress in childhood arthritis

Dr. Jaime Guzman and nationwide researchers of the Canadian Alliance of Pediatric Rheumatology Investigators (CAPRI)

The finding: A snapshot of patient data collected from children across Canada diagnosed with juvenile idiopathic arthritis over a decade shows that with the growing use of biologics and other disease-modifying antirheumatic drugs, the proportion of children achieving inactive disease has also gone up.

The future: Understanding how the treatment landscape is evolving and its link to patient outcomes will help pediatric rheumatologists better communicate options with newly diagnosed families.

Predicting persistent osteoarthritis pain

Christie Costello, Memorial University of Newfoundland
Supervisor: Dr. Guangju Zhai
Dr. Anthony Perruccio, University Health Network

The finding: In people with knee osteoarthritis, traces of a biochemical process called phosphatidylcholine metabolism that can be detected in blood are associated with lingering pain even after joint replacement surgery.

The future: This could lead to a blood test to predict who is likely to still have treatment-resistant pain after joint replacement. The blood test could be used to create better care plans. It also suggests that future metabolism-altering treatments might be able to reduce knee osteoarthritis pain.

Signs of ankylosing spondylitis in the blood

Dr. Fataneh Tavasolian, University Health Network
Supervisor: Dr. Robert Inman

The finding: Tiny particles called exosomes that carry molecular messages between cells can be found in the blood of people with ankylosing spondylitis. Their distinguishing patterns of proteins and other molecules help explain why the immune system goes out of control in this disease.

The future: These features could be used as biomarkers (signs in the blood) to help detect and diagnose ankylosing spondylitis and provide many new potential targets for future drug development to treat this painful disease.

Hip cartilage health in young adults

Carly Jones, University of British Columbia
Supervisor: Dr. David Wilson

The finding: Bone marrow lesions (BMLs, bone features linked to osteoarthritis pain that can be seen with medical imaging) are found underneath damaged hip cartilage in young adults with hip pain, further emphasizing the role that BMLs may play in osteoarthritis.

The future: Confirming the relationship between BMLs and cartilage breakdown in the hip early in the osteoarthritis disease process is an important step in predicting and slowing the progression of joint damage.

Sensitivity to pain from physical activity

Dr. Timothy Wideman, McGill University

The finding: A molecular sign of inflammation detected in the saliva of people with back pain can distinguish who might experience more pain from physical activity, which is usually recommended to reduce joint pain. A new assessment tool based on pain experienced during tasks can also give a better picture of the impact of this sensitivity on pain and mood in daily life, compared to traditional pain questionnaires.

The future: These insights can help physical therapists and other health and exercise professionals to develop and prescribe more personalized physical activity programs or routines to help effectively manage pain in daily life for people with back pain.

Particle-based drug delivery for osteoarthritis

Dr. Jean-Philippe St-Pierre, University of Ottawa

The finding: Small particles made from a type of molecule called polyphosphate can be used to effectively deliver drugs into the cartilage that pads the joints – a typically hard-to-reach area for drugs.

The future: This research validates the need to look beyond drugs themselves and further explore their delivery into the body to extend therapeutic benefits for diseases involving cartilage degeneration, like osteoarthritis. This could lead to new, more effective treatments for millions of people living with osteoarthritis.

Intriguing similarities between systemic sclerosis and cancer

Dr. Mohamed Osman, University of Alberta

The finding: People with systemic sclerosis, a potentially life-threatening form of inflammatory arthritis that causes scar tissue build-up, have unusually high levels of specific carbohydrates in their skin and blood. These carbohydrates are often seen in aggressive cancers.

The future: Discovering connections between systemic sclerosis and cancer may help explain how systemic sclerosis starts and progresses. It also points to the possibility of using these carbohydrates as a biomarker (a sign in skin or blood samples) for more severe disease.

Blood markers for rapid osteoarthritis progression

Dr. S. Amanda Ali, University Health Network (Supervisors: Dr. Mohit Kapoor and Dr. Rajiv Gandhi) and Dr. Andy Kin On Wong, University Health Network

Finding: A specific pattern of molecules can be detected in the blood of people with early-stage knee osteoarthritis that accurately predicts who will have more rapid disease progression.

Future: With further validation, this molecular signature could help identify people who would benefit most from approaches to try to prevent progressive joint damage and maintain joint health before the disease becomes severe.

How a gut protein and bacteria promote inflammatory arthritis

Etienne Doré, CHU de Québec – Université Laval (Supervisor: Dr. Éric Boilard)

Finding: A protein naturally present in the gut acts directly on intestinal bacteria to cause changes in the immune system and promote inflammatory arthritis in mice.

Future: Additional research may unravel which bacteria might be protective or damaging in relation to inflammatory arthritis in people, and whether treatments that impact gut bacteria could offer a new approach to preventing or treating inflammatory arthritis.

How to promote knee health after injury to prevent osteoarthritis

Dr. Jackie Whittaker and Justin Losciale, University of British Columbia – Arthritis Research Canada

Finding: Leading an extensive collaboration between 36 international clinical and scientific experts led to a consensus-based set of recommendations grounded in the best available evidence on how to optimize knee health after injury to prevent osteoarthritis.

Future: Specific recommendations for clinicians will help guide the development and implementation of post-injury knee rehabilitation programs focused on patients’ needs. Recommendations for researchers will help prioritize and coordinate initiatives to address the most pressing gaps in existing knowledge on preventing post-injury osteoarthritis.

Toward personalized treatment for rheumatoid arthritis

Dr. Vidyanand Anaparti, University of Manitoba (Supervisors: Dr. Hani El-Gabalawy and Dr. Neeloffer Mookherjee)

Finding: A specific pattern of molecules detected in a tiny biopsy sample of joint lining tissue from people with early rheumatoid arthritis can predict whether they will respond to – or resist – routine treatments and how they will fare in the long term.

Future: With further validation, this could help rheumatologists match patients with medications most likely to be effective from the outset, avoiding the common cycle of trial and error to ultimately improve their disease control sooner.

Cannabis chemical to reduce joint pain and inflammation

Dr. Jason McDougall, Dalhousie University

Finding: Myrcene is one of the hundreds of chemicals found in cannabis that give it a distinct odour, and applying it to chronically arthritic rat joints reduced joint pain and inflammation.

Future: The promise this understudied cannabis chemical showed in lab models requires further research into whether myrcene or myrcene-rich cannabis strains could offer more relief to people with chronic arthritis pain.

A new drug target in inflammatory arthritis

Dr. Fawzi Aoudjit, Université Laval

Finding: An underexplored molecular signal triggers a highly inflammatory type of immune cell to promote the development of arthritis. Blocking this signalling made arthritis less severe in mice.

Future: Appreciating the critical role of this signalling pathway in the immune system and in inflammatory arthritis identifies it as a possible target for the development of new innovative therapies.

The winding paths in childhood arthritis treatment

Dr. Luiza Grazziotin, University of Calgary (Supervisor: Dr. Deborah Marshall) and the UCAN CURE Consortium

Finding: The patterns of how children with juvenile idiopathic arthritis (JIA) are prescribed medications can follow a complex trial-and-error path, with more than 100 different sequences identified in medical records. While almost half of children are prescribed a biologic medication, many must try a second or third.

Future: No child with arthritis is the same, but they are not alone. This research highlights the need for personalized medicine to get the right treatments to the right children at the right time, and also sheds light on real-world prescribing practices.

Potential biomarkers for spine degeneration

Dr. Lisbet Haglund, Dr. Hosni Cherif, and Matthew Mannarino, McGill University

Finding: A set of genes in the cells of intervertebral discs (the tissue in between the bones of the spine) can predict whether the discs are degenerating, which could be useful as new biomarkers.

Future: With further study, these biomarkers could help identify a degenerative cause of low back pain, and may give researchers new ideas on how low back pain starts at a cellular level and how to treat it.

Genetic links between systemic sclerosis and cancer

Dr. Mohamed Osman, University of Alberta

Finding: In systemic sclerosis – a rare but deadly autoimmune disease that can involve the skin, internal organs, and joints – cells in affected skin have gene mutations similar to those seen in many cancers.

Future: Understanding more about how systemic sclerosis may be driven by cancer-like changes in its early stages may reveal opportunities to repurpose cancer therapies as novel treatments for this devastating disease.

People with arthritis need more information and support

Dr. Elizabeth Badley, Jessica Wilfong, and Dr. Anthony Perruccio, University Health Network and Arthritis Community Research and Evaluation Unit (ACREU)

Finding: Almost half of people diagnosed with arthritis don’t actually know what type they have. While they still experience significant pain, disability and fatigue, they may have lower health literacy and are less likely to access healthcare, information and support services to help them manage their disease.

Future: This highlights the incredible importance of educating people with arthritis and their healthcare providers on arthritis self-management and making sure every arthritis patient is given the tools they need to understand their diagnosis and manage their lifestyle.

Childhood arthritis impacts school performance

Dr. Lily Lim, University of Manitoba

The finding: Childhood arthritis affects physical function and can limit kids’ ability to actively participate in school. It was unclear whether this leads to lower academic performance in childhood and adolescence, which could impact future higher education and career opportunities. Researchers reviewed provincial health and academic records of students in Manitoba with childhood-onset arthritis. They found that students with childhood arthritis performed worse than their peers on their Grade 12 standardized math and language tests, independent of their sociodemographic factors and common childhood mental health issues.

The future: These findings will be used to encourage healthcare workers, teachers and families to address unique challenges and offer academic supports so that children and teens with arthritis can have equitable opportunities to succeed.

Impact of COVID-19 on young workers with arthritis

Dr. Arif Jetha, Institute for Work and Health

The finding: The impact of the COVID-19 pandemic on the work force and economy has been profound. Researchers found that the pandemic contributed to a loss of employment among young adults with arthritis. The pandemic also created barriers to healthcare and treatment access, affected working conditions and made work feel less safe.

The future: These findings highlight the need for targeted strategies for young adults with arthritis that promote economic recovery amidst the COVID-19 pandemic and address gaps in their healthcare.

Life after youth sports injury

Dr. Jackie Whittaker, University of British Columbia – Arthritis Research Canada
Christina Le, University of Alberta – Arthritis Research Canada

The finding: Youth who have had a sports-related knee injury are more likely to develop knee osteoarthritis (OA). Researchers found that youth and young adults experience a poorer health-related quality of life – including physical, psychological, and social aspects – even as long as three to 12 years after injury. Those with previous knee injuries who had a more complex injury history, injury type, or knee pain were even more likely to experience poorer outcomes.

The future: Understanding the factors that influence the quality of life of young people with a history of knee injury will help inform knee injury management, rehabilitation, and OA prevention strategies.

Better healthcare for inflammatory arthritis

Dr. Mark Harrison, University of British Columbia

The finding: In 2011, the British Columbia Ministry of Health introduced a billing code that encouraged rheumatologists to employ nurses for the care and education of people with complex rheumatic diseases, including many types of inflammatory arthritis (IA). Researchers found that rheumatologists and patients think this new multidisciplinary model of care improved the way medical practices functioned, access to care, patient experience, time management, clinician experience, and patient health outcomes.

The future: A multidisciplinary model of care that includes nurses is perceived to be effective across rheumatology settings in B.C. and could be replicated in other provinces to improve healthcare experiences and outcomes for people with IA.

Mimicking osteoarthritis in the lab

Dr. Sowmya Viswanathan, University Health Network and University of Toronto
Mable Wing Yan Chan, University Health Network and University of Toronto

The finding: Researchers created a new tool to evaluate osteoarthritis (OA) treatments in the lab by collecting cartilage and joint lining (synovium) that were donated from people with advanced OA during knee replacement surgery. Cartilage and synovium tissues were processed and incubated together in special two-compartment containers with the final product representing the complex environment found in arthritic joints. The model was tested with a common corticosteroid used to treat OA and effectively captured the effects of the drug on the tissues.

The future: This innovative research tool can mimic how the human disease behaves in the body and help better predict the effects of new therapies for OA. This could accelerate the testing and development of new drugs that are urgently needed for this disease.

Three new osteoarthritis subtypes

Salem Werdyani, Memorial University of Newfoundland
(Supervisor: Dr. Guangju Zhai)

The finding: Metabolomics is the study of the complex profile of small molecules produced by cells as they generate energy – and a snapshot of how the body is working. Researchers studied the metabolomic “fingerprints” in blood from hundreds of people with osteoarthritis (OA) in Newfoundland and Labrador and discovered they could be divided into three groups with distinct blood markers.

The future: This provides insight into how different subtypes of OA might develop and sets the stage for the personalized treatments tailored to people’s metabolic profiles.

Investing in exercise for osteoarthritis

Darren Mazzei, University of Calgary
(Supervisor: Dr. Deborah Marshall, University of Calgary)

The finding: Researchers reviewed the current evidence on strategies to manage osteoarthritis (OA) with education, exercise and weight management. They found that supervised exercise programs for people with hip and knee OA provide health benefits and are cost-effective. In contrast, education on self-management strategies, exercise, or diet did not appear to be as cost-effective on their own and may be more helpful when used in combination with a structured exercise program.

The future: These insights will inform provincial decision-making on funding for OA exercise programs to maximize the use of healthcare resources.

Mental health and gout

Dr. Mary De Vera, University of British Columbia – Arthritis Research Canada

The finding: Gout is a type of inflammatory arthritis that is caused by small crystals that form in the joint. Researchers found that people with gout are more likely to develop depression and anxiety compared to those without this painful condition. Specific disease characteristics, like a greater number of affected joints or frequency of flare-ups, can increase the likelihood of depression.

The future: Mental health disorders can go unnoticed in a rheumatology setting. Heightened awareness of the risk of anxiety and depression in gout can help ensure people get the timely psychiatric care and support they need.

Toward a new treatment for spondyloarthritis

Dr. Nigil Haroon, University Health Network

The finding: Spondyloarthritis is a form of inflammatory arthritis that can affect the joints, spine, gut, skin and eyes. Biologic medications only help about half of people with spondyloarthritis and don’t address the abnormal bone formation that often comes with it. Researchers used a mouse model to discover how a protein called MIF is involved in the immune system and its novel role in spondyloarthritis. They found that blocking MIF with a drug could stop the development or progression of the disease.

The future: This work sets the stage for further development and clinical testing of MIF-blocking drugs. This could lead to a new treatment to improve quality of life for people living with the unrelenting pain of spondyloarthritis.

Putting the brakes on inflammation

Dr. Maria Fernandes, Université Laval

The finding: A protein called CLEC12A can help counteract inflammatory responses seen in gout and other types of inflammatory arthritis – but how it works wasn’t clear. Researchers have unravelled how CLEC12A sends molecular signals in immune cells to dampen this inflammatory response.

The future: Understanding how CLEC12A works may uncover a novel therapeutic strategy, leading to new treatments for inflammatory arthritis.

Immune reactions in systemic lupus erythematosus and the antiphospholipid syndrome

Yann Becker, Centre de Recherche du CHU de Québec – Université Laval
Supervisor: Dr. Éric Boilard

The finding: Mitochondria are small structures inside cells that are considered to have evolved

from bacteria. If cells are damaged and mitochondria are released, the body’s immune system can mistake them for foreign threats and mount an immune response as if there was an infection. This immune overreaction takes place in several diseases such as systemic lupus erythematosus (SLE), an autoimmune form of arthritis, and the antiphospholipid syndrome (APS), a disease often associated with SLE. Yann Becker identified several mitochondrial features that are recognized by the immune defenses of people living with SLE and APS. Anti-mitochondrial antibodies that occur because of this defence may be associated with specific symptoms of the disease.

The future: At this time, there are no clinical tests that can diagnose SLE or predict how symptoms progress. This study will help to improve understanding of the role of mitochondria in the development of autoimmune diseases as well as the design of new tests to better diagnose SLE.

How parents influence kids undergoing arthritis treatment

Yvonne Brandelli, Dalhousie University
Supervisor: Dr. Christine Chambers

The finding: While childhood arthritis can cause debilitating pain on its own, parents can be further disheartened by having to administer treatments to their kids that can also cause pain or discomfort. Yvonne Brandelli found that parents who were more afraid of their child’s pain, especially when their child was receiving more painful treatments like self-injections, struggled more with sticking to the recommended treatment plans.

The future: These findings highlight a need for psychological support and resources for parents of children with arthritis to help them recognize and deal with how they feel about their children’s pain to ensure they and their child receive the best treatment possible.

Removing “zombie” cells to reduce pain and degeneration in the spine

Dr. Hosni Cherif, McGill University
Supervisor: Dr. Lisbet Haglund

The finding: Degeneration of parts of the spine can cause debilitating back pain and osteoarthritis (OA). While some treatments can help manage the pain, there is no cure or way to prevent the degeneration from progressing. “Zombie” or senescent cells – ones that have stopped multiplying but haven’t died – may play a key role in spine degeneration. Dr. Hosni Cherif was the first to find that RG-7112, a synthetic drug, and o-Vanillin, a natural compound, triggered changes that helped new, healthy cells to grow and at the same time, killed senescent cells.

The future: These findings could lead to new drugs for back pain that slow the degeneration of the discs and reduce pain.

Predicting cardiovascular risk in people with psoriatic disease

Dr. Lihi Eder, Women’s College Hospital
Trainee: Keith Colaço, Women’s College Hospital
Supervisors: Dr. Dafna Gladman and Dr. Lihi Eder

The finding: Psoriatic disease (PsD) is a chronic inflammatory skin and joint disease that includes psoriasis and psoriatic arthritis. People with PsD are more likely to develop cardiovascular diseases, such as heart attack and stroke, but doctors need a better way to predict which patients have the highest risk. Dr. Lihi Eder and Keith Colaço discovered abnormalities in lipid particles and cardiac biomarkers in patients with psoriatic diseases.

The future: These biomarkers, when added to traditional risk factors for cardiovascular disease, such as high blood pressure or smoking, could identify patients that will go on to develop disease in the next 5-10 years. The ability to identify high risk patients will lead to better care and reduced cardiac risk.

Investigating a new treatment for scleroderma

Dr. Andrew Leask, University of Saskatchewan

The finding: Scleroderma is characterized by a build-up of tough scar-like fibrous tissue in the skin. A type of cell called the fibroblast is responsible for the overproduction of collagen and the development of tough scar tissue (a process called fibrosis). Dr. Andrew Leask found that inhibiting a protein inside the fibroblast, called YAP1, can block genes that are responsible for fibrosis.

The future: This provides early clues into a new area for investigation – how drugs that target YAP1 can be used to reverse fibrosis, leading to more treatment options and improved quality of life for people with scleroderma.

Reducing the risk of flu in people with rheumatoid arthritis

Dr. Ines Colmegna, The Research Institute of the McGill University Health Centre

The finding: Patients with rheumatoid arthritis (RA) are more prone to infections than people without RA. One of the most frequent causes of infections in RA is seasonal influenza or flu. Dr. Ines Colmegna led the first study to show that the use of a high dose influenza vaccine provides better protection from the flu in RA patients compared to the standard dose vaccine.

The future: These results support the use of the high dose influenza vaccine for people with RA of any age. This may enhance vaccine induced protection and lower the risk of influenza in those patients.

Improving joint protection for people with hand osteoarthritis

Dr. Joy MacDermid, Western University
Trainee: Pavlos Bobos, Western University

The finding: Joint protection programs help patients with hand osteoarthritis alleviate pain and improve function. In a comprehensive review of the literature, Pavlos Bobos found challenges with these programs, for example, a lack of consistency, few are evidence-based, many are outdated, and few use assistive devices. Dr. Joy MacDermid created a new way of measuring the impact of daily tasks on hands using a sensor embedded in a fake fingernail.

The future: A better understanding of the forces used in daily tasks will support the development of new joint protection programs to improve hand function and preserve joints.

A triple threat for seeing joint damage in rheumatoid arthritis

Dr. Sarah Manske, University of Calgary

The finding: People with rheumatoid arthritis (RA) have swelling and bone damage in their joints, but how that damage starts and gets worse is unclear. Dr. Sarah Manske developed techniques to put together images from different times and different tests (e.g., MRI, ultrasound and CT) to better measure the changes that are happening in the bones of people with RA, and the inflammation that might be causing those changes.

The future: Greater use of imaging tools to detect inflammation that is not seen on clinical examination will help clinicians determine how RA is progressing, including if people are at risk for further bone damage, and if so, what strategies can help to minimize joint damage.

Cannabis targeting arthritis pain

Dr. Jason McDougall, Dalhousie University

The finding: Many people with osteoarthritis (OA) struggle with effective pain relief. One of the limitations of pain control is that prescribed analgesics, like NSAIDs, treat pain caused by inflammation, and are not effective for neuropathic pain, caused by damaged nerves in the joints. Dr. Jason McDougall identified a natural cannabinoid system in animal joints that is effective in relieving neuropathic and inflammatory pain. He also discovered new cannabis constituents that may help patients better manage their pain.

The future: By tapping into the body’s natural cannabinoid system, people with OA may be able to reduce the dose of NSAIDs needed to treat joint pain and inflammation, leading to fewer side effects.

How rheumatoid arthritis starts in a high-risk population

Dr. Vidyanand Anaparti, University of Manitoba
Supervisors: Dr. Hani El-Gabalawy and Dr. Neeloffer Mookherjee

The finding: First Nations people have elevated rates of rheumatoid arthritis (RA), but it’s not clear why. Dr. Vidyanand Anaparti is studying First Nations people with a high risk of RA as they start to show symptoms to determine what factors precede or aid in the onset of the disease. One factor is microRNAs, which are “cellular switches” that turn genes on and off. Dr. Anaparti identified that first-degree relatives of people with RA have altered levels of microRNAs and how they are expressed varies depending on the type of immune cell.

Another cellular switch is called methylation, a biochemical process that controls gene expression. Dr. Anaparti found that the methylation of specific genes in RA patients was different and may play an important role in the development of RA. He also identified that the levels of metabolic markers (such as vitamin D, omega-3 and omega-6 fatty acids, oxylipins, and adipokines) are changed in high risk, first-degree relatives of people with RA.

The future: Dr. Anaparti found that microRNAs and methylation have a direct influence on the expression of genes involved in RA. These findings are not unique to the indigenous population and may generally help to identify people at risk of developing RA.

Advancing drug delivery for osteoarthritis
(Consumer favourite)

Dr. Frank Beier in collaboration with Dr. Elizabeth Gillies, Western University

The finding: While many scientists are working towards new treatments for osteoarthritis (OA), drugs that circulate throughout the whole body often have undesirable side effects. To help address this, researchers developed a new delivery method for an anti-inflammatory drug by converting it into tiny particles that could be injected directly into the joint.

The future: With further development, this innovative drug delivery system could be used to target new and existing OA treatments directly to the joint to help minimize side effects and maximize benefits.

An innovative cell therapy for osteoarthritis

Dr. Sowmya Viswanathan, University Health Network

The finding: Treatments to limit the impact that osteoarthritis (OA) has on lives are limited. Cell-based therapies could hold the key but have not yet been proven to be safe or effective. Canada’s first clinical trial on cell therapy for advanced knee OA revealed that it could be a safe approach to reducing joint pain and improving function, likely by combatting inflammation.

The future: This groundbreaking discovery lays the foundation for larger clinical trials on the path to new treatments. Reducing joint inflammation and pain while restoring mobility and quality of life with a single injection of cells could give people with knee OA back the life they’re missing.

First Nations and Métis patient preferences for rheumatoid arthritis management

Dr. Glen Hazlewood, University of Calgary

The finding: Rheumatoid arthritis (RA) is more common in First Nations and Métis Peoples than in non-Indigenous populations. However, little is known about the preferences of Indigenous patients regarding RA management. Researchers found that First Nations or Métis patients with RA at rheumatology clinics in Southern Alberta accept a holistic approach to managing the physical, mental, emotional and spiritual aspects of living with RA. Their preferences for medication were also influenced by clinical, familial and societal factors.

The future: These insights will help healthcare providers build relationships with their First Nations and Métis patients based on trust and effective communication. This is expected to encourage shared decision-making in a culturally safe environment to improve RA treatment in this population.

Preventing a life-threatening complication of scleroderma

Dr. Sabrina Hoa, Jewish General Hospital – Lady Davis Institute
(Supervisors: Dr. Marie Hudson and Dr. Sasha Bernatsky)

The finding: Scleroderma (sometimes called systemic sclerosis) is a rare autoimmune disease that involves a build-up of tough scar-like tissue in the skin and sometimes other organs. If the lungs are involved, people can develop a complication called interstitial lung disease (ILD), which can be fatal. Researchers found that drugs that suppress the immune system in people with mild ILD help preserve lung function and prevent ILD progression.

The future: This suggests a promising “window of opportunity” to treat ILD early on, when it is mild, to prevent its progression to a life-threatening complication. With further study, this treatment approach could save lives for those with scleroderma.

Vitamin D and rheumatoid arthritis?

Dr. Vidyanand Anaparti, University of Manitoba
(Supervisors: Dr. Hani El-Gabalawy and Dr. Neeloffer Mookherjee)

The finding: First Nations people have high rates of rheumatoid arthritis (RA), but it’s not clear why. Surprisingly, researchers found that vitamin D levels in the serum of the blood increased in a small group of First Nations people with a high risk of RA as they started to show clinical symptoms of the disease.

The future: This research provides early clues into a new area for investigation – how vitamin D might be involved in the development of RA in this population.

Wearable technology to measure function before knee replacement

Dr. Matthew Teeter, Lawson Health Research Institute

The finding: Wearable sensors may become the future of preoperative assessment of people with arthritis preparing for knee replacement surgery. Researchers found that combining wearable sensors to track knee movement with a form of artificial intelligence called machine learning could be used at pre- and post-operative appointments to classify people according to their likelihood of improving their knee function.

The future: With further development, this technology could be used to help patients manage their expectations and inform their post-operative recovery and rehabilitation plans.

Artificial intelligence to guide treatment in childhood arthritis

Dr. Simon Eng, The Hospital for Sick Children
(Supervisor: Dr. Rae Yeung)

The finding: Some children have mild forms of arthritis, while others can have forms with devastating impacts that last into adulthood. It’s hard to predict which children might be able to avoid unnecessary treatments and side effects. Researchers discovered an algorithm using artificial intelligence that can predict how childhood arthritis will behave.

The future: This new approach will shape clinical practice and inform tailored treatment decisions to keep children with arthritis healthy.

Depression and anxiety in lupus

Dr. Zahi Touma, University Health Network

The finding: Lupus, or systemic lupus erythematosus (SLE), is a serious inflammatory disease that can involve the joints and many organs, including the nervous system. This can lead to several mood disorders that can often go undiagnosed. Researchers found that simple patient screening questionnaires could be helpful in identifying people with lupus who may have depression or anxiety and found that these conditions were present in up to half of all lupus patients.

The future: Bringing attention to the high prevalence of depression and anxiety in people with lupus and providing reliable tools to help healthcare providers screen for them can help ensure patients get the timely psychiatric care and support they need.

Earliest joint changes on the path to post-injury osteoarthritis

Dr. Steven Boyd, University of Calgary

The finding: Tearing the anterior cruciate ligament (ACL) in the knee is a common sports injury that increases the risk of developing knee osteoarthritis (OA). In more detail than ever before, researchers were able to use advanced medical imaging to visualize some of the earliest changes to the bones in the knee joint after an ACL injury.

The future: Knowing how the bone is lost or damaged in the injured joint in the months immediately after an ACL tear suggests that efforts to rehabilitate the joint should begin early after injury to prevent future OA.

Long wait times for multidisciplinary pain treatment

Simon Deslauriers, Université Laval
(Supervisor: Dr. Kadija Perreault)

The finding: People with arthritis can receive comprehensive pain management services in pain clinics, where multiple healthcare providers provide coordinated care for chronic pain. Pain clinic services can improve patients’ quality of life but often have long wait times. Researchers found that about a third of people with arthritis in Quebec waiting to be seen at a pain clinic waited longer than 6 months before their first appointment.

The future: This research highlights a gap in access to timely and effective care and identified several barriers to be addressed to improve access to comprehensive pain management services.