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Top 10 Research Advances of 2020

Research advancements of 2020 that are transforming the future of arthritis.

Thanks to the generosity and vision of our donors, the Arthritis Society is the leading charity in funding cutting-edge arthritis research across Canada. With this crucial support, innovative minds are answering the most pressing research questions spanning the many types of arthritis. Whether working in the lab, the clinic, or alongside people living with arthritis in their everyday lives, researchers are turning your support into discoveries to help improve care for people with arthritis today, while searching for a cure for tomorrow. Here are some of the many advances made possible in 2020.

Immune reactions in systemic lupus erythematosus and the antiphospholipid syndrome

Photography of Yann Becker, Eric Boilard and Paul FortinYann 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

Photography of Yvonne Brandelli and Dr. Christine ChambersYvonne 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

Photography of Dr Hosni Cherif adn Dr Lisbet HaglundDr. 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

Photography of Dr. Lihi Eder, Keith Colaço and Dr. GladmanDr. 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

Photography of Dr. Andrey LeaskDr. 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

Photography of Dr. Ines ColmegnaDr. 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

Photography of Dr. Joy MacDermid and Pavlos BobosDr. 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

Photography of Dr. Sarah ManskeDr. 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

Photography of Dr. Jason McDougallDr. 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

Photography of Dr. Vidyanand Anaparti, Dr. Hani El-Gabalwy and Dr. Neeloffer-MookerjeeDr. 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. 

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