In 1996, Shirley Robert was diagnosed with psoriatic arthritis (PsA) in both her hips. With treatment she was able to go into remission in the early 2000s, but then she experienced a severe flare-up that was almost fatal.

Medication was able to get the inflammation from Shirley’s PsA under control, but not before the damage to her hips became so significant that she required surgery in 2008 to replace both hips.

In 2011, just when she thought she had her disease under control, a flare in her right knee turned out to be osteoarthritis (OA), as joints that had compensated for her compromised hips started to give way themselves.

Rewind the clock – what would Shirley’s future have been like if her PsA had been controlled from the start?

That’s the kind of question that drives researcher Meital Yerushalmi, a PhD student at the University Health Network’s Krembil Research Institute. Yerushalmi has received a Graduate PhD Salary Award from the Arthritis Society to study the role that skin bacteria play in the development of psoriasis and PsA.

PsA can lead to progressive joint damage, pain, disability, and poor quality of life, but its impact can be quite variable. This variation cannot yet be explained by known risk factors. Under the supervision of Dr. Vinod Chandran, Yerushalmi is working on a first-of-its-kind study of skin bacteria in people with psoriasis and different types of PsA in the context of the person’s genetics. This research will help reveal what role a person’s “skin microbiome” plays in the development and severity of PsA, which could provide insight into possible new treatments to help people like Shirley before their joints become damaged.

“I felt numb,” says Shirley of learning that her PsA had led to OA. “Did I not have enough to deal with already? I had a good cry – and then I decided that my disease would have to live with me instead of me living with my disease.”

Shirley lives that determination every day, keeping herself mobile so she can keep up with her busy family. Shirley exercises 3 times a week, including muscle strengthening, and walks 20 minutes a day. She is also active in supporting the work of the Arthritis Society, including work with our advocacy committee and taking part in the Walk for Arthritis.

Research like this may offer Shirley and people like her new hope for ways to manage their disease – before it affects their mobility and quality of life.

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