In spite of significant progress, inflammatory diseases remain poorly understood and difficult to treat and are of growing public health importance. This fellowship application is for translational research on improving treatment for inflammatory diseases, including rheumatoid arthritis. It will link the senior clinical appointments of Prof Ian Wicks in Rheumatology at the Royal Melbourne Hospital with his appointment as Head of the Inflammation Division at the Walter & Eliza Hall Institute of M ....In spite of significant progress, inflammatory diseases remain poorly understood and difficult to treat and are of growing public health importance. This fellowship application is for translational research on improving treatment for inflammatory diseases, including rheumatoid arthritis. It will link the senior clinical appointments of Prof Ian Wicks in Rheumatology at the Royal Melbourne Hospital with his appointment as Head of the Inflammation Division at the Walter & Eliza Hall Institute of Medical Research.Read moreRead less
Transforming Treatment Options And Delivery Of Care For Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$2,510,793.00
Summary
Osteoarthritis is highly prevalent and a leading cause of disability. Despite this burden, current management is frequently inappropriate and associated with enormous financial costs. This program of research leverages established resources and existing funding to investigate the key challenges for OA in the next decade, including 1) Further enhance the methods for disease modification trials and deploy novel trials, and 2) Optimise the delivery of care for those with extant disease.
Towards A Diagnostic Test For Juvenile Idiopathic Arthritis
Funder
National Health and Medical Research Council
Funding Amount
$661,670.00
Summary
Childhood arthritis is an autoimmune disease that affects around 6000 Australian children. It can be difficult to diagnose, but quick diagnosis is important to prevent ongoing pain and limit long term damage to joints. We have been able to use genetic information to predict which people have autoimmune celiac disease. In this project, we will find out how well genetic information can predict which children have childhood arthritis, and whether genetics can be used as a diagnostic test.
Improving Outcomes In Low Back Pain: Identifying Risk Factors And Patient Subgroups
Funder
National Health and Medical Research Council
Funding Amount
$348,768.00
Summary
Low back pain is the leading cause of disability globally with no effective treatment. Although low back pain is a complex condition, current treatment strategies use a ‘one size fits all’ approach which has contributed to lack of effective treatments and patient’s dissatisfaction. This fellowship aims to identify novel risk factors, patient groups and patient specific factors related to poor outcomes so that effective treatments can be targeted to those most likely to benefit.
Implementation Of A Treat-to-target Remission Strategy For Rheumatoid Arthritis In Australian Public And Private Rheumatology Clinics
Funder
National Health and Medical Research Council
Funding Amount
$178,157.00
Summary
Rheumatoid arthritis (RA) is a common and incurable inflammatory joint disease affecting 2% of Australians. RA is associated with significant pain, disability, loss of work capacity and reduced life expectancy. Research has shown that 'treating to a target' for the goal of remission significantly improves outcomes for people living with RA. This TRIP fellowship will assess the barriers to clinicians and people living with RA managing the disease in a targeted way and develop a package to assist.
Improving Translation Of Evidence Into Practice For Musculoskeletal Conditions
Funder
National Health and Medical Research Council
Funding Amount
$948,684.00
Summary
Musculoskeletal conditions place a huge burden on the world’s population. Yet current trials in this field may not reflect priorities based upon this burden and few trials address well-recognised evidence-practice gaps. My fellowship will aim to transform the current ad hoc approach to Australian musculoskeletal clinical trials. It will identify the most critical unanswered questions, formulate a national research agenda, and identify best methods for optimising uptake of findings into practice.
Novel Mechanisms And Targets In Neonatal Lupus: Clues To Systemic Autoimmunity
Funder
National Health and Medical Research Council
Funding Amount
$428,250.00
Summary
Autoimmune diseases represent the third greatest clinical burden to the community after heart disease and cancer. Management of the diseases remains primitive because of our poor understanding of the disease mechanisms. Autoantibodies are one of the key markers of diseases such as lupus and Sj gren's syndrome, but their role in producing tissue damage is largely unresolved. However in the neonatal lupus syndrome, autoantibodies from the mothers cross the placenta and appear to cause inflammation ....Autoimmune diseases represent the third greatest clinical burden to the community after heart disease and cancer. Management of the diseases remains primitive because of our poor understanding of the disease mechanisms. Autoantibodies are one of the key markers of diseases such as lupus and Sj gren's syndrome, but their role in producing tissue damage is largely unresolved. However in the neonatal lupus syndrome, autoantibodies from the mothers cross the placenta and appear to cause inflammation of particular target organs such as the heart and skin in the babies. Neonatal lupus offers a unique opportunity to investigate the pathological role of autoantibodies and other factors (e.g. infection) in autoimmune diseases, and is likely to offer vital clues to lupus in adults. For example, the skin disease in babies with lupus mimics the cutaneous lesions in adult lupus patients. Recent work from our group using an animal model has shown that certain autoantibodies cross the placenta and bind to cells undergoing physiological death in the fetus, in the same organ distribution as human neonatal lupus. Using sophisticated imaging techniqes we can now trace the fate of maternal autoantibodies in the babies for the first time and understand how the target proteins in heart and skin become exposed to the damaging effects of these autoantibodies. We also believe that certain types of autoantibodies can directly alter contraction and electrical activity in the heart in babies with neonatal lupus, leading to heart block which can be fatal. We have already discovered similar functional autoantibodies in adult patients with Sj gren's syndome whose babies can also also develop neonatal lupus, and plan to characterise them using unique physiological assays in intact hearts. We will characterise the redistribution of antigenic proteins in cells in fetuses and the interaction of maternal autoantibodies with these proteins to cause tissue damage and functional heart block.Read moreRead less