A new multidisciplinary clinical research center (MCRC) at the University of North Carolina at Chapel Hill, funded by a $5.6 million grant from the National Institutes of Health, seeks better ways to address the costly public health issue of osteoarthritis (OA). Arthritis affects 50 million people in the United States, with more than 27 million of those suffering the disabling pain of OA, a form of arthritis that causes joint swelling and degeneration. These numbers are expected to grow significantly as the population ages and gets heavier, since extra weight puts additional strain on joints, especially knees and hips.
“We know that arthritis is the leading cause of disability among older adults,” said Dr. Joanne Jordan, principal investigator for the grant and director of UNC’s Thurston Arthritis Research Center (TARC). “With this grant, we plan to create a true multidisciplinary hub for OA and musculoskeletal research here at UNC – one that leverages our research, clinical, education and training strengths across disciplines to better understand and treat this chronic and often debilitating disease.” Jordan also is chief of the division of rheumatology, allergy and immunology in the UNC School of Medicine’s Department of Medicine.
Arthritis affects 50 million people in the United States, with more than 27 million of those suffering the disabling pain of OA, a form of arthritis that causes joint swelling and degeneration.
The new MCRC will take a three-pronged approach to mitigating the public health impact of osteoarthritis: understanding what causes and contributes to developing arthritis and resulting disability; identifying best practices to help communities address this public health issue; and transforming the face of arthritis research on campus by serving as a center for innovation, training and collaboration.
“We will build on our existing strengths, including the long-term community project in Johnston County, where we have been working with residents since 1991,” Jordan said. The federal Centers for Disease Control and Prevention, which has helped support the program, describes it as, “… a unique, community-based, longitudinal study of approximately 3,200 rural white and black residents aged 45 and older, followed for over 20 years.”
The Johnston County study now includes hand, foot, spine, shoulder and ankle OA; osteoporosis, diabetes, cardiovascular disease and other chronic conditions. It has been the source of more than 30 other studies examining risk factors for OA, such as diet, occupational demands, physical activity, genetics and environmental exposures to metals and others. The study has also housed several clinical trials and community interventions for arthritis.
The MCRC includes two new research studies. The first, also based in Johnston County, will look at ways a spouse or other committed partner can help people with knee or hip OA become more physically active. “Increasing physical activity in older adults can help arthritis and many other chronic conditions,” said Christine Rini, director of the study and research associate professor of health behavior in UNC’s Gillings School of Global Public Health.
The second study builds on the multisite Joint Undertaking to Monitor and Prevent Anterior Cruciate Ligament Injury, or JUMP-ACL. The collaborative program is looking at risk factors for injury to the ACL, one of the knee’s major ligaments, among cadets in U.S. military academies. ACL injuries have been linked to early-onset osteoarthritis. “We hope to be able to identify clinical characteristics and biomarkers of the disease process that will help us recognize who will go on to develop post-traumatic OA, so that we can target them for early intervention to try to prevent the arthritis,” said Stephen Marshall, study leader, director of UNC’s Injury Prevention Research Center and professor of epidemiology at Gillings.
Other UNC faculty involved in the MCRC include Dr. Leigh Callahan, its associate director, professor of medicine and social medicine in UNC’s School of Medicine and adjunct professor in epidemiology at Gillings; and Todd Schwartz, research assistant professor in biostatistics at Gillings and faculty statistician for the Johnston County project.
The new MCRC will work closely with the N.C. Translational and Clinical Sciences Institute, housed at UNC-Chapel Hill and home of the NIH Clinical and Translational Science Awards Program. Together, they will identify and strengthen collaborative opportunities in OA and musculoskeletal research and training across UNC’s campuses and beyond.