Congratulations to Yvonne C. Lee, MD, MMSc, of Northwestern Medicine Rheumatology, on receiving the 2022 Innovative Research Award from the Rheumatology Research Foundation. This award encourages independent investigators to conduct novel studies that generate new insights into the cause, progression, treatment and outcomes of rheumatic diseases.
Transcriptional Profiles of Circulating Monocytes and Their Association With Pain Centralization and DMARD Response in Rheumatoid Arthritis
Among patients with rheumatoid arthritis (RA), pain may persist even when inflammation is controlled. This pain may be due to pain centralization, a process that changes the way the brain and spinal cord regulate pain.
The goal of this proposal is to develop insights into the processes underlying pain centralization by studying the relationship between gene expression in monocytes (a type of white blood cell) and pain centralization. The rationale for studying monocytes is based on rodent models showing that monocytes are involved in maintaining chronic pain.
The hypothesis is that uniquely characteristic patterns of gene expression are associated with pain centralization. The specific aims are to:
Fifty subjects with RA will be assessed before starting a DMARD and 12 weeks after completing it. Subjects will complete surveys to characterize their pain experience and undergo quantitative sensory testing (QST) to assess patterns of pain sensitivity associated with specific pain pathways. Blood will be drawn to collect monocytes for RNA-sequencing. Machine-learning techniques will be used to model if gene expression is associated with QST patterns of pain centralization and if it can predict pain response after DMARD therapy.
This research is innovative because it uses cutting-edge functional genomic approaches to identify pathways associated with chronic pain in RA and because it uses QST, in addition to self-reported measures of pain, to assess pain centralization.
This research is impactful because it would enable the development of non-opioid analgesics for chronic pain in patients with RA. This proposal aligns with the Foundation’s goal to support research that studies biological parameters associated with clinical manifestations and responses to therapy.
Yvonne C. Lee, MD, MMSc, is the Helen Myers McLoraine Professor of Rheumatology, and associate professor of Medicine (Rheumatology) and Preventive Medicine at Northwestern Medicine.
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