Osteoarthritis Center of Excellence Research Story
Our osteoarthritis (OA) center of excellence (COE) is currently funding three Clinical Trial Network demonstration studies that may lead to better diagnosis and earlier treatments for OA. Researchers from six different institutions will collaborate in various aspects of these cutting-edge studies. The three studies are connected to one another for a common purpose and they build on previous research funded by the Arthritis Foundation. This is the second in a series of three blogs describing these studies. Read the first one here.
Dr. Virginia Byers Kraus is working to identify biochemical biomarkers found in synovial (joint) fluid and urine from post-traumatic OA patients who have suffered anterior cruciate ligament (ACL) rupture. The samples used for this study come from samples collected from a 2013 Arthritis Foundation-funded project that validated using magnetic resonance imaging (MRI) techniques to measure the molecular changes that begin to occur in joints immediately after an ACL tear.
Urine and synovial fluid (from damaged knee joints) were collected from patients at five timepoints: baseline (less than 4 weeks after the joint injury), during surgery (about 6 weeks after the injury), 6 weeks after surgery, 6 months after surgery, and 1 year after surgery. The analysis of the 177 urine samples and 101 synovial fluid samples will take about 6 months.
The goal of this project is to evaluate which biochemical markers are connected to inflammation and cartilage breakdown following ACL rupture. The team is working to identify which biomarkers are most critical for predicting risk of OA after injury and to confirm the earliest and best timepoints to start treatments.
“With heart attacks, we treat immediately for best results,” explained Dr. Kraus. “We’re hoping to show that the same is true for joint injuries. What is important is the time from the injury to medical intervention. We must treat early to prevent further damage. What we currently see is that about half of the patients who have surgery for an ACL tear eventually develop more serious disease.”
By identifying biomarkers that appear early following an injury and by using more sensitive MRI imaging techniques, researchers hope to identify the individuals at highest risk for more serious joint disease and to determine the “window of opportunity” for providing treatment to prevent subsequent OA. Earlier interventions might include new drugs designed to halt the disease process and other anti-inflammatory drugs, thus reducing the need for joint replacements later and improving the quality of life.
Dr. Kraus was inspired to study OA by her father. Her father, a surgeon during the Vietnam War, damaged his hip and as a result endured 3 hip replacements over the rest of his life. While her father continued working into his 70’s, Dr. Kraus felt frustrated watching his daily suffering and the suffering of her clinic patients. It’s pushed her to want to make a difference and stop OA in its tracks.
“Osteoarthritis is a big and challenging beast -it’s the most prevalent disease in the world,” she explained. “It affects mobility, which in turn affects your heart and many other aspects of your health. We’ve begun to see success in understanding many types of arthritis, but up to now, we haven’t been as successful with OA. It’s so frustrating for me to see the suffering caused by this disease.”
We’re so proud to call Dr. Kraus a Champion of Yes. She explained why she likes to submit her research projects to us: “The Arthritis Foundation has stayed the course in maintaining prolonged interest in finding a cure. It has worked at building on prior innovative research – it’s hard to get funding for these types of studies. The Foundation has created a nimble mechanism for doing this type of research and moving it forward faster. This brings us closer to finding cures for patients more quickly.”
Dr. Kraus, the principal investigator in this project, is a professor of Medicine, Pathology and Orthopaedic Surgery at Duke University in Durham, NC. She will be working with other researchers from Duke University, as well as researchers from the University of California San Francisco (UCSF), Hospital for Special Surgery (HSS) in NYC, and the Mayo Clinic in Rochester, MN.