Current research projects in rheumatology
Project 1: Understanding more about Juvenile Idiopathic Arthritis (JIA)
Juvenile Idiopathic Arthritis (JIA) is the most common rheumatologic disease of childhood, affecting up to one in every 500 children. To prevent soft tissue deformities, irreversible joint damage and the adverse side effects of medication for this disease, it is important that we gain a better understanding of the inflammatory processes occurring within arthritic joints.
The synovial fluid within active joints is known to contain TH17 cells which are the major cause of inflammation and joint damage in adults with arthritis: however, to date there has only been one study showing that Th17 cells are also commonly found in the joints of children with the same condition. This project aims to uncover the frequency, type and function of Th17 cells within active joints of JIA patients, in order to understand the inflammatory process better and to help treat JIA earlier and more effectively.
Commenced in 2009, this research project is being carried out at the Women's and Children's Hospital in Adelaide, in partnership with the Women's and Children's Health Research Institute. It involves eight researchers led by Dr Christina Boros, leader of the Rheumatology Stream at the Children's Research Centre and Head of the Department of Rheumatology at the Women's and Children's Hospital.
Project 2: Tailoring arthritis treatment
The treatment options for children with Juvenile Idiopathic Arthritis (JIA) have expanded significantly in recent times, but unfortunately not all children with the same arthritis subtype respond equally well to treatment. These children are at greater risk of joint deformity, growth failure, osteoporosis and reduced life expectancy.
The aim of this project is to assist in the creation of more individualised treatment options for this patient group. By using a technique called "tandem mass spectrometry", which has never before been used in studies in JIA, we are able to measure the level of prostanoids in the blood and synovial fluid of children with arthritis, and learn much more about the nature of arthritic activity.
Prostanoids are biologically active lipids which are involved in the inflammatory response: by using them as biomarkers for JIA, we are better able to predict the disease course and create opportunities for more customised treatments.
Commenced in 2010, this research project is being carried out at the Women's and Children's Hospital in Adelaide, in partnership with the Directorate of Genetic and Molecular Pathology at SA Pathology. It involves four researchers led by Dr Christina Boros, leader of the Rheumatology Stream at the Children's Research Centre and Head of the Department of Rheumatology at the Women's and Children's Hospital.
Project 3: Is the HPV vaccine effective in immunosuppressed children?
It is widely known that Human Papilloma Virus (HPV) is the major cause of cervical cancer, as well as several other cancers and conditions. There are now effective vaccines against the main cancer-causing HPV types (HPV16 and HPV18) and a free, national HPV vaccination program for adolescent girls was launched in 2007.
However there is currently no research on the safety and effectiveness of the HPV vaccine in immunosuppressed children and adults, including those with rheumatic diseases such as JIA. This study is investigating this previously unexamined field by monitoring changes in disease activity after immunisation among immunosuppressed patients, and documenting their corresponding antibody levels. It is hoped that this project will provide a valuable insight into the safety of, and responses to, immunisation in immunocompromised children and help inform guidelines for the future immunisation of these patient groups both locally and globally.
Started in 2008, this research project is being carried out at the Women's and Children's Hospital in Adelaide, as part of a national study coordinated by the National Centre for Immunisation Research and Surveillance and the Children's Hospital at Westmead. The South Australian site is funded by an Arthritis Australia Paediatric Grant and is led by Dr Christina Boros, leader of the Rheumatology Stream at the Children's Research Centre and Head of the Department of Rheumatology at the Women's and Children's Hospital.
