Over 400,000 people in the UK have rheumatoid arthritis (RA) with important consequences for individuals, health services and society. RA causes the body's own immune system to attack healthy joints and tissues, causing joint inflammation and damage. The cost of RA to the UK economy is estimated at £3.8-4.8 billion.
Up to half a million people in the UK are also affected by Sjögren’s syndrome, an autoimmune condition that can accompany RA, and it is estimated that 15,000 people are affected by systemic lupus erythematosus (SLE).
At the University of Birmingham, our rheumatology research focusses on understanding why inflammation of the joint persists, and why it persists in some but not all joints. The Rheumatology Research Group, comprising of over 50 staff, aims to improve clinical outcomes for those with, and at risk of developing, RA, Sjögren’s syndrome and SLE, by developing diagnostic tests, drugs, cell based therapies and lifestyle assessments to predict, prevent and reverse disease pathology.
Process driven pathway-focussed pathology
A unique feature of our translational research is that we have pioneered a first in class, “process-driven pathway-focused” approach to the biology of inflammatory arthritis, which has become an internationally accepted paradigm.
Our therapeutic targeting of the tissue microenvironment and our skills in comparing and contrasting the biological processes underpinning the development, maintenance and resolution of inflammation – our process driven approach - has allowed us to develop this unique approach to inflammation research.
Our approach compares shared biological mechanisms across a number of traditionally independent organ-based medical disciplines to develop biologically meaningful and therapeutically tractable process-driven with strong links to other disease areas in inflammation biology.
Furthermore, our approach breaks down traditional bench to bedside, bedside to bedside and primary care-secondary care silos that have prevented a truly integrated, multidisciplinary, patient centred approach to treating chronic inflammation in general.
Professor Christopher Buckley
Kennedy Professor of Translational Rheumatology
“If you’ve ever suffered from an inflammatory disease, such as asthma, multiple sclerosis, or psoriasis you go to different specialists to look after your inflammation. What our research is trying to do is to break down those silos between different clinical specialties – what we call bedside to bedside problems – so that patients with these different diseases can be looked after in a common way.
Understanding the processes by which inflammation is specific to one site but yet also share common features is a really important concept that needs a structural change in the way in which we approach inflammatory diseases.”
A national centre of excellence
In recognition of our world-leading expertise in this area, we host a number of national centres of excellence.
The NIHR Birmingham Biomedical Research Centre is a centre of excellence in inflammation that allows us to use cutting-edge experimental medicine to translate scientific discoveries into new drugs, devices and diagnostics tests for patients living with chronic inflammatory and autoimmune joint, muscle, bowel and liver diseases.
The Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE) is a collaboration between the Universities of Birmingham, Glasgow and Newcastle, working together to find better treatments and ultimately a cure for rheumatoid arthritis.
An accelerated approach to find novel therapies
The Arthritis Therapy Acceleration Programme (A-TAP) is a £7 million concept funded by the Kennedy Trust for Rheumatology Research. It brings together the University of Birmingham, the University of Oxford and seven NHS partners along the M40 corridor. It is also supported by combined access to a 7 million population.
Led by Professor Christopher Buckley, the A-TAP aims to support and develop novel treatments for four immune-mediated inflammatory diseases (RA, Sjögren’s syndrome, inflammatory bowel disease and spondyloarthropathy) based on the underlying causes of inflammatory disease. The A-TAP aims to develop a new taxonomy of disease that moves away from an organ-based approach to therapy and towards a process-driven and pathway-focused driven classification. The results will help to treat the cause of disease, not just their symptoms.
The initiative seeks to perform experimental medicine trials in carefully selected patient populations to facilitate uptake of new therapies at pace and scale. The network will also provide researchers in Oxford, Birmingham and beyond with access to tissue samples and patient cohorts to facilitate translational and clinical research.
Early diagnosis to allow early treatment
The early treatment of RA leads to significantly improved clinical outcomes. However not all patients who present with a new onset of arthritis go on to develop RA; in some cases the patient’s arthritis resolves spontaneously and in other cases they develop another form of persistent arthritis. It is thus important to be able to predict which patients with early arthritis will develop RA to allow targetted early treatment. Prof Karim Raza and Dr Andrew Filer lead the BEACON early arthritis cohort study, in which over 800 patients are studied from the earliest stages of arthritis.
Furthermore, a wide range of medications are available for the treatment of RA and there are considerable inter-individual differences in responses to treatment. The ability to predict treatment response is thus of considerable clinical importance.
Birmingham's Rheumatology Research Group has demonstrated that there are significant delays in patients making initial contact with their GP, which leads to delays in referral to a rheumatologist and starting treatment; this situation has been shown to be worse in patients of South Asian origin. The outcome of the work has been incorporated into national policy documents and clinical guidance material and has underpinned patient focused campaigns to raise awareness of the disease and the need for early diagnosis.
Patients and members of the public play an important role in the development, delivery and dissemination of research, enhancing its relevance and impact. Professor Karim Raza has been instrumental in establishing the Birmingham Rheumatology Research Patient Partnership (R2P2). Led by Dr Marie Falahee, with 40 active members, the Partnership provides crucial input into clinical and translational studies across the Rheumatology Research Group.
Members of R2P2 are actively involved in setting priorities for research, informing the way that research studies are carried out and helping to develop future knowledge.
Kennedy Professor of Translational Rheumatology and Director of Birmingham NIHR Wellcome Trust Clinical Research Facility
Versus Arthritis Professor of Rheumatology and Honorary Consultant Rheumatologist
Reader in Translational Rheumatology
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Institute for Inflammation and Ageing ➤
Versus Arthritis ➤
Lupus UK ➤
The Kennedy Trust for Rheumatology Research ➤
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