June 25, 2001
Research targets arthritis among African-Americans
By Alicia Sands Lurry
The School of Medicine is one of four major academic medical centers
in the southeast United States that will begin gathering data for investigators
interested in the genetics of rheumatoid arthritis (RA) in African Americans.
Support is being provided by the National Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS).
NIAMS, a component of the National Institutes of Health (NIH), has awarded
a research contract for the Consortium for the Longitudinal Evaluations
of African Americans with Early Rheumatoid Arthritis (CLEAR) Registry
to the University of Alabama-Birmingham. In addition to Emory, the other
participating centers are the Medical University of South Carolina and
the University of North Carolina.
The registry will provide clinical and x-ray data and DNA to help scientists
analyze genetic and nongenetic factors that might predict disease course
and outcomes of RA in this population. Certain genes that play a role
in the immune system are associated with a tendency to develop RA.
Some individuals without these genes may develop this disease, while
others who possess the genes never develop RA.
Scientists believe that some environmental factors may play a part, triggering
the disease process in people whose genetic makeup makes them susceptible
There are currently no ongoing studies evaluating early RA in African
Americans. African Americans are often under-represented in most clinical
studies, including current observational studies of people with RA.
Participating investigator Doyt Conn, director of allergy, immunology
and rheumatology and chief of rheumatology at Grady Hospital, said about
40 patients at Grady and Emory have been identified as possible study
participants. He said the research is important because it will eventually
help identify new treatment approaches for patients, particularly African
The genetic factors correlated with clinical factors will help
us understand rheumatoid arthritis better, Conn said. In addition,
the genetic profile in African Americans may be different than that of
whites. There are not that many RA studies that focus on African Ameri-cans,
and genes and environment do play a factor. This study will provide a
cross-section of genetic profiles.
Larry Moreland, principal investigator of the CLEAR Registry, agreed.
This registry of African Americans with early RA will be critical
in identifying risk factors, including genetic and environmental, that
point to a more aggressive disease process, he said. Ultimately,
the ability to identify patients very early in the disease process who
might have a worse long-term outcome will allow physician to provide better
treatments for these patients.
Investigators at all four centers intend to register 600 participants.
Those who participate will have been diagnosed with RA less than two years
ago, and will be evaluated three times over a five-year period.
The key is seeing them early and getting them on the appropriate treatment, Conn said. Thats the goal. We believe patients will function better and the incidence of surgery will decrease.