The AF funds three major types of grants:
- Career development and training programs: These grants encourage scientists to begin research careers in the arthritis field and develop into independent arthritis researchers.
- Investigator-initiated programs: These grants support basic, clinical, and health services research relevant to arthritis.
- Special targeted research initiatives: These grants focus on promising areas of arthritis research or on specific types of arthritis.
We have supported many projects that have facilitated bringing new discoveries to the marketplace and showing applications for patient care.
Additionally, the AF established a new innovative grants program in 2002. This was designed to support creative, high-risk ideas in arthritis research. The dollar amounts and time frames for AF grants vary but can reach $100,000 over two years.
The AF research program funds studies with the greatest potential for improving the lives of people with arthritis. The organization supports a broad spectrum of types of research and scientific disciplines. These include basic “bench” research in such areas as genetics, immunology, biochemistry, and cell biology; clinical “bedside” and behavioral studies that utilize human subjects to develop and test new medical, rehabilitation, surgical, and educational treatments; and research in the real world, including epidemiology studies to increase understanding of disease patterns.
Most funding for AF research comes from contributions from the public, according to John H. Klippel, MD, president and CEO of the organization. The program’s funding stream involves direct mail, annual giving programs, special events such as the Jingle Bell Run/Walk, and community-level activities such as breakfasts.
The AF employs a peer review process for evaluating and selecting research projects for funding. Additionally, the organization has a research council, involving rheumatologists, consumers, scientists, and others, charged with guiding its research program.
John Hardin, MD, the AF’s chief scientific officer, says that AF-funded studies have received tremendous visibility and attention over the years. “About 90% or more of researchers we fund actually publish studies in a scientific journal,” he says. “Many of these articles appear in the most respected publications in the field.”
AF-funded studies, have led to the development of new therapeutic agents and discoveries such as the epidemiology of Lyme disease. “We have supported many projects that have facilitated bringing new discoveries to the marketplace and showing applications for patient care,” he says.
Leap Research Barriers
Dr. Hardin urges rheumatologists and other practitioners to get involved in research despite the challenges. “Basic science in this country is vigorous and strong, but we always need more funding,” he says. Additionally, there are bottlenecks slowing the process of translating scientific discoveries into treatments and products. “We need a more streamlined bureaucracy that ensures the translation of research into products and practice is done properly,” he says.
All rheumatologists can help arthritis research overcome one important barrier—engaging patients in studies. “They can help patients understand the benefits and value of research studies,” says Dr. Hardin. He adds that practitioners can help identify seniors and children—two important specialty populations—who might be appropriate for studies. “We need to protect these individuals, but we don’t want to exclude them from studies.”
Create Strong Researchers
From the beginning, a cornerstone of the AF’s research program has been to train and nurture talented researchers. “In the early ’50s, there was a limited number of specialists in musculoskeletal disease and research programs relating to arthritis were relatively weak,” explains Dr. Hardin.
Therefore, an early AF task was to “develop an army of investigators” to take on the challenges of arthritis research. The organization created an original program designed to fund the training of researchers, including rheumatologists and other clinical specialists.
Ultimately, “the Foundation trained the vast majority of people currently active in academic rheumatology and research,” he says. “Our core program was designed to develop arthritis investigators. On top of that is a layer of grants to help experienced investigators and move them into their role as independent scientists.”
Unlike National Institutes of Health (NIH) grants, which generally require a number of preliminary background studies supporting any research idea or proposal, AF’s research program accommodates studies that have only limited data to support their feasibility. “We often fund studies that are at earlier stages of the game. We generally anticipate that the work done under these grants will blossom into research endeavors that will acquire the support of NIH,” Dr. Hardin adds. In fact, he sees a seamless interface between the Foundation and NIH.
All rheumatologists can help arthritis research overcome one important barrier—engaging patients in studies.
Role for Rheumatologists
Rheumatologists—in all settings and with all levels of experience—are welcome to participate in AF research programs. “They are well positioned to participate in inquiries into arthritis research issues,” he says. “Patients are as important for clinical research as are scientists; and it is important for rheumatologists and other physicians to identify patients who may be good candidates for research studies.” Additionally, rheumatologists also can play a role by helping to raise money for research.
Dr. Klippel emphasizes that rheumatologists have a role beyond research. “Rheumatologists have stepped into major voluntary leadership roles. At the community level, every AF chapter has a rheumatologist involved,” he says. “These practitioners create teams for AF Walks to create a sense of awareness within the community and promote the role of the rheumatologist in caring for these patients.”
For rheumatologists seeking information and educational materials for themselves or their patients, the AF can help there as well. “The Foundation has a goal of being a true resource of accurate information for people who have or want to learn more about arthritis,” says Dr. Klippel. “We believe that educating people about chronic diseases such as arthritis is critically important, and we take this job seriously.” In addition to a variety of brochures and other patient information pieces, meetings such as an annual research conference, and publications such as Arthritis Today magazine, the AF is currently preparing the 13th edition of its Primer on the Rheumatic Diseases.
“No matter what level of skills, abilities, or interest you have, you can make a contribution,” says Dr. Hardin. Practicing rheumatologists are our partners in ensuring the best possible care for patients with arthritis.”
Joanne Kaldy is a medical journalist based in Maryland.
AF Howley Prize Recipient: Profile of Vision and Focus
The Howley Prize recognizes those researchers whose contributions during the previous five years have represented a significant advance in the understanding, treatment, or prevention of arthritis and rheumatic diseases.
Gary S. Firestein, MD, has been involved in arthritis research for several years. With numerous studies and countless papers and presentations under his belt, he remains philosophical and modest about his accomplishments, including being named the 2006 Lee C. Howley Sr. Prize for Research in Arthritis recipient. “I’m enormously gratified and honored by this recognition. But one doesn’t go into this line of research to win awards,” he says. “Our touchstone over the years is that we were—and are—trying to improve patients’ lives.”
Over the years, Dr. Firestein’s research efforts have focused on the pathogenesis of rheumatoid arthritis. His laboratory helped define the synovial cytokine profile of RA and demonstrated the dominance of macrophage and fibroblast products as opposed to the expected T-cell cytokines. These studies contributed to the development of the highly effective anti-TNF approaches in RA. Recently, Dr. Firestein focused his attention on synoviocyte transformation in RA as a mechanism of joint destruction. His group was the first to describe somatic mutations in the p53 tumor suppressor genes in the RA synovium. The mutations were subsequently demonstrated to be dominant negative and increase the cartilage invasiveness of these cells. Dr. Firestein’s laboratory has also worked extensively on metalloproteinase and cytokine gene regulation in synoviocytes by MAP kinases and NF-kb as well as on novel gene therapy approaches to RA.
“Ultimately, the goal is to understand the pathway of RA so that we can cure it or put it into remission. Perhaps we even can use the information we glean to treat other diseases,” says Dr. Firestein. “The most interesting advances come when people think outside the box. Good research requires teamwork and experienced investigators who are willing to mentor novice peers,” he says. “It is critical to mentor young investigators and help them to develop their research careers. It is unlikely that I will be able to cure RA in my lifetime, but the people trained by myself and others will take what we have done and move it to the next level; and we all will contribute to a cure when it ultimately happens.” He adds that he was fortunate in his career to have a mentor in Nathan Zvaifler, MD.
Dr. Firestein says the greatest challenge of his career has been maintaining focus. “There are so many interesting things that one could study, it is easy to get sidetracked and try to do too many things. If something is interesting but of lower yield, you have to put it on the back burner,” he explains. At the same time, he says, “You can’t always just take on the highest-yield projects. Sometimes you need to do something riskier that has a greater potential for payoff.”
While gratifying, research is not always exciting, Dr. Firestein admits. “Working in the lab is a combination of repetition and failure. There rarely is a ‘eureka’ moment. Success and results come incrementally,” he says.
Accepting the award at the Arthritis Foundation’s National Meeting in Boulder, Colo., in November was especially gratifying for Dr. Firestein. “Studies in this field would be impossible without the Foundation,” he says. “For me, the first grant I received for my signaling work was from the Foundation. I was able to leverage this into a large NIH grant. I am grateful to the Foundation and its belief in innovative studies and researchers like me.”
