The NIH Almanac

Until May 19, 1972, the National Institute of Arthritis and Metabolic Diseases; until June 23, 1981, the National Institute of Arthritis, Metabolism, and Digestive Diseases; until April 8, 1986, the National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases.

Mission

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) was established in 1986. The mission of NIAMS is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases.

The Institute also conducts and supports basic research on the normal structure and function of joints, muscles, bones, and skin. Basic research involves a wide variety of scientific disciplines, including immunology, genetics, molecular biology, structural biology, biochemistry, physiology, virology, and pharmacology. Clinical research includes rheumatology, orthopaedics, dermatology, metabolic bone diseases, heritable disorders of bone and cartilage, inherited and inflammatory muscle diseases, and sports and rehabilitation medicine.

Important Events in NIAMS History

November 20, 1985—The Health Research Extension Act of 1985 (P.L. 99-158) authorized the establishment of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

April 8, 1986—NIAMS was established.

February 18, 1987—The first meeting of the National Arthritis and Musculoskeletal and Skin Diseases Advisory Council was held.

April 15, 1996—NIAMS held a 10th anniversary symposium: "Progress and Promise in Chronic Disease."

April 2006—NIAMS celebrated its 20th anniversary.

NIAMS Legislative Chronology

August 1950—An arthritis program was established within the National Institute of Arthritis and Metabolic Diseases under Public Law 81-692.

May 1972—P.L. 92-305 renamed the Institute the National Institute of Arthritis, Metabolism, and Digestive Diseases,.

1973—Senator Alan Cranston introduced legislation that would eventually lead to the National Arthritis Act. Companion legislation was introduced in the House by Congressman Paul Rogers.

January 1975—The National Arthritis Act (P.L. 93-640) established the National Commission on Arthritis and Related Musculoskeletal Diseases to study the problem of arthritis in depth and to develop an arthritis plan. The act also established the position of associate director for arthritis and related musculoskeletal diseases and authorized an interagency arthritis coordinating committee; community demonstration project grants; an arthritis data bank; an information clearinghouse; and comprehensive centers for research, diagnosis, treatment, rehabilitation, and education.

April 1976—After a year of study and public hearings, the commission issued a comprehensive plan aimed at diminishing the physical, economic, and psychosocial effects of arthritis and musculoskeletal diseases. It laid the groundwork for a national program encompassing research, research training, education, and patient care.

October 1976—The Arthritis, Diabetes, and Digestive Diseases Amendments of 1976 (P.L. 94-562) established the National Arthritis Advisory Board to review and evaluate the implementation of the Arthritis Plan, prepared in response to the National Arthritis Act (P.L. 93-640).

December 1980—P.L. 96-538 changed the name of the Institute to the National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases. 1982—The U.S. Department of Health and Human Services (HHS) conferred bureau status on the Institute, resulting in creation of the Division of Arthritis, Musculoskeletal, and Skin Diseases and the appointment of a division director.

November 1985—The Health Research Extension Act of 1985, P.L. 99-158, established the National Institute of Arthritis and Musculoskeletal and Skin Diseases to bring increased emphasis to research on these disorders. The legislation provided for the development of a plan for a national arthritis and musculoskeletal diseases program, and establishment of 2 interagency coordinating committees, one on arthritis and musculoskeletal diseases and one on skin diseases. It also expanded the activities of the National Arthritis Advisory Board to include musculoskeletal and skin diseases.

September 1993—The NIH Revitalization Act of 1993 (P.L. 103-43) called on NIAMS to establish "an information clearinghouse on osteoporosis and related bone disorders to facilitate and enhance knowledge and understanding on the part of health professionals, patients, and the public through the effective dissemination of information."

October 2000—The Children’s Health Act of 2000 (P.L. 106-310) called on NIAMS to expand and intensify research programs on juvenile arthritis and related conditions, in coordination with other NIH Institutes and the Arthritis and Musculoskeletal Diseases Interagency Coordinating Committee. Further language stipulated that the Institute’s current information clearinghouse include resources on juvenile arthritis and associated conditions.

November 2000—The Lupus Research and Care Amendments of 2000, which passed as part of the Public Health Improvement Act (P.L. 106-505), required NIAMS to expand and intensify research and related activities regarding lupus, and to coordinate such efforts with other NIH Institutes, as appropriate. Among other provisions, the bill called for information and education programs for health professionals and the public.

December 2001—The Muscular Dystrophy Community Assistance, Research, and Education Amendments of 2001, or the MD-CARE Act (P.L. 107-84), called on several components of NIH, including NIAMS, to enhance research on muscular dystrophy, including establishing Centers of Excellence.

February 2003—The Office of the Secretary, HHS, was called on to establish a Federal working group on lupus for the purpose of exchanging information and coordinating Federal efforts regarding lupus research and education initiatives (P.L. 108-7, Omnibus Appropriations Act for FY 2003). NIAMS, as the lead institute at the NIH for lupus research, was asked to lead this Federal working group. The group is comprised of representatives from all relevant HHS agencies and other Federal departments having an interest in lupus.

Biographical Sketch of NIAMS Director Stephen I. Katz, M.D., Ph.D.

Dr. Katz earned a B.A. degree cum laude in history from the University of Maryland, College Park; an M.D. degree cum laude from Tulane University Medical School, New Orleans, LA; and a Ph.D. degree in immunology from the University of London, England. He completed a medical internship at Los Angeles County Hospital, CA; a residency in dermatology at the University of Miami School of Medicine, FL; military service at Walter Reed General Hospital in Washington, DC; and postdoctoral work at the Royal College of Surgeons of England.

In 1974 he joined the National Institutes of Health (NIH) as a senior investigator in the Dermatology Branch of the National Cancer Institute (NCI), becoming acting chief in 1977 and chief from 1980 to 2001. He is still an active senior investigator. From 1989 to 1995, he also served as Marion B. Sulzberger professor of dermatology at the Uniformed Services University of the Health Sciences in Bethesda, MD. On August 1, 1995, he was appointed Director of NIAMS.

Dr. Katz’s studies of Langerhans cells and epidermally derived cytokines have demonstrated that skin is a critical component of the immune system both in its normal function and as a target in immunologically mediated diseases. He has also made seminal discoveries in the field of inherited and acquired blistering skin diseases.

At NCI, he led a program of investigations in fundamental biological and clinical problems in neoplastic and inflammatory diseases of the skin. He has trained a large number of immunodermatologists from the United States and abroad. These individuals are now leading their own independent research programs.

Dr. Katz has received many Government- and private-sector honors and awards, including the Lifetime Achievement Award from the American Skin Association, the Presidential Distinguished Rank Award, Presidential Executive Meritorious Rank Award, Public Health Service Superior Service Award, NIH Director’s Award, Sulzberger Lecture Award from the American Academy of Dermatology, Martin Carter Mentor Award from the American Skin Association, Alfred Marchionini Gold Medal, Outstanding Alumnus Award of Tulane University School of Medicine, Stephen Rothman Memorial Award of the Society for Investigative Dermatology (SID), Inflammatory Skin Disorders Research Award, Scleroderma Foundation’s Messenger of Hope Award, honorary membership in many international dermatologic societies, and election into the Institute of Medicine of the National Academy of Sciences.

He has served many scientific organizations in leadership positions such as president of SID, membership on the board of directors of SID and of the Association of Professors of Dermatology, secretary-general of the World Congress of Dermatology, and secretary-treasurer of the Clinical Immunology Society. In addition, he was named president of the International League of Dermatological Societies in 1997, for a 5-year term.

Dr. Katz has also served on the editorial boards of most clinical and investigative dermatology journals and many immunology journals. He has authored or coauthored more than 200 scientific articles and 60 book chapters and edited several conference proceedings and books.

NIAMS Directors

Name	In Office from	To
Lawrence E. Shulman	April 1986	October 1994
Michael D. Lockshin (Acting)	November 1994	July 1995
Stephen I. Katz	August 1995	Present

Research Programs

NIAMS supports a multidisciplinary program of basic, clinical, and translational investigations; epidemiologic research; research centers; and research training for scientists within its own facilities as well as grantees at universities and medical schools nationwide. It also supports the dissemination of research results and information through the National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse and through the NIH Osteoporosis and Related Bone Diseases~National Resource Center.

The NIAMS Extramural Program supports research via grants and contracts in 2 Divisions: the Division of Skin and Rheumatic Diseases and the Division of Musculoskeletal Diseases. A wide array of basic, translational, and clinical research and research training in the fields of rheumatology, muscle biology, orthopaedics, bone and mineral metabolism, and dermatology is being pursued through these programs.

The Intramural Research Program of NIAMS conducts innovative basic, translational, and clinical research relevant to the health concerns of the Institute and provides training for investigators interested in careers in these areas. The ultimate goals are: 1) to provide new insights into the normal function of bones, joints, skin, and muscles and diseases that affect them; and 2) to generate a cadre of well-trained investigators to continue toward a complete understanding of these structures and the disease conditions that affect them adversely.

Extramural Research Program

Known as "extramural" research, most funding for NIAMS supports investigators involved in a wide spectrum of basic, clinical, epidemiologic, training, and other programs in universities, medical schools, and academic health centers. Research in the NIAMS Extramural Program's 2 Divisions—the Division of Skin and Rheumatic Diseases and the Division of Musculoskeletal Diseases—is conducted as follows:

Division of Skin and Rheumatic Diseases

The mission of this Division is to promote and support basic, translational, and clinical studies of the skin in normal and disease states; and research leading to prevention, diagnosis, and cure of rheumatic and related diseases. Research is managed under 2 main areas:

Arthritis and Rheumatic Diseases. The overall goals of the programs in this area are to advance high-quality basic, translational, and clinical biomedical and biopsychosocial research to treat, cure, and prevent arthritis and rheumatic diseases. This includes work that advances the understanding of the natural history of these disorders, as well as mechanisms of disease susceptibility and development. The programs support research in rheumatoid arthritis; adjuvant and chemically induced inflammatory arthritis; systemic lupus erythematosus; systemic scleroderma; spondyloarthropathies; dermatomyositis and myositis; vasculitis; fibromyalgia; juvenile arthritis and general autoimmunity; the basic biology of cartilage and related diseases (such as osteoarthritis) and heritable disorders of connective tissue (such as Marfan's syndrome); gout; Lyme disease; and infection-related arthritis. An important dimension of these programs involves taking advantage of new insights in the fields of genetics, genomics, proteomics, and imaging related to arthritis and rheumatic diseases. NIAMS is committed to pursuing new opportunities that identify risk factors for these disorders, enhance disease prediction, and advance prevention strategies.

Skin Biology and Diseases. The programs in these areas support a broad portfolio of basic and translational research in skin. These efforts include work on the developmental and molecular biology of skin, the study of skin as an immune organ, and the genetics of skin diseases. Areas of particular emphasis include: investigations of stem cells found in skin; metabolic studies of skin, such as the effects of hormones and interactions with enzymes; and immunologically mediated cutaneous disorders, such as atopic dermatitis, contact dermatitis, and vasculitis. Research is underway to better understand keratinizing disorders such as psoriasis and ichthyosis; disorders of pigmentation such as vitiligo; and bullous diseases such as pemphigus, pemphigoid, and epidermolysis bullosa. Other studies encompass acne and the physiologic activity of the sebaceous glands, as well as disorders of the hair, such as alopecia areata. Tremendous opportunities exist in the field of skin diseases research, from work toward a deeper understanding of the basic biology of skin, to new approaches for developing artificial skin, to advances in imaging technologies for diagnosis and tracking of skin disease progression. NIAMS is committed to pursuing these and other avenues of research to improve health outcomes for patients with skin diseases.

Division of Musculoskeletal Diseases

The musculoskeletal system is comprised of the skeleton, which provides mechanical support and determines shape; the muscles, which power movement; and connective tissues such as tendon and ligament, which hold the other components together. The cartilage surfaces of joints and the intervertebral discs of the spine allow for movement and flexibility.

The Division of Musculoskeletal Diseases supports research aimed at improving the diagnosis, treatment, and prevention of diseases and injuries of the musculoskeletal system and its component tissues. Key public health problems addressed by this research include osteoporosis, osteoarthritis, and muscular dystrophy. Research is conducted at every level, from fundamental biology to clinical intervention. Research is managed under 3 main areas:

Bone Biology and Diseases. The programs in these areas cover a broad spectrum of research to better understand genetic and cellular mechanisms involved in the buildup and breakdown of bone. Research areas include: regulation of bone remodeling; mechanisms of bone formation, bone resorption, and mineralization; and effects of hormones, growth factors, and cytokines on bone cells. The programs emphasize the application of fundamental knowledge of bone cell biology to the development of drug and gene therapies for bone diseases, especially osteoporosis. This program area supports several large epidemiologic cohorts for the characterization of the natural history of osteoporosis and for the identification of genetic and environmental risk factors that contribute to bone disease. Like other cohort studies supported by NIAMS, the ultimate goals are to contribute to the development of better diagnostic tools, treatments, and prevention strategies.

Muscle Biology and Diseases. The programs in these areas support a wide range of basic, translational, and clinical research projects in skeletal muscle biology and diseases. They focus on the fundamental biology of muscle development, physiology, and muscle imaging. Particular interests include the basic biology of satellite and muscle stem cells, excitation-contraction coupling, muscle metabolism, and adaptation of muscle to exercise. The programs address a need for translational research to develop discoveries that enhance treatment and improve management of muscle and musculoskeletal diseases and disorders. The overarching objective is to advance the understanding of—and ultimately prevent and treat—muscular dystrophies, inflammatory myopathies, muscle ion channel diseases, and muscle disorders such as disuse atrophy and age-related loss of muscle mass.

Musculoskeletal Biology and Diseases. The programs in these areas focus on understanding the fundamental biology of tissues that constitute the musculoskeletal system, and on translating and applying this knowledge to a variety of diseases and conditions. Research includes the study of the causes and treatment of acute and chronic injuries—including carpal tunnel syndrome, repetitive stress injury, and low back pain—and clinical and epidemiological studies of osteoarthritis. The programs support the development of new technologies such as methods for imaging bone and cartilage to improve the diagnosis and treatment of skeletal disorders, or to facilitate the repair of damage caused by trauma to otherwise healthy musculoskeletal tissue. Therapeutic approaches of interest in the programs include drugs, nutritional interventions, joint replacement (including biomaterials and implant science), bone and cartilage transplantation, and gene therapy. Tissue engineering, regenerative medicine, sports medicine, and musculoskeletal fitness are areas of special emphasis.

Intramural Research Program

The NIAMS Intramural Research Program (IRP) consists of 11 main components: Office of the Clinical Director, Office of Science and Technology, Arthritis and Rheumatism Branch, Autoimmunity Branch, Cartilage Biology and Orthopaedics Branch, Genetics and Genomics Branch, Molecular Immunology and Inflammation Branch, Laboratory of Muscle Biology, Laboratory of Skin Biology, Laboratory of Structural Biology Research, and Protein Expression Laboratory.

The Office of the Clinical Director implements innovative clinical research programs that relate to the broad field of rheumatologic, musculoskeletal, and skin disorders. Through specific programs in translational research, rheumatology fellowship training, and health partnerships, the Office of the Clinical Director plays an important role in establishing innovative therapeutic paradigms, in providing medical education in the field of rheumatology, and in reaching out to the community to reduce health care disparities and to improve the understanding of rheumatic and related diseases.

• Translational Research Program. The Bridge Between Basic Research and Clinical Disease. A goal of clinical investigation is to bridge information gained from laboratory research with that afforded by clinical experience. Carefully designed observational and interventional studies provide opportunities to verify basic biological understanding of disease. These studies then bring back to the laboratory new insight into the biology of the human body.
• Rheumatology Fellowship Program. The NIAMS/NIH Rheumatology Fellowship Training Program is dedicated to the clinical and research training of physicians wishing to pursue careers in biomedical or translational research related to the rheumatic diseases. The fellowship program is 2 years in duration, with extensions available for individuals interested in advanced research training. The program is accredited by the Accreditation Council for Graduate Medical Education (ACGME), and graduates are eligible to sit for the certifying examination in the subspecialty of rheumatology.
• NIAMS Community Health Center. The NIAMS Community Health Center is a health information and medical center, carrying out research and providing health care services to people affected by arthritis, lupus, and other rheumatic diseases. The health center offers patient care with access to a specialist, health information and education programs, and referral to clinical investigations for the prevention and treatment of rheumatic diseases. The health center is located in upper northwest Washington, DC.

The Office of Science and Technology encompasses an infrastructure of research and support facilities designed to enhance the research capabilities of all scientists of the IRP. In addition, members advise the Scientific Director, Laboratory and Branch Chiefs, and other key officials on collaborative and cooperative activities, training programs, and proper use of laboratory animals. Members also negotiate and facilitate scientific collaborations that involve trans-institute and trans-NIH initiatives and agreements. The Office includes the following:

• The Career Development Section serves as a resource to all NIAMS students, fellows, and their sponsors to ensure that NIAMS continues to attract the best fellows and provide them with a genuine growth experience.
• The Flow Cytometry Section provides state-of-the-art multiparameter analytic and sorting capabilities for IRP investigators.
• The Laboratory Animal Care and Use Section provides support to all IRP branches and laboratories using animals.
• The Light Imaging Section functions as a core facility, offering IRP scientists access to state-of-the-art light imaging equipment and expertise in light imaging techniques.
• The Biodata Mining and Discovery Section assesses the scientific computing needs of IRP scientists and develops strategies and designs computational support for researchers.
• The X-Ray Crystallography Facility is an NIAMS core facility that provides equipment, training, assistance, and technological innovations to determine 3-dimensional structures of protein and other macromolecules (large biological molecules).

The Arthritis and Rheumatism Branch conducts a variety of basic and clinical investigations. The historical focus of the branch has been the study of the autoimmune rheumatic diseases, particularly rheumatoid arthritis, systemic lupus erythematosus, and myositis. Current studies focus on inflammatory and genetic diseases affecting the musculoskeletal system.

The Autoimmunity Branch conducts basic and clinical research to develop new insights into the molecular basis of autoantibody formation. Autoimmune diseases such as lupus are characterized by the formation of tissue-affecting autoantibodies. The basis of this formation is not known. Branch scientists are using molecular and cell-biologic techniques as well as multiparameter flow cytometry (a technique that allows large numbers of individual cells to be characterized in detail) to analyze autoantibody formation in patients with lupus and other autoimmune diseases.

The Cartilage Biology and Orthopaedics Branch, which consists of the Cartilage Molecular Genetics, Developmental Biology, Orthopaedics, and Tissue Engineering Sections, conducts basic and clinical research directed towards understanding the mechanisms regulating cartilage function, the basis of cartilage and orthopaedic diseases (such as osteoarthritis), and the development of functional cartilage tissue substitutes. Researchers are using cellular, molecular, bionomic, and bioengineering approaches to analyze cartilage development, growth, diseases, and aging, as well as applying the emerging technology of tissue engineering for functional cartilage replacement.

The Genetics and Genomics Branch identifies and characterizes susceptibility genes for rheumatic and inflammatory diseases. This includes the study of Mendelian autoinflammatory diseases such as Familial Mediterranean Fever (FMF), tumor necrosis factor-associated periodic syndrome (TRAPS), neonatal onset multisystem inflammatory disease (NOMID), and the syndrome of pyogenic arthritis with pyoderma gangrenosum and acne (PAPA). The branch also studies genetically complex conditions such as rheumatoid arthritis. Included in the branch are the Inflammatory Biology Section and the Genomics Section.

The Molecular Immunology and Inflammation Branch conducts basic and clinical investigations on the molecular mechanisms underlying immune and inflammatory responses in rheumatic and autoimmune diseases. A major focus is the study of receptor-mediated signal transduction and how these processes link to the regulation of genes involved in inflammatory responses. Included in the branch are the Lymphocyte Cell Biology, Genomic Integrity, and Molecular Inflammation Sections.

The Laboratory of Muscle Biology conducts a broad range of research in muscle and structural biology. This includes the molecular mechanisms of contraction, muscle elasticity and plasticity, differentiation and assembly of muscle cells, pathobiology of muscle diseases, and the development and application of emerging technologies in proteomics and nanotechnology in muscle research.

The Laboratory of Skin Biology conducts basic research on the skin and its diseases, emphasizing the epidermis.

The Laboratory of Structural Biology Research conducts research into the structural basis of the assembly and functioning of macromolecules and their complexes (such as viruses and cytoskeletal proteins), and the mechanisms and proteins that control their assembly. These studies make extensive use of cryoelectron microscopy and 3-dimensional image processing in studies of virus infection and replication; renewal of the epidermis, with maintenance of barrier function; prionogenesis (structural transitions of infectious proteins called prions); and intracellular protein quality control by energy-dependent proteases.

The Protein Expression Laboratory plans and conducts research on the expression, purification, and structural characterization of human immunodeficiency virus (HIV) and HIV-related proteins. Laboratory scientists also collaborate with NIH intramural researchers studying the structure and function of HIV and HIV-related proteins. The lab serves as a support and resource group for the expression and purification of these proteins.

Communications

The Office of Communications and Public Liaison (OCPL) leads the NIAMS efforts in information dissemination, public input, and health education. OCPL disseminates health and research news and updates, creates print and Web publications, manages the NIAMS Web site, coordinates outreach and promotion, and serves as a point of contact for the media, the public, and public organizations. OCPL oversees the NIAMS Information Clearinghouse, which operates a toll-free service to provide information and information sources on arthritis and rheumatic diseases, musculoskeletal and connective tissue disorders, and skin diseases. OCPL also oversees the NIH Osteoporosis and Related Bone Diseases~National Resource Center, which disseminates information on bone diseases.