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Advisory Council Minutes
January 2002 (historical)
Minutes of the 46th meeting
January 31, 2002
8:30 a.m. to 3:00 p.m.
Department of Health and Human Services
Public Health Service
National Arthritis and Musculoskeletal
and Skin Diseases Advisory Council
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CALL TO ORDER
Dr. Steven J. Hausman, Deputy Director, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) welcomed Advisory Council members and called to order the 46th meeting of the National Arthritis and Musculoskeletal and Skin Diseases (NAMS) Advisory Council at 8:43 a.m. on January 31, 2002.
Attendance
Council members present
Mr. Chris Allen
Dr. Gunnar Andersson
Dr. John P. Atkinson
Ms. Priscilla Ciccariello
Dr. Bess Dawson-Hughes
Dr. Sue K. Donaldson
Dr. Michael M. Frank
Ms. Victoria Kalabokes
Dr. Cato Laurencin
Dr. Matthew H. Liang
Ms. Jean Mandeville
Dr. Richard Moxley
Dr. Robert J. Oglesby
Dr. Francesco Ramirez
Ms. Mary Elizabeth Replogle
Dr. Dennis R. Roop
Dr. Linda J. Sandell (via teleconference)
Dr. Oretta Mae Todd
Council members absent
Dr. Paul Bergstresser
See Attachment, Council Roster, for titles, affiliations, terms of appointment, and contact information for Council members.
Staff and guests
Extramural program and senior staff, NIAMS, and guests attending the meeting, in addition to the Director, included the following:
Staff
Dr. Deborah Ader, Health Science Administrator, Rheumatic Diseases Branch
Dr. Janet Austin, Director, Office of Communications and Public Liaison
Ms. Patricia Brandt, Acting Legislative Liaison Officer
Dr. Tommy L. Broadwater, Chief, Grants Review Branch
Dr. Julia B. Freeman, Director, Centers Program
Ms. Janette D. Gabriel, Equal Employment Opportunity, Outreach and Training Officer
Dr. Elizabeth Gretz, Health Science Administrator, Rheumatic Diseases Branch
Dr. Steven J. Hausman, Deputy Director
Ms. Margaret Kerza-Kwiatecki, Associate Director for Management and Operations
Dr. Peter Lipsky, Scientific Director
Dr. Richard W. Lymn, Director, Muscle Biology Branch
Dr. Joan A. McGowan, Director, Musculoskeletal Diseases Branch
Dr. Alan N. Moshell, Director, Skin Diseases Branch
Dr. James Panagis, Director, Orthopaedics Program
Dr. Susana Serrate-Sztein, Director, Rheumatic Diseases Branch
Ms. Helen M. Simon, Director, Office of Program Planning
Dr. William Sharrock, Director, Bone Biology Program
Ms. Christine Steyer, Director, Human Resources Management Branch
Ms. Robyn J. Strachan, Budget Officer
Ms. Eileen D. Webster-Cissel, Contracts Management OfficerIn addition, other staff members of NIAMS were present for portions of the meeting.
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CONSIDERATION OF THE MINUTES
The minutes of the 45th Council meeting, held in September 2001, were approved.
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FUTURE COUNCIL DATES
Future Council meetings are planned on the following dates:
June 20-21, 2002
September 26-27, 2002
January 23-24, 2003
May 22-23, 2003
September 25-26, 2003Council meeting dates for 2004 will be distributed by Dr. Hausman via e-mail in the near future.
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REPORT OF RECENT MEETINGS
Skeletal Genetics
Dr. McGowan delivered a summary of the Skeletal Genetics: The Next Decade meeting, which was held on October 29-30, 2001. Topics addressed at the meeting included:
Bone mineral density experiments to examine heritability of osteoporosis. This research focused on new phenotypes that may be associated with genes related to osteoporosis. Multiple loci likely influence bone mass, size, structural quality, and other factors that affect fracture risk. However, lipoprotein receptor protein 5 has been linked to increased bone mass.
Future research opportunities, including use of human genome information and collaboration with the private sector.
Systemic Lupus Erythematosus
Dr. Serrate-Sztein delivered a summary of the Systemic Lupus Erythematosus (SLE): Targets for New Therapeutics Conference, which was held on January 10-12, 2002. NIAMS partnered with the SLE Foundation of New York to organize this conference. The short- term purpose of the conference was to facilitate the exchange of information between scientists across a wide range of disciplines. The long-term purpose of the conference was to develop new strategies for clinical intervention. The five plenary sessions of the conference addressed:
Intrinsic and extrinsic factors related to autoimmunity. Extrinsic factors included bacteria and viruses that induce increased immune activation and, possibly, trigger a cross reaction with antibodies. Intrinsic factors included female gender.
Immunoregulatory mechanisms.
Mediators of tissue injury. Research is examining how autoantibodies may cause Fc receptors to malfunction, leading to nephritis.
Predisposing factors.
Novel therapies, including antibodies to CTLA4, CD20, and CD5.
The conference concluded with a panel discussion of Drug Trials and Tribulations. The panel included representatives from the biotechnology industry and the federal government, a basic scientist, a clinician conducting a trial, and her patient. Several challenges to the conduct of SLE clinical trials were identified, including:
Tracking multiple symptoms at multiple sites throughout the trial
Small sample sizes due to the small numbers of SLE patients
Nonconcordance of disease activity scales and the general lack of adequate measures of response to treatment.
More than 90 posters also were presented at the conference. Almost all invitees attended the entire conference.
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REVIEW OF THE MEMORANDUM OF UNDERSTANDING FOR COUNCIL OPERATIONS
Dr. Hausman summarized the items in the current Memorandum of Understanding (MOU) between NIAMS and the Council. The MOU was approved unanimously without revisions.
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STATUS OF THE NIAMS CAREER TRANSITION AWARD (K22)
The purpose of the NIAMS K22 Award is to facilitate the transition of intramural fellows into the extramural research community. A Program Announcement (PA) that describes this award was distributed at the meeting. The Award provides for 2-3 years of funding at NIAMS, then 2-3 more years of funding at an academic institution, including a salary and research expense account. Candidates for this Award are required to collaborate with a mentor at NIAMS to develop research and career development plans. The candidates' transition to the extramural phase and the position that he or she accepts must be approved.
Dr. Lipsky noted that the K22 provides an opportunity for research training in areas that relate to the NIAMS mission. Few NIAMS fellows currently take advantage of this mechanism. Participants indicated that this award may be more attractive if it provides candidates the opportunity to conduct their own innovative research. Dr. Liang recommended that the program be expanded to provide opportunities beyond basic research, including epidemiological and statistical studies. Participants agreed that, when appropriate, candidates should be encouraged to obtain two mentors, one from NIAMS, and one from another Institute with expertise in an area (such as epidemiology) that is not well covered by NIAMS. In addition, the 5-year funding period may need to be extended for some investigators who have no prior in-depth research experience and training.
Dr. Atkinson emphasized that the K22 program should be carefully monitored, evaluated, and revised as needed. Dr. Moshell added that the program needs to be continually advertised to current fellows and institutions receiving NIAMS funding. Ms. Kalabokes also recommended that the K22 award be marketed to voluntary health organizations.
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DIRECTOR'S REPORT AND DISCUSSION
Dr. Katz introduced new Council members. Orientation of new Council members was conducted by Dr. Hausman on January 30, 2002.
Dr. Katz indicated that Dr. Hausman will shortly relinquish his position as Director of the Extramural Research Program so that he can devote more time to the NIH Electronic Research Initiative (eRA) and Ethics Program. He will continue to serve as Institute Deputy Director. The NIAMS will shortly begin a search for a new Director of Extramural Program.
A request was made for names of unsuccessful NIH grant applicants to be released under the Freedom of Information Act. This request was approved and unsuccessful applicants are being notified that their names and addresses have been provided to the litigant.
Budget Update
The NIH received a $23.2 billion (14%) budget increase for fiscal year (FY) 2002. NIAMS received a $448.7 million (13.2%) increase. These additional funds should allow NIAMS to achieve a 26-27 percent success rate. The NIAMS FY 2002 Funding Plan is being finalized and will be available on the NIAMS Web Site. The President's FY 2003 budget is expected to be unfolded during the first week of February 2002.
NIAMS budget increases will permit:
Increased funding for the new K23 and K24 awards
Pre- and postdoctoral research trainee stipend increases consistent with the rest of the NIH
Funding to begin implementation of the public/private partnership of the Osteoarthritis Initiative and new Loan Repayment Programs
Funding for continued planning and renovation activities associated with the Collaborative National Center for Musculoskeletal Medicine.
Accelerated Funding Concept
Dr. Katz introduced a new concept for accelerated funding that was developed by the National Institute of General Medical Sciences and the National Institute of Diabetes and Digestive and Kidney Diseases to free more money in the out years for new and competing grants as NIH budget increases gradually decline. This concept involves a redistribution of grant funding reductions over multiple years. For example, a 9 percent reduction in funding for a 5-year study can be distributed as: (1) a 6 percent reduction in the first 3 years of a grant, and a 13.5 percent reduction in the last 2 years, or (2) a 6 percent reduction in the first 4 years, and a 21 percent reduction in the last year. Dr. Katz noted that centers and clinical studies generally are exempted from funding reductions.
Dr. Katz indicated that the accelerated funding concept should be implemented this year because of the relatively high current success rate. Participants endorsed the implementation of this concept, most with enthusiasm. They also expressed a preference for higher pay lines in the later years of a grant. Participants recommended that reductions and accelerated funding be explained to the investigators who will be affected by these changes. The explanation should be thorough so that investigators are prepared to appropriately manage changing annual budgets. Dr. Katz agreed to draft a letter of explanation and submit it to the Council for review. Dr. Ramirez added that this letter should be sent to institutional grant offices as well as investigators. Dr. Serrate-Sztein noted that new R01 recipients may need some assistance in budgeting with accelerated funding.
Dr. Lipsky noted that accelerated funding may exacerbate budgeting difficulties for investigators with nonfunded renewals. Investigators can minimize this problem by applying for funding renewals a few years before the end of the funding period. In any case, accelerated funding is likely to complicate budgeting, particularly when a project depends on multiple sources of funding and salary increases are mandated. Management of a complex budget may become a full-time activity for an investigator. Dr. Atkinson noted that investigators may want to know why the R01s are targeted for reductions rather than clinical studies, for example. Dr. Katz responded that about 60 percent of the NIAMS research budget is allocated to research project grants, so reductions in this type of funding will produce the greatest improvement in success rates.
Osteoarthritis Initiative
Dr. Katz noted that the Osteoarthritis Initiative was featured in the January 29, 2002 issue of the Washington Post. He agreed to distribute copies of this article to Council members. The scheduled update on this initiative was postponed for the June 2002 Council meeting.
Chronic Rheumatic, Musculoskeletal, and Skin Diseases in Children Initiative
NIAMS is planning an initiative in 2003 that focuses on multidisciplinary, translational research projects in rheumatic and immuno-inflammatory skin and muscle diseases in children. This initiative will be supported by the NIH pediatric rheumatology clinic, which was initiated by Dr. Lipsky approximately 1 year ago.
Skin Disease Initiatives
NIAMS is planning a meeting to discuss measurement of the burden of skin diseases. A key research question to be addressed at this meeting is "How do we quantify quality of life?" Initiatives also are being developed to address two critical gaps in skin disease research: (1) lack of a common vocabulary to describe diseases, and (2) lack of a cadre of trained clinical investigators. NIAMS recently awarded a contract to the University of Rochester to develop an international dermatology lexicon. NIAMS also is partnering with the Herzog Foundation to develop a fellowship program in epidemiology, health services, and outcomes research in skin diseases.
Muscular Dystrophy Meetings
Three meetings were held in 2000 to discuss: (1) facioscapulohumeral muscular dystrophy (FSHD), (2) inflammatory myopathies, and (3) other muscular dystrophies. These meetings led to the creation of several new programs to address these diseases. For example, exploratory grants have been established to identify new areas of research on FSHD. NIAMS staff recently met with representatives from the Muscular Dystrophy Association, the FSHD Association, the National Institute of Child Health and Human Development, and the Neurological Disease Institute to discuss areas of potential collaboration.
Information Dissemination
Information dissemination activities for NIAMS are conducted primarily through the NIAMS Office of Communications Public Liaison, the NIAMS Information Clearinghouse, and the NIH Osteoporosis and Related Bone Diseases National Resource Center. Several voluntary and professional organizations also partner with NIAMS to disseminate health information. NIAMS is encouraging these partners to regularly distribute information to their members on new NIAMS initiatives and funding opportunities. The American Academy of Orthopedic Surgeons has agreed to rapidly transmit this information to its Board and many members throughout the United States.
Other Initiatives
Dr. Katz announced other new NIAMS initiatives, including:
The National Center for Musculoskeletal Medicine and the Cartilage Biology and Orthopedics Branch at the NIH. The Center is a consortia of seven Institutes.
Participation in ongoing trans-NIH efforts to build genetic and genomic resources, including: Provision of almost $300,000 in FY 2002 to support the accelerated sequencing of the mouse genome Contribution to mammalian gene collection efforts Provision of approximately $350,000 in FY 2002 to the Shared Inheritance for Medicine Map (SymMap) to characterize haplotypes linked to various disease phenotypes.
Partnerships
NIAMS has developed collaborative relationships with several other NIH entities, including the National Center on Minority Health and Health Disparities, the Office of Research on Women's Health, the National Center for Complementary and Alternative Medicine, the new National Institute of Biomedical Imaging and Bioengineering, and other Institutes. These entities cofund initiatives and selected grants. NIAMS has identified several grants in its research portfolio that relate to the mission of the National Institute of Biomedical Imaging and Bioengineering.
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DISCUSSION OF THE MUSCULOSKELETAL, ORAL, AND SKIN SCIENCES (MOSS) INTEGRATED REVIEW GROUP (IRG)
Dr. Michael Martin, Director of the Division of Physiological Systems in the Center for Scientific Review (CSR), provided an update on the reorganization of the NIH IRGs, particularly the MOSS IRG. He noted that the initial recommendations of the NIH Panel on Scientific Boundaries for Review and their implementation plan are available on the Web at http://www.csr.nih.gov. The plan for the earlier reorganization of seven NIH IRGs (related to behavioral and neurosciences) as well as the process by which current IRGs were organized are accessible on the Web at http://www.csr.nih.gov/events/implementplan.htm. The first phase of the NIH IRG reorganization process is expected to be completed by the end of 2002. The meeting of the MOSS IRG meeting was held in 2001.
The reorganization of the IRGs was evaluated using a mock referral (based on abstracts) of applications submitted in May 2000 (N=10,000). After all applications were assigned to one of the 24 proposed IRGs, the IRG chiefs were asked to evaluate and suggest alternative assignments. Through this process, 375 abstracts were assigned to the MOSS IRG, and 88 alternate abstracts were identified that also could be assigned to this IRG. These assignments and accompanying comments were shared with the MOSS study section boundaries (SSB) team. A working group also was formed to review existing study sections and make recommendations to the MOSS SSB team. Based on information collected during the mock referral process and the working group report, the MOSS SSB team met and recommended the following study sections:
Oral, dental, and craniofacial sciences
Skeletal biology and diseases 1 (cellular/molecular focus)
Skeletal biology and diseases 2 (tissue and organ systems focus)
Musculoskeletal exercise and rehabilitation
Arthritis, connective tissue, and skin sciences.
These recommendations were posted on the Web and comments were solicited from the extramural research community. Comments from extramural researchers reflected several crosscutting concerns, including:
Lack of epidemiology, behavioral, social, and nursing sciences study sections. Drs. Liang and Andersson emphasized that applications for epidemiological studies should be subjected to scrutiny by basic scientists to ensure that the study moves the field forward and has some value for clinical application.
Overlap of the Skeletal Biology and Diseases 1 study section with the Oral, Dental, and Craniofacial study section with regard to biomineralization.
Lack of a study section for imaging and muscle metabolism. These issues can be addressed by the Endocrinology, Metabolism, and Reproductive Sciences IRG, which will meet in late April 2002.
Overlap of the Musculoskeletal Exercise and Rehabilitation study section with IRGs that address cranial injuries.
Lack of a study section to address bacterial pathogens. This issue can be addressed by the Infectious Disease and Microbiology IRG.
Need for language about traumatic skin injuries.
Overlap between the Arthritis, Connective Tissue, and Skin Sciences Study Section and the Immunological Sciences IRG. Comments will be shared with this IRG when it meets in April 2002, and the comments of this IRG will be posted on the CSR Web Site. The extramural rheumatology community is concerned that inflammatory joint disease may not be adequately addressed by the IRGs.
Next Steps
Dr. Martin indicated that next steps would be to: (1) share comments with the Steering Committee, (2) conduct a second mock sort and referral of applications, (3) develop options for addressing gaps and overlaps in research areas covered by the IRGs, and (4) present these options to the Steering Committee. The CSR Director will make the final decisions regarding study sections although these may not be ready to meet until late 2003, at the earliest.
Discussion
Dr. Martin noted that several study sections focus on clinical research that is relevant to NIAMS mission. Dr. Andersson recommended continuing the commitment to ensure that clinical research comprises at least 30 percent of the NIAMS portfolio. Dr. Donaldson added that guidelines should be written to communicate this commitment. Dr. Martin is willing to review the MOSS guidelines with the Council to determine where language may need to be modified. Dr. Liang further recommended that NIAMS proactively encourage clinical applications. He suggested that NIAMS accept concept papers for clinical studies, then select a set of papers to fund, and assist applicants with the development of research methodology.
Dr. McGowan indicated that epidemiology study sections often lack reviewers with expertise in rheumatological and bone diseases. She recommended that expertise in relevant basic, clinical, epidemiological, and statistical sciences should be combined within study sections. Dr. Ramirez responded that NIAMS may have difficulty identifying a team of reviewers with expertise in a wide range of areas who collaborate in making funding decisions. Dr. Atkinson recommended forming a group of basic and clinical scientists in the field of rheumatology to discuss approaches to improving the process for reviewing applications for funding of rheumatology research. Dr. Martin indicated that he is willing to meet with such a group after the Immunological Sciences IRG has met.
Dr. Serrate-Sztein indicated that research on clinical applications of basic science is impeded by a lack of instrumentation, clinical trial designs, and opportunities to fund small clinical studies. Methodology and outcomes research, as well as small clinical trials of innovative treatments need to be addressed by the study sections. Dr. Martin indicated that most applications will be reviewed within the context of a disease. Efforts are being made to address clinical and methodological issues within these study sections. For example, each study section includes a biostatistician. Some study sections may be split into applied (clinical trials) and basic science, when enough clinical applications are received.
Ms. Kalabokes noted the need to create technology-driven study sections (hypothesis- generating rather than hypothesis-driven). Several IRGs have been formed with the purpose of reviewing hypothesis-generating research applications.
Dr. Katz recommended that members of the rheumatic and skin disease communities participate in the upcoming IRG 10 meeting. The MOSS IRG reviewed a portion of applications referred to other study sections, such as IRG 10, to determine whether the some of these applications should be referred to the MOSS IRG.
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FUTURE DIRECTIONS FOR NIH RESEARCH IN THE BEHAVIORAL AND SOCIAL SCIENCES
Dr. Raynard Kington delivered a report on the National Research Council/National Academy of Sciences (NRC/NAS) research priorities in the behavioral and social sciences for the NIH. Dr. Kington is the Acting Director of the National Institute of Alcohol Abuse and Alcoholism and Director of the Office of the Office Behavioral and Social Science Research.
Dr. Kington noted that the mission of the OBSSR is to: (1) enhance behavioral and social science research and training across the NIH, (2) promote a biobehavioral inter-disciplinary perspective, and (3) improve communication about social and behavioral science advances to the public and the scientific community. The OBSSR works closely with NIH Centers and Institutes to develop Requests for Applications (RFAs), PAs, and research agendas that accomplish this mission.
The executive summary of the report of the NRC/NAS committee to advise NIH on priority areas in the behavioral and social sciences was distributed at the meeting. Dr. Kington reviewed the seven priority areas discussed in this report. He also discussed OBSSR priorities, which include: (1) collaboration with NIH Institutes and Centers on crosscutting initiatives, (2) strategic investments in the priority areas named in the NCR/NSA report, (3) integration of recommendations of this report with reports that address the same areas, and (4) NIH-supported research conferences to educate investigators about social and behavioral issues and their importance for health research. Next steps for the OBSSR include: (1) collaboration with Institutes and Centers on health disparities research initiatives, (2) support of social and behavioral methods workshops, and (3) research into pathways linking education and health.
Discussion
Dr. Katz asked about opportunities to partner with other federal agencies to address some of the issues discussed by Dr. Kington. The OBSSR is collaborating with the Agency for Health Care Research Quality to develop an RFA to address differential treatment by race/ethnicity within health care systems. The OBSSR also has been directed by Congress to improve collaboration between NIH and the Centers for Disease Control and Prevention to translate behavioral advances into health interventions.
Dr. Moxley indicated that an important research area for the OBSSR may be quality-of-life and how it is defined within diverse communities. This question may have implications for outcome measures in therapeutic studies. Dr. Katz recommended that Dr. Moshell work with the OBSSR to plan a discussion of quality-of-life measures at the Burden of Skin Diseases meeting. Dr. Kington added that the OBSSR is developing a PA to examine methodologic issues.
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LOAN REPAYMENT PROGRAM
Dr. Katz indicated that the announcement for new NIH loan repayment programs has been posted on the Web. The four types of loan repayment programs include:
(1) Pediatric Research (clinical research only), (2) Extramural Clinical Research (by qualified health professionals), (3) Health Disparities Research (by qualified health professionals), and (4) Clinical Research by Health Professionals from Disadvantaged Backgrounds. The last two programs are administered by the Office of Minority Health and Health Disparities. NIAMS is committed to the first two programs. Programs are restricted to individuals with NIH funding and pay up to $35,000 per year; which is renewable in 1-year increments. K award recipients who currently are involved in intramural research also qualify (except K24 recipients). The NIH has committed to funding approximately 250 loan repayment awards in the first year of the program, and this number is expected to double for 2003. Dr. Katz is serving on a committee to determine eligibility criteria for 2003. The committee is discussing the possibility of extending eligibility to basic researchers and individuals who are not NIH grantees in 2003. Dr. Andersson voiced his support of this change. Dr. Frank also emphasized the importance of extending eligibility to pediatric researchers without current NIH funding because of the shortage of pediatric researchers and the dearth of funding (at the NIH and elsewhere) for new investigators in this field. Participants noted that funding for new pediatric researchers is available through foundations. Dr. Liang added that nonfinancial types of support may be needed to encourage more minority individuals to pursue research.
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CONTRACT CONCEPT CLEARANCES
Dr. Janet Austin discussed two initiatives related to information dissemination that are up for competitive renewal in FY 2003. The first is the NIAMS Information Clearinghouse contract and the second is the NIH Osteoporosis and Related Bone Disorders National Resource Center cooperative agreement. The Clearinghouse and Resource Center received more than 50,000 requests for information and distributed more than 1 million publications in 2001.
Concept clearance documents were sent to Council members prior to this meeting. Participants voted for a continuance (recompetition) of both initiatives.
Dr. Atkinson inquired about data on integration and overlap of the Clearinghouse and Resource Center activities with those of the Arthritis, Osteoporosis, and Lupus Foundations. Dr. Austin indicated that biannual surveys of and interviews with these and other related organizations are conducted. Information from these surveys and interviews is analyzed and reviewed by an ad hoc committee, and a plan to address information gaps is proposed.
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REPORT ON THE STATUS OF THE INTRAMURAL RESEARCH PROGRAM
Dr. Peter Lipsky delivered a report of several NIAMS intramural programs. He also distributed a detailed document describing these programs at the meeting. A blue ribbon panel examined and developed a report of the status of the NIAMS intramural programs. Many programs formed over the past 2 years were initiated in response to issues raised by the panel.
The Trans-NIH Collaboration for Musculoskeletal Medicine
A Trans-NIH Collaboration for Musculoskeletal Medicine was formed to bring together investigators conducting research related to musculoskeletal medicine. This Collaboration has identified facilities for a laboratory at the Naval Medical Center. Seven NIH Institutes, led by NIAMS, are collaborating to obtain and renovate these facilities. The Trans-NIH Collaboration plans to connect three buildings at the Naval Medical Center, which would result in a total of 80,000 square feet of space, with 15,000 square feet expected to be used by NIAMS. Research conducted in the NIAMS portion of the planned laboratory will focus on bone, cartilage, or muscle biology. A key advantage of a laboratory located on the Navy campus is the opportunity to collaborate with the Navy physicians on clinical projects. The Navy has an efficiently run clinical facility that serves about 7,000 patients with musculoskeletal complaints each month. NIAMS expects to make a final decision about participation in the renovation project in FY 2002. If plans proceed to renovate the facility, it is expected to open in 2004.
NIAMS also has recruited Dr. Rocky Tuan to lead the Cartilage Biology and Orthopedics Branch. This Branch is recruiting an orthopedic surgeon to lead a program of clinical research in the area of orthopedics. This program is expected to provide research and training opportunities for orthopedic surgeons.
Genetics and Genomics Branch
Dr. Daniel Kastner has established a Genetics and Genomics Branch at NIAMS, which includes a microarray component and a genomics component that allows high-density single nucleotide polymorphism (SNP) analyses. These capabilities are available to both intramural and extramural investigators. The Genetics and Genomics Branch is collaborating with the National Rheumatoid Arthritis Genomic Consortium to conduct high-density SNP analyses of genetic regions that appear to be associated with rheumatoid arthritis and, possibly, other rheumatic diseases.
Autoimmunity Branch
Dr. Lipsky heads the Autoimmunity Branch, which almost is fully staffed. This Branch is supporting several collaborative research efforts related to the initiation of autoimmune diseases, particularly SLE.
Molecular Immunology and Inflammation Branch
Dr. John O'Shea heads the Molecular Immunology and Inflammation Branch. His work focuses on understanding abnormalities in signal transduction that may underlie a variety of rheumatic and related diseases.
Office of Science and Technology
A group of investigators was organized to discuss the technology infrastructure needs of NIAMS and to recommend technologies that merit investment. The technology needs identified by this group are being addressed by the Office of Science and Technology. The Office recently invested in state-of-the-art confocal microscopy and flow cytometry technologies. The technologies are made available to both intramural and extramural researchers. Extramural researchers access these technologies through the Office of Scientific Interchange.
The Clinical Program
In response to a mandate, NIAMS established the following programs and initiatives to invigorate its clinical program:
A pediatric rheumatology clinic. Within this clinic, pediatric expertise is developing in several areas that were not previously addressed by NIAMS, including fevers, lupus, and myositis. A network of local rheumatologists has been formed to refer patients to this clinic. The clinic activities are producing new scientific discoveries through collaboration with other NIAMS Branches.
A training program in rheumatology directed by Dr. Gregory Dennis. Several well-qualified M.D. and Ph.D. candidates now are applying for rheumatology training through this program.
Collaboration with the National Cancer Institute (NCI) to recruit a bone marrow transplantation expert to conduct stem cell transplants in children and adults with lupus, myositis, and possibly systemic juvenile rheumatoid arthritis. Dr. Frank emphasized that pediatric bone marrow transplantation will require extensive ancillary services, including a superior critical care unit. Collaboration with the NCI provides access to an established transplant unit and specialists on the NIH Campus. The NIH also has a program in transfusion medicine with expertise in preparing stem cells for transplant. A Pediatric Network also has been established by NIAMS and the Arthritis Foundation.
The Health Partnership Program, which is a collaboration between the intramural program and the Office of Communication and Public Liaison. The purpose of this Program is to investigate the health needs of minority populations and develop programs to address these needs (including access to clinical trials). One of these programs is an outreach clinic in the Cardozo region of Washington, DC, that provides full-service rheumatology care, under protocol, to minority populations (about one-half African American and one-half Hispanic). Patients at this clinic have access to all NIH services, including medication. However, each patient at the clinic must have a primary care provider. Another purpose of this clinic is to study issues related to health disparities. Tools are under development for evaluating the outreach clinic program.
Mr. Allen noted that the Health Partnership Program provides and opportunity to conduct long-term quality-of-life research. He suggested that this Program be replicated in other urban areas. Dr. Lipsky responded that an initial goal is to develop a model program. A meeting was held on February 25, 2002, to plan program activities for the next 5 years. The replicability of the program will be discussed at this meeting.
Dr. Lipsky added that the NIAMS intramural program now conducts annual retreats and weekly meetings at which postdoctoral fellows and faculty present their research.
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CONSIDERATION OF APPLICATIONS
The Council reviewed a total of 561 applications in closed session requesting $107,462,165 and recommended for $77,705,660.
There being no other business, Dr. Katz adjourned the 46th meeting of the NAMS Advisory Council on January 31, 2002, at 4:03 p.m.
I hereby certify that, to the best of my knowledge, the foregoing summary and attachments are accurate and complete.
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Steven J. Hausman, Ph.D. |
Stephen I. Katz, M.D., Ph.D. |
National Arthritis and Musculoskeletal and Skin Diseases Advisory Council
CHAIRMAN
KATZ, Stephen I., M.D., Ph.D.
Director
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Bethesda, Maryland 20892
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ALLEN, Chris (2003) |
CICCARIELLO, Priscilla (2002) |
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ANDERSSON, Gunnar Bengt Johan, M.D. (2004) |
DAWSON-HUGHES, Bess, M.D. (2004) |
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ATKINSON, John P., M.D. (2003) |
DONALDSON, Sue K., Ph.D. (2002) |
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BERGSTRESSER, Paul R., M.D. (2003) |
FRANK, Michael, M., M.D. (2004) |
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KALABOKES, Victoria B. (2005) |
REPLOGLE, Mary Elizabeth, CPA (2005) |
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LAURENCIN, Cato T., M.D. Ph.D. (2005) |
ROOP, Dennis R., Ph.D. (2002) |
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LIANG, Matthew H., M.D. (2002) |
SANDELL, Linda J., Ph.D. (2002) |
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MANDEVILLE, Jean (2003) |
TODD, Oretta Mae, PhD., RN (2004) |
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MOXLEY, Richard T., M.D. (2005) |
EX OFFICIO |
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RAMIREZ, Francesco B., Ph.D. (2005) |
OGLESBY, Robert J., M.D. |
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EXECUTIVE SECRETARY |
