March 15, 2001
UAB is one of four major academic medical centers in the southeast United
States that will soon gather data for investigators
interested in the genetics of rheumatoid arthritis (RA) in
African Americans. The effort is supported by the National Institute
of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
The institute, a component of the National Institutes of
Health (NIH), awarded a research contract for the
Consortium for the Longitudinal Evaluations of African
Americans with Early Rheumatoid Arthritis (CLEAR) Registry
to UAB and Emory University, the Medical
University of South Carolina, and the University of North
Carolina.
The registry will provide clinical and x-ray and DNA data
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 some environmental factors may
play a part, triggering the disease process in people whose
genetic makeup makes them susceptible to RA.
The investigators intend to register 600 participants.
Because there are currently no ongoing studies evaluating
early RA in African Americans, the investigators have
targeted this population. African Americans are
underrepresented in most clinical studies, including
current observational studies of people with RA.
"Identifying any factor, genetic or otherwise, that may
predispose an individual to rheumatoid arthritis or provide
clues to an individual's disease outcome will greatly
improve our efforts to treat and ultimately prevent this
disease which affects so many people," said Stephen I.
Katz, MD, PhD, NIAMS director.
"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," said Larry Moreland, MD, principal investigator
of the CLEAR Registry. "Ultimately, the ability to
identify patients very early in the disease process who
might have a worse long-term outcome will allow physicians
to provide better treatments for these patients." Dr. Moreland is joined by
S. Louis Bridges, Jr., MD, PhD, who is a co-director of CLEAR at UAB.
RA is an autoimmune disease, in which the body's immune
system attacks its own tissues. It occurs in all races and
ethnic groups, and affects about two to three times as many
women as men. Scientists estimate that RA affects the
lives of one percent of the adult population in the United
States, although young adults and children can also be
affected. Symptoms and severity vary greatly among
individuals, and may include inflammation, pain, swelling,
stiffness and progressive loss of function in the joints.
It may also cause fatigue, occasional fever and a general
sense of not feeling well. In some cases, the internal
organs and systems can become involved and ultimately
damaged.