Dalhousie Medical School researchers are leading an international team of physicians and scientists investigating the role inflammation plays in rheumatoid arthritis and heart failure.
Inflammation is a natural process that normally helps fight infection and enables the body’s tissue to recover from injury. The problem is that some people experience dysfunctional inflammatory responses that can lead to chronic health conditions, such as arthritis and cardiovascular disease.
“Heart failure and rheumatoid arthritis both involve an initial inflammatory injury," explains Dr. Jean Marshall, professor and head of the Department of Microbiology & Immunology at Dal. "There are many studies looking at what goes wrong in the healing process that follows; we’re trying to determine what goes right.
“Using this information, we’ll begin to examine ways to better treat — and even prevent — inflammation-related heart damage, arthritis, and other inflammatory diseases. This could involve the modified use of existing drugs or the development of new ones.”
The Dalhousie-led group will study two cohorts of patients: those recovering from recent heart attacks and those living with newly-diagnosed rheumatoid arthritis. It’s known that inflammation resolves normally in a subset of these patients — either naturally or with early treatment, while in other patients the inflammation doesn’t go away, causing further damage to their bodies.
“Part of this study will be to review the clinical characteristics of Nova Scotians who have suffered a heart attack in the past 20 years,” says Dr. Jean-Francois Légaré, associate professor and staff cardiac surgeon with the Department of Surgery at Dalhousie and Capital health. “By doing this, we hope to better inform the collection of samples for the current study, and help doctors better identify the patients who are likely to heal after a heart attack and those who are likely to suffer complications, such as the development of heart failure.”
Looking for new therapies
The goal of the study is to determine what the differences are between those people who suffer from ongoing inflammation and those who don’t. By looking at joint fluids and blood samples from these different patients, scientists will be able to see what’s going on inside their immune systems and how they’re responding to anti-inflammatory and immune modifying therapies. Researchers will also be looking at how other health conditions, a person’s sex, and habits such as smoking might influence the disease outcome. Combined, this information could be used to help doctors identify which patients would benefit from early treatment strategies.
“Despite many treatments for rheumatoid arthritis (RA), these are not effective in all patients and are associated with side-effects in some cases,” says Dr. John Hanly, professor and staff rheumatologist with the Departments of Medicine and Pathology at Dalhousie and Capital Health. “More effective therapies of RA will improve the quality of life for patients with the disease and provide economic benefits through enhanced productivity and savings in health care delivery.”
The study is funded by a $2.3-million grant from the Canadian Institutes of Health Research and $100,000 from The Arthritis Society. Additional funding has been provided by a number of partners including Dalhousie University, the Capital District Health Authority, and the IWK Health Centre.
“The Arthritis Society is excited to team with CIHR to facilitate research on inflammation in the body and how to treat the diseases it causes,” says Susan Tilley-Russell, executive director of The Arthritis Society’s Maritime Region. “In particular, we are pleased to be funding a portion of this research at Dalhousie University, and celebrate the role of local researchers in this effort to pursue life-altering insights in treating inflammatory conditions.”