Translational Rheumatology Research Lab
Decoding Juvenile Arthritis to Advance Pediatric Care
The Translational Rheumatology Laboratory at ¾Ã¾Ã¾Ã¾Ã¾Ã¾Ã¾Ã¾«Æ· Children’s in Delaware Valley transforms care for children with juvenile idiopathic arthritis (JIA), the most common type of childhood arthritis.Ìý
We’re studying joint cells, called fibroblast-like synoviocytes (FLS). FLS cells line the joint and help to lubricate and maintain joint tissue. In cases of JIA, FLS cells grow too fast, invade cartilage and bone, and release chemicals that damage joint tissue.Ìý
Our lab is uncovering new insights that could lead to new treatments. We’re identifying signals, or biomarkers, of disease severity, understanding the role of FLS cells in disease progression, and exploring how arthritis medication impacts FLS cells.
Our approach goes beyond current assumptions about joint inflammation and cartilage damage in pediatric arthritis. We’re looking at individual cells and details that may ultimately lead to customized therapies and better quality of life for children everywhere.
Principal Investigator
AnneMarie Brescia, MD, FAAP, FACR
Chief, Division of Pediatric Rheumatology
Associate Professor of Pediatrics
Senior Research Scientist
Research Areas of Focus
Improving JIA Outlook Predictions
For some children, JIA resolves quickly. For others, it can be severe and last for years. By uncovering the development of this disease, we hope to predict severity and identify kids with a high-risk for long-term, destructive arthritis. This means they can start advanced therapies before irreversible joint damage occurs.Ìý
Decoding Disease Drivers
To help further treatments, we’re exploring howÌýfibroblast-like synoviocytes change in severe cases and drive disease progression. We look for cellular pathways that cause destructive FLS activity, so we can use more targeted medications to stop arthritis progression before it starts.Ìý
Informing Medication Advancements
Children respond to current medications differently. We’re exploring how certain medications impact FLS cell communication and behavior. We hope to uncover why response varies so we can develop better treatment options for all children with this disease.
LEARN MORE ABOUT OUR RESEARCH
- Notable Projects
- Outcomes & Impact
- Awards & Recognition
- Grants & Partnerships
Recent Research Highlights
Prognostic Biomarkers
We are exploring signaling pathways that contribute to disease progression by examining proteins that directly contribute to inflammation which ultimately leads to severe disease.
Role of FLS in the Pathogenesis of JIA
We have identified several unique features of FLS, including their chondrocyte, fibroblast and smooth muscle cell-like features, which may contribute to disability in JIA.
Effects of Arthritis Medications on FLS
We have discovered that arthritis medication alters the chondrocyte-like phenotype of JIA FLS found in the more severe forms of JIA. We have found that cells from different kinds of juvenile idiopathic arthritis respond differently to varying therapies.
How We’re Making a Difference
Key findings from our lab include:
- Showed that FLS cells play a major role in driving inflammation and tissue damage in kids with juvenile arthritis, like what’s been seen in rheumatoid arthritis.Ìý
- Used special techniques to reveal substantial differences between individual FLS cells in juvenile arthritis at the smallest cell level, potentially helping to understand differences between disease subtypes.
- Studied how FLS cells communicate with and impact other cells in the joint, uncovering signals that promote inflammation and bone and cartilage damage.
- Identified a transforming growth factor beta signaling pathway in FLS cells that may contribute to early onset arthritis becoming a severe, lifelong disease.
- Discovered remarkably similar activity patterns in FLS cells from different juvenile arthritis subtypes, despite different symptoms and outcomes in patients.Ìý
Awards & Recognition
Researchers at ¾Ã¾Ã¾Ã¾Ã¾Ã¾Ã¾Ã¾«Æ· are often recognized for their exceptional contributions to pediatric research. Our team’s passion to advance children’s health and well-being is celebrated in these recent honors:
Presentations
- American College of Rheumatology Annual Meeting (November 2021):ÌýHeterogeneity of Juvenile Idiopathic Arthritis Synovial Fibroblasts Correlates to Disease Progression and Provides Compelling Diagnostic Data, Simmonds, M.M., Sullivan, K.E., Rose, C.D., Brescia, A.C. (presenter).
- Childhood Arthritis and Rheumatology Research AllianceÌýAnnual Meeting (May 2022):ÌýPredicting and Preventing Extension in Juvenile Idiopathic Arthritis, Brescia, A.C. (presenter), Simonds, M.M.
- Delaware Clinical and Translational Research ACCELÌýCommunity Research Exchange (May 2022):ÌýSynovial Fluid Biomarkers in Juvenile Idiopathic Arthritis, Brescia, A.C. (presenter), Simonds, M.M.
- American College of Rheumatology Pediatric Rheumatology Symposium (April 2020, meeting canceled):ÌýChondrocytes Influence Fibroblast-Like Synoviocytes from Patients with Juvenile Idiopathic Arthritis, Through the Abrogation of BMP Signaling, to Delay Cell Differentiation and Maturation, Simonds, M.M., Schlefman, A.R., McCahan, S.M., Sullivan, K.E., Rose, C.D., Brescia, A.C.
- Delaware Clinical and Translational Research ACCELÌýCommunity Research Exchange (February 2021):ÌýPredicting and Preventing Extension to Polyarticular Course in Juvenile Idiopathic Arthritis, Brescia, A.C.
- American College of Rheumatology Pediatric Rheumatology Symposium (March 2023):ÌýPredicting Extension in Juvenile Idiopathic Arthritis, Simonds, M.M., Sullivan, K.E., Brescia, A.C. (presenter).
- Northeast Regional Idea Conference (August 2023):ÌýPredicting Extension in Juvenile Idiopathic Arthritis, Simonds, M.M., Sullivan, K.E. Brescia, A.C., Best Poster Award
Major Grants
Our research is recognized and validated through generous grants. This support moves us forward and allows us to meaningfully contribute to scientific discovery. Our team has recently been awarded:Ìý
Childhood Arthritis and Rheumatology Research Alliance (CARRA)
Predicting and Preventing Extension in Juvenile Idiopathic Arthritis (2021-2024, NCE) | Brescia, A.C. (PI)
National Institute of Arthritis and Musculoskeletal and Skin DiseaseÌý(NIAMS)
Synovial Biomarkers in Oligoarticular Juvenile Idiopathic Arthritis (2014-2020) | Brescia, A.C. (PI)
Delaware Clinical and Translational Research (DE-CTR) ACCEL Program
Pilot Grant Awards
Validating Biomarkers in Childhood Arthritis (2020-2023) | Hicks, G. (PI)
Mentored Research Development Award (2020) | Hicks, G. (PI), MRDA Scholar
Private Grant Funding
The Nancy Taylor Foundation for Chronic Diseases, Inc. |ÌýPrognostic Synovial Biomarkers in Juvenile Idiopathic Arthritis (2014-2024) | Brescia, A.C. (PI)
Research in Context
Our labs contribute to research that informs pediatric care, working in alignment with research centers and focused areas of scientific study at ¾Ã¾Ã¾Ã¾Ã¾Ã¾Ã¾Ã¾«Æ·.
Rheumatology
CLINICAL CARE
Pediatric specialists at ¾Ã¾Ã¾Ã¾Ã¾Ã¾Ã¾Ã¾«Æ· diagnose and treat joint, muscle, and bone diseases that can cause pain, swelling, stiffness, and deformity.
Interventional Radiology
CLINICAL CARE
Minimally invasive, image-guided procedures performed by pediatric specialists at ¾Ã¾Ã¾Ã¾Ã¾Ã¾Ã¾Ã¾«Æ· Children’s hospitals and select specialty locations across our regions.