The Division of Rheumatology, with its home at the Hospital for Special Surgery (HSS), is widely recognized for its contributions to research defining the underlying mechanisms of autoimmune and musculoskeletal conditions. Throughout its distinguished history, the Division of Rheumatology has taken the approach that progress in understanding systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), osteoarthritis (OA) and other rheumatic diseases will move most rapidly toward new and more effective therapies if basic research is combined with research driven by the patient. Through its basic and clinical research programs, patient registries and disease-targeted Centers of Excellence, the Division of Rheumatology is well organized for multidisciplinary studies of the genetic, epigenetic and immunologic factors that result in disease, along with clinical studies of novel interventions and outcomes. Members of the Division of Rheumatology amplify the impact of the division's research through their leadership positions in the American College of Rheumatology, non-profit research funding agencies, and as members of NIH study sections.
11 full-time physician scientists, along with 15 clinically-based rheumatologists and Ph.D. scientists, collaborate to characterize molecular and cellular mechanisms that are features of many autoimmune and inflammatory diseases, as well as those mechanisms that define patient subsets. Rheumatology investigators have been leaders in research that takes a personalized medicine approach, through development of patient cohorts and documentation of detailed longitudinal clinical data that is then related to laboratory-generated data. Studies of genetic variants, chromatin modifications, gene expression, and protein markers associated with disease activity, flares or organ involvement have led to identification of type I interferon as a central pathogenic mediator in SLE, components of the complement system and tumor necrosis factor (TNF) as mediators of pregnancy loss in lupus, and the Jak-STAT cytokine signaling pathway in RA. Basic research in the laboratory suggests additional novel mechanisms that regulate production of pathogenic T cell cytokines and cleavage of TNF from the cell membrane.
HSS rheumatologists have leadership roles and are active investigators in the NIH-funded Accelerating Medicines Partnership program, studying joint tissue from RA patients at the single cell level. Rheumatology investigators have collaborated with Weill Cornell Medicine cardiologists to study the cardiovascular complications of rheumatic diseases, with the goal of defining the mediators that are responsible for this important comorbidity. The close integration of physician scientists in the laboratory, clinical rheumatologists and other specialists is a unique feature of rheumatology research at HSS and Weill Cornell Medicine.
Our rheumatologists are translating discoveries made in the laboratory at HSS by testing new therapeutic agents that target the type I interferon pathway in lupus, or approaches that may reduce the risk for pregnancy complications in antiphospholipid syndrome and lupus. The Scleroderma, Vasculitis and Myositis Center of Excellence has designed investigator-initiated trials in scleroderma and vasculitis, and its rheumatologists are participating in multicenter sponsored trials of novel agents for these important diseases.
HSS rheumatologists and clinical investigators also work closely with the institution's orthopedic surgeons to define predictors of outcomes of orthopedic surgery procedures. A rich registry of data from patients undergoing hip or knee arthroplasty forms the basis of studies that have documented excellent outcomes of patients - even those with underlying autoimmune and inflammatory rheumatologic conditions - undergoing those procedures. A new collaboration between rheumatologists and orthopedic surgeons is addressing disparities in joint replacement surgery among patient populations based on ethnicity and socioeconomic factors.
As an active partner in the Weill Cornell Clinical and Translational Science Center, and as a national leader in rheumatic disease research, the Division of Rheumatology continues to improve the care of patients with autoimmune and musculoskeletal diseases.
