Resolution of acute inflammation in autoimmune rheumatic disease
Research type
Research Study
Full title
The innate and adaptive inflammatory response to intradermal e.coli in patients with autoimmune rheumatic disease and healthy controls.
IRAS ID
177924
Contact name
Derek Gilroy
Contact email
Sponsor organisation
University College London
Duration of Study in the UK
5 years, 0 months, 0 days
Research summary
A healthy immune system has two features: firstly the ability to fight foreign particles (e.g. infection), whilst secondly not attacking the person’s own tissues.
In patients with autoimmune rheumatic disease, the immune system is overactive, leading to chronic inflammation attacking the normal structures of the body. Many autoimmune rheumatic diseases, such as Rheumatoid arthritis (RA) and Ankylosing spondylitis (AS) are systemic i.e. the inflammation can affect multiple organs (e.g. joints, lungs, gut). These patients are also particularly susceptible to infection. This may be due to the disease rendering the immune system also, paradoxically, underactive (or at least less effective) at its job of fighting foreign particles.
Acute inflammation, such as that resulting from infection or injury, may be considered in phases, with 'onset' and 'progression' being followed by active 'resolution'. We hypothesise that an inability to properly resolve acute inflammation plays a key role in autoimmune rheumatic diseases, and therefore plan to study the resolution of acute inflammation to gain insight into why the disease develops (and also with a view to future manipulation of these pathways as an alternative therapeutic approach).
Very little work has been done to see how the immune system of these patients responds to an external challenge (e.g. an infection) resembling that encountered in real life. We plan to do this using an injection of a killed bacterium (same principle as vaccination) into the skin of the forearm. We will study the local resolution process following the injection by sampling the fluid at the site (using suction blister and microdialysis catheter techniques), and the cells at the site (using suction blister and skin biopsy techniques).
The resolution pathways in patients with autoimmune rheumatic disease will be compared to those with osteoarthritis (joint damage but theoretically normal immune system) and healthy controls.
REC name
West Midlands - Solihull Research Ethics Committee
REC reference
15/WM/0368
Date of REC Opinion
23 Oct 2015
REC opinion
Favourable Opinion