Immediate and Long-Term Career Goals: Jose U. Scher, MD, has a strong background in clinical immunology and rheumatology, as well as basic and translational research. His overarching career goal is to become an independent academic research scientist working at the interface between rheumatic diseases, immunology, microbiology, and computational analytics in the area of causal discovery methods. To achieve this long-term goal, Dr. Scher plans to extend his research area into the medical sciences through a plan for acquiring 'omics and computational expertise, as well as learning essential skills for upstream and downstream analysis of large datasets. Environment - Key Elements of the Research Career Development Plan: Dr. Scher is currently a junior faculty member in the Department of Medicine, Division of Rheumatology at New York University School of Medicine. Under the guidance of the mentoring team (mentor Dr. Steven B. Abramson; co-mentor Dr. Constantin Aliferis), collaborators (Drs. Martin Blaser, Andrea Neimann, Jonathan Samuels) and advisors, Dr. Scher will enter a rigorous training program consisting of: 1) hands-on research training in advanced computational analytics; 2) formal didactic training via graduate courses in Advanced Causal Pathway Discovery Methods, Computational Studies, Biostatistics, and Clinical Trials Design; 3) contribution to journal clubs and group meetings in the research groups of the mentors, collaborators and advisors; 4) participation in national and international conferences and symposia; and 5) participation in training courses in the responsible conduct of research. Research Project: Psoriatic arthritis (PsA) is a chronic inflammatory disease of unknown etiolology, occurring in about one third of people with psoriasis of the skin (a condition that affects 2-3% of the population). Gut and skin microbiota (the totality of microbes that reside in/on the human body) have long been thought to contribute to inflammatory diseases, and multiple reports in animal models and humans suggest a predominant role in autoimmune and rheumatic disease manifestations. There is strong genetic, clinical and therapy-based evidence that psoriasis, psoriatic arthritis and inflammatory bowel diseases represent examples of the same disease spectrum. Given the long-considered hypothesis that bacterial infection could represent an environmental trigger for PsA development, the application of modern microbiology technologies and causal discovery methods to assess this question could have significant impact on the field. We therefore propose to study the role of intestinal and skin microbiota in PsA utilizing state-of-the-art, culture-independent, DNA sequencing techniques coupled with sophisticated computational analytical tools. Our primary hypotheses are that: 1) characterization of microbes in human intestine/skin will provide insight into disease pathogenesis; and 2) gut/skin microbiota are associated with local and systemic immune responses potentially responsible for (and predictive of) the passage from psoriasis of the skin to PsA. Insights attained may elucidate how microbial communities interact with host intestinal/cutaneous components and provide a rationale for the development of new diagnostic and therapeutic approaches for PsA. Two primary Specific Aims are proposed:
Aim 1) To study the role of intestinal microbiota in new-onset Psoriatic Arthritis by: a) characterizing the alterations of skin microbiota community at the onset of PsA; and b) studying the link between intestinal microbiota in PsA patients and the local intestinal immunologic response.
Aim 2) To determine the role of skin microbiota in new- onset PsA by: a) investigating whether alterations in the skin microbiota correlate with phenotypic differences in patients with psoriasis of the skin versus PsA patients; and b) studying the association between skin microbiota in PsA patients and the systemic immunologic response. An additional secondary aim, Aim 3, will also be pursued in order to a) expand an established longitudinal database/biorepository for the study of natural history of PsA and b) investigate whether baseline skin and/or gut microbiota can predict development of arthritis/enthesitis. Carefully selected outcomes should permit us to correlate the presence of a specific microorganism or microbiome pattern with changes in immune response, other specific biomarkers, and clinical activity. Relevance: This project is consistent with the goals of the Human Microbiome Project, a major NIH Roadmap initiative, and has the potential to be truly transformative by filling a fundamental knowledge gap regarding the cause of inflammatory arthritis. The results could transform our understanding of the relationships between microbes and humans, and lead to innovative diagnostic tests and future treatments.

Public Health Relevance

Psoriatic arthritis (PsA) is a chronic inflammatory disease of unknown cause, occurring in about one third of people with psoriasis of the skin (a condition that affects 2-3% of the population). Gut and skin microbiota (the totality of microbes that reside in/on the human body) have long been thought to contribute to inflammatory diseases. This project will use new DNA technology and state-of-the-art computational analytical methods to identify the microbes living on the skin and in the intestine of patients with psoriasis and PsA, and has the potential to be truly transformative by filling a fundamental knowledge gap regarding the cause of inflammatory arthritis. The results could transform our understanding of the relationships between microbes and humans, and lead to innovative diagnostic tests and future treatments.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23AR064318-03
Application #
8827246
Study Section
Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
Program Officer
Mao, Su-Yau
Project Start
2013-04-01
Project End
2016-03-31
Budget Start
2015-04-01
Budget End
2016-03-31
Support Year
3
Fiscal Year
2015
Total Cost
Indirect Cost
Name
New York University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
121911077
City
New York
State
NY
Country
United States
Zip Code
10016
Manasson, Julia; Shen, Nan; Garcia Ferrer, Helga R et al. (2018) Gut Microbiota Perturbations in Reactive Arthritis and Postinfectious Spondyloarthritis. Arthritis Rheumatol 70:242-254
Garcia Ferrer, Helga Raquel; Azan, Alexander; Iraheta, Isa et al. (2018) Potential risk factors for reactive arthritis and persistence of symptoms at 2 years: a case-control study with longitudinal follow-up. Clin Rheumatol 37:415-422
Yang, Lu; Fanok, Melania H; Mediero-Munoz, Aranzazu et al. (2018) Augmented Th17 Differentiation Leads to Cutaneous and Synovio-Entheseal Inflammation in a Novel Model of Psoriatic Arthritis. Arthritis Rheumatol 70:855-867
Clemente, Jose C; Manasson, Julia; Scher, Jose U (2018) The role of the gut microbiome in systemic inflammatory disease. BMJ 360:j5145
Isaac, Sandrine; Scher, Jose U; Djukovic, Ana et al. (2017) Short- and long-term effects of oral vancomycin on the human intestinal microbiota. J Antimicrob Chemother 72:128-136
Caminer, Ana Clara; Haberman, Rebecca; Scher, Jose U (2017) Human microbiome, infections, and rheumatic disease. Clin Rheumatol 36:2645-2653
Okhovat, Jean-Phillip; Ogdie, Alexis; Reddy, Soumya M et al. (2017) Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network Consortium (PPACMAN) Survey: Benefits and Challenges of Combined Rheumatology-dermatology Clinics. J Rheumatol 44:693-694
Scher, Jose U; Joshua, Vijay; Artacho, Alejandro et al. (2016) The lung microbiota in early rheumatoid arthritis and autoimmunity. Microbiome 4:60
Catrina, Anca I; Deane, Kevin D; Scher, Jose U (2016) Gene, environment, microbiome and mucosal immune tolerance in rheumatoid arthritis. Rheumatology (Oxford) 55:391-402
Abdollahi-Roodsaz, Shahla; Abramson, Steven B; Scher, Jose U (2016) The metabolic role of the gut microbiota in health and rheumatic disease: mechanisms and interventions. Nat Rev Rheumatol 12:446-55

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