The Multipurpose Arthritis & Musculoskeletal Diseases Center at the University of North Carolina at Chapel Hill, chartered by the School of Medicine as the Thurston Arthritis Research Center, consists of a Biomedical Research Component, an Education, Epidemiology, & Health Services Research (E/E/HSR) Component, a Biomolecular Core, a Numerical Sciences Core, and an Administrative Unit. Ongoing Investigation in the Biomedical Research Component encompasses many of the issues relevant to autoimmunity, arthritis, and musculoskeletal disease: genetics, regulation, and function of recognition elements in normal and abnormal immune responses; peptide/MHC structure function relationships; induction and regulation of cytokine and inflammatory response genes; the repertoire of T cell receptor and B cell Ig genes and their role in autoimmunity; stem cell development; abnormal T cell activation and signal transduction in SLE; molecular genetics of autoantibody formation; contribution of autoantibodies to disease pathogenesis; immunosuppression; inciting agents in autoimmunity (bacterial cell walls, heat-shock proteins, mercury chloride); inflammation in experimental arthritis, and its therapy; biochemistry of osteoarthritis; experimental orthopaedics research; muscle metabolism; and clinical investigation. The Biomolecular Core will provide database support, DNA sequencing, flow cytometry, and mouse colony support for ongoing laboratory research. Three Developmental & Feasibility projects are proposed: 1) D&F project #1 involves basic studies on autoantibodies to phospholipids, which are associated with an increased risk of thrombosis, recurrent fetal loss, and thrombocytopenia; D&F project #2 proposes to clone and characterize a gene associated with a defect in muscle metabolism; D&F project #3 explores the role of IkappaB, an important regulatory element for induction of inflammatory genes, in SLE T cells. Areas of special emphasis in the E/E/HSR Component, which serves North Carolina and surrounding states, include: social and behavioral research, epidemiology of osteoarthritis, work disability, health promotion/disease prevention, health services research, arthritis in the elderly, and low back pain. Four E/E/HSR projects are proposed: project #1 entails a systematic examination and synthesis of novel behavioral science concepts as a means of developing an effective, efficient intervention strategy for patient education; project #2 examines the epidemiology of osteoarthritis and its influence on work force participation in minority and economically disadvantaged citizens; projects #3 and #4, respectively, will document the arthritis-related self-care behaviors of the elderly and examine the extent to which women approaching menopause recognize their increasing risk of osteoporosis and practice appropriate preventive behaviors. Support provided to the E/E/HSR Component by the Numerical Sciences Core includes: data entry, data management, programming, and consultation concerning research design, methodology, and data analysis.
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