Research is an integral part of the fellowship training program. We have active clinical research programs evaluating patients with systemic lupus erythematosus, vasculitis, rheumatoid arthritis, connective tissue disease related interstitial lung disease, osteoporosis, and inflammatory myositis. In addition to clinical research, our basic science researchers investigate lymphocyte biology in autoimmunity, pathways of angiogenesis and vasculogenesis, and gene expression profiling in patients with autoimmune disease. The goals of the research component of our fellowship training are broad and flexible according to the skills and needs of individual trainees.
Each fellow is expected to submit an abstract yearly to the American College of Rheumatology Annual Meeting. This is accomplished through close faculty mentorship throughout the process. A suggested timeline and intermittent presentations at informal research meetings helps the fellow to identify feasibility, stay on track, and accomplish goals. Amy Major, PhD directs the research curriculum of the fellowship.
Two unique tools available to fellows for clinical research are the Synthetic Derivative and BioVU. The Synthetic Derivative is a de-identified copy of the electronic health record. BioVU is a biorepository of de-identified DNA samples that is linked to the health record. Our fellows have consistently been able to produce abstracts for the ACR annual meeting and publications using these tools to ask questions with faculty mentorship.
For fellows strongly interested in research, the Masters of Science in Clinical Investigation (MSCI) program is a unique opportunity offered at VUMC.
One of the most exciting opportunities for trainees in the Division of Rheumatology at Vanderbilt University Medical Center is in the area of Precision Medicine. Mike Stein and Cecilia Chung collaborate with Vivian Kawai in a NIH-funded project focused on the genetic susceptibility of antinuclear antibodies. They also collaborate on the genetics of systemic lupus erythematosus and rheumatoid arthritis susceptibility. April Barnado uses electronic health records to stratify patients with systemic lupus erythematosus, and Cecilia Chung leads projects on the pharmacogenomics of immunosuppressants. Their teams leverage wide-ranging resources at Vanderbilt, such as de-identified biobanks and large clinical datasets. In addition, they have developed strong multidisciplinary networks as they collaborate with investigators from the Vanderbilt Genetics Institute, the Departments of Biostatistics, and the VUMC Divisions of cardiology, clinical pharmacology, nephrology, bioinformatics, and infectious diseases.
Mike Stein and Cecilia Chung study the effects of frequently used drugs in large populations using big data from claims datasets, and electronic health records. In close collaboration with Dr. Wayne Ray from the Department of Health Policy, their work has focused on defining the side effects of opioids, non-steroidal anti-inflammatories, and muscle relaxants which led to publications in journals like JAMA, Lancet, and Clinical Pharmacology and Therapeutics. Ongoing work include the study of the comparative safety of non-opioid pain medications and is funded by the NIH and the Veterans Affairs administration.
Clinical studies in patients with rheumatic conditions
Our group was among the first to show that coronary atherosclerosis was increased in patients with inflammatory diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Mike Stein, Michelle Ormseth, and Cecilia Chung also study the role of traditional and non-traditional risk factors and biomarkers for atherosclerosis in patients with RA and SLE. Ongoing studies include the evaluation of the role of salt on inflammation, and the role of micro-RNAs in RA susceptibility and treatment response. This research is funded by the NIH and the Veterans Affairs administration.