Anna Lois Waters Endowed Chair, Division of Clinical Immunology and Rheumatology
Professor of Medicine
Director, Division of Clinical Immunology & Rheumatology
Shelby Building, Room 178C
1825 University Boulevard
Administrative Associate: Paula Kiley
Shelby Building, Room 178B
1825 University Blvd.
BS, Preprofessional Studies, University of Notre Dame, 1980
MD, Louisiana State University School of Medicine, 1984
PhD, University of Alabama at Birmingham, 1995
Internship and Residency, Internal Medicine, University of Texas Medical Branch, Galveston 1984-1987
Chief Residency, Internal Medicine, University of Texas Medical Branch, Galveston 1987-1988
Fellowship, Clinical Immunology and Rheumatology, University of Alabama at Birmingham, 1988-1991
|Stephanie S. Ledbetter, MS||Program Manager|
|Keith Wanzeck||Lab Manager|
|Jinyi Wang||Research Associate|
|Selena D. Luckett-Smith, RN||Study Coordinator|
|Laticia Woodruff, RN||Study Coordinator|
|Dongmei Sun, PhD||Database Manager|
|Vincent Laufer||MD/PhD Student|
Research Description and Potential Projects for Trainees
My earliest research interest, the role of B lymphocytes and autoantibodies in rheumatoid arthritis (RA), particularly immunoglobulin gene expression and antibody repertoires in synovial tissue, formed the basis of my PhD studies. In addition, my research has focused on identification of genetic influences on RA susceptibility and severity, particularly in African-Americans, and on autoantibodies and biomarkers of treatment response in RA. I have led several multicenter consortia, including the Consortium for the Longitudinal Evaluation of African-Americans with Rheumatoid Arthritis (CLEAR) Registry and Repository; the Biorepository of the Treatment of Early Aggressive RA (TEAR) Trial; and the Treatment Efficacy and Toxicity in RA Database and Repository (TETRAD).
Click here for a complete list of publications in PubMed.
Active Research Projects
Multidisciplinary Clinical Research Center
As Director of UAB's Multidisciplinary Clinical Research Center (MCRC), funded by NIH P60 AR064172, I oversee a multidisciplinary program to promote research related to the causes, diagnoses, treatments and improved care of patients with arthritis and musculoskeletal diseases. The MCRC contains an Administrative Core, a Methodology Core (led by Xiangqin Cui, PhD, and David Redden, PhD of the UAB Department of Biostatistics, SOPH) and two research projects (see below).
The mission of the MCRC Methodology Core is to develop and provide state of the art methodology and methodological education in the collaborative support of clinical and translational research in arthritis and musculoskeletal disease (MSD) at the local, regional, national, and international level. Toward this goal, the Core will continue to provide the statistical, epidemiological, outcomes research, statistical genetics, economics/cost effectiveness and bioinformatics leadership and expertise required to develop and perform cutting edge clinical research in arthritis and MSD it pursues four broad goals:
- To support the design, data collection, management and analytic efforts of the MCRC projects
- To nurture original research in methodology applicable to clinical research in arthritis and MSD
- To develop new investigators in the area of arthritis and MSD research
- To provide methodology seminars, workshops and mini-courses to introduce the newest methodological approaches to the MCRC research base.
MCRC Project 1. Facilitating Treat-to-Target Strategies Using Novel Health Technology with Decision Support (PI: Jeffrey R. Curtis, MD, MS, MPH). This project will extend and evaluate novel health information technology to enable the systematic collection and integration of Patient Reported Outcome (PRO) and healthcare provider data in routine clinical practice; make use of this data to facilitate patient-provider interaction around optimal use of rheumatoid arthritis (RA) therapies; integrate this data with information in Electronic Health Record (EHR) systems; and demonstrate benefit for both process and outcomes among patients with RA.
MCRC Project 2. Adaptive Immune Responses to Gut Microbiota in Juvenile and Adult Spondyloarthritis (PI: Charles O. Elson, MD, and Co-PI: Matthew Stoll, MD, PhD, MSCS). This project will integrate cutting-edge technologies of antigen identification with microbiome/metagenome analysis to provide novel information on the microbial contributions to spondyloarthritis. The data will result in new insights into the pathogenesis of SpA, suggest potential new biomarkers for diagnosis and monitoring, and lead to new approaches to therapy by manipulating the microbiota and adaptive immune responses to it.
Center of Research Translation (CORT) in Gout and Hyperuricemia
As Co-Director of the UAB CORT in Gout and Hyperuricemia (NIH P50 AR060772 - KG Saag, Contact PI; SL Bridges, Jr., PI), I am involved in three research projects focused on characterizing biomarkers of inflammation (CRP), vascular disease (endothelial function), and blood pressure changes associated with allopurinol (Project 1); examining factors associated with suboptimal gout care and factors influencing effective and safer dosing of allopurinol and colchicine in African-Americans and Caucasians (Project 2); and comparing the effectiveness of a novel pharmacy-based "virtual" Gout Clinic that includes protocol-driven care to usual care in the treatment of chronic gout (Project 3). The overall goal of our CORT (K. Saag, Director) is to improve the health of patients with gout and hyperuricemia by applying scientifically rigorous, state-of-the-art methodology to clinically important questions in translational investigation and to educate clinical investigators through an enrichment program. These innovative projects hold the promise of significant improvements in our understanding of the pathogenesis of gout and related co-morbid conditions, and may ultimately lead to better ways to predict, treat, or prevent gout and hyperuricemia.
Rheumatic Disease Cores Center
As Associate Director of the UAB Rheumatic Disease Cores Center (RDCC) (NIH P30 AR048311, John D Mountz, MD, PhD, PI and Director), I serve as collaborate with Dr. Mountz to provide assistance in the strategic planning, management and evaluation functions of the RDCC; and have primary responsibility for the development of Scientific Programs & Career Development program and for the management and monitoring the progress of the Pilot & Feasibility (P&F) Program. The RDCC consists of UAB investigators pursuing research in the rheumatic diseases, the Administrative Core, and three Research Cores: Comprehensive Flow Cytometry Core (CFCC); Analytical Imaging and Immunoreagent Core (AIIC); and Analytical Genomics and Transgenics Core (AGTC).
I serve as investigator and Director of the Biorepository for the Safety and Effectiveness of Live Zoster Vaccine in Anti-TNF Users (Varicella zostER VaccinE [VERVE]) trial, a randomized, double-blind, placebo-controlled large pragmatic trial to evaluate the immunogenicity, safety, and longer-term effectiveness of the live HZ vaccine in arthritis patients receiving anti-TNF therapy (UM1 AR065705 - JR Curtis, PI).
A more recent interest is in mechanisms of muscle inflammation and it impact on mobility after joint replacement for arthritis. Though R01 HD084124 Overcoming TWEAK Signaling to Restore Muscle and Mobility after Joint Replacement (M Bamman, Contact PI/SL Bridges, Jr., MPI), we will test the hypothesis that progressive resistance exercise training plus adjunctive functional mobility training after total hip or knee arthroplasty will more effectively restore muscle mass and mobility function to healthy standards than usual care, particularly in patients with TWEAK (TNF-like weak inducer of apoptosis)-mediated muscle inflammation. We will perform a randomized controlled trial of THA/TKA patients to test this hypothesis and study the cellular and molecular mechanisms of muscle mass regulation.
National Resource Center for High-Impact Clinical Trials in Medical Rehabilitation
Our NIH-funded P2C National Resource Center for High-Impact Clinical Trials in Medical Rehabilitation (High-Impact Trials Center, HITC) will serve as a catalyst for the design and implementation of rigorous, high-impact clinical trials to advance medical rehabilitation research. Oversight of the Center is provided by Marcas Bamman, PhD (Director). I serve on the Executive Committee and as Director of the HITC Pilot Component (Pilot-C). The goal of this component is to catalyze the success of medical rehabilitation researchers and interdisciplinary teams by providing consultation, seed funds, key expertise and resources, and ultimately feedback, to medical rehabilitation researchers for the conduct of innovative pilot projects, early-stage proof-of-concept studies, and futility studies needed to shape more definitive clinical trials. The central goal will be met by achieving the following aims: Aim 1. To work closely with the Collaborative Component, providing consultation to medical rehabilitation research teams on how to: 1) Formulate and refine strong and impactful research questions; 2) Identify the goals and aims needed to achieve future clinical outcome trials. Aim 2. To identify and prioritize the most competitive proposals for both pilot studies and voucher funding via an annual peer review process. Aim 3. To provide expertise, resources, and/or mentorship to selected pilot study awardees with ongoing availability during the planning and implementation phases in order to: 1) Bolster the scientific yield of each pilot study; and 2) Position each awardee for a subsequent, highly competitive clinical trial application. Aim 4. To provide constructive and substantive feedback to applicants not selected for funding, and to direct those applicants toward other programs and opportunities within the Center that can strengthen future applications. The Pilot-C will award four $40K pilot studies per year.
The Rheumatoid Arthritis Synovial Tissue Network
I served as site PI of the Rheumatoid Arthritis Synovial Tissue Network (REASON) Study (UH2 AR067687 - RM Pope, Northwestern Univ). The goals of this study are to create a new generation of rheumatologists in the United States who will perform minimally invasive ultrasound guided synovial biopsies that is critical for obtaining of synovial tissue from patients at all phases of RA (early, established, DMARD or biologic inadequate response). We have assembled a consortium of leading academic rheumatology groups which includes UAB, Columbia University, Mayo Clinic, Washington University, University of Michigan, and Northwestern University to obtain synovial tissue from RA patients for translational studies to identify novel pathways and potential biomarkers that might predict therapeutic response. We anticipate that we will be part of the NIH Accelerating Medicines Partnership to provide training for synovial biopsy, as well as RA synovial tissue samples to the collaborative research network.