Drs. Monach and Grayson conduct “translational research,” which involves use of laboratory techniques to approach problems relevant to clinical medicine, in the hope of “translating” the results into tests that can help doctors provide better care for their patients. Some of this research is done only at Boston Medical Center, and some is done in collaboration with colleagues in the VCRC and associated with clinical trials. Both Drs. Monach and Grayson have obtained competitive grant funding for this research.
Our translational research includes biomarker studies, gene expression studies, and genetics. Biomarkers are substances that can be measured in blood or other body fluids and that tell us something about a disease state. We are trying to identify better biomarkers of active vasculitis (is the disease in remission or not?), involvement of particular organs, and prognosis (is the disease going to relapse or not?) in multiple forms of vasculitis.
Modern laboratory techniques allow for the measurement of the expression (the amount of RNA produced for a given gene) of tens of thousands of genes simultaneously, which has the potential to give insight into the cause of a disease, or ideas for biomarkers, or even suggest new approaches to treatment. We are studying gene expression in the blood and organ tissue of patients with granulomatosis with polyangiitis (GPA, Wegener’s), microscopic polyangiitis (MPA), and Churg-Strauss syndrome.
Genetics plays some, but not a large role in vasculitis. Although there will never be a genetic test for vasculitis, and patients and their family members should be reassured that occurrence of multiple cases of vasculitis in one family is rare, study of genetics provides an opportunity to better understand the causes of these diseases. We have completed genetics studies in GPA (Wegener’s) and plan to conduct studies on other types of vasculitis.