Jack Thomson Arthritis Fund

Project: The effectiveness of joint replacement surgery for hip and knee osteoarthritis

Principal investigator: Dr Ross Wilson, Department of Surgery & Critical Care, Faculty of Medicine, University of Otago

Osteoarthritis (OA) affects over half a million New Zealanders and represents a diverse spectrum of pathological processes culminating in joint damage and loss of function. Recent research has highlighted an inflammatory type of OA, suggesting potential for repurposing existing therapies to target early inflammation. Currently, identifying patients with inflammatory OA typically relies on imaging modalities such as ultrasound or MRI, which are resource-intensive and impractical for widespread screening. Developing a cost-effective biomarker for early inflammatory OA could revolutionise diagnostic and treatment approaches, enabling timely intervention and preventing irreversible joint damage. This project builds on pilot data, potentially identifying pathways for targeted interventions based on inflammatory cytokine signatures.

 

Identifying pro-inflammatory biomarkers for osteoarthritis

Principal investigator: Dr Adele Woolley, Department of Pathology, Dunedin School of Medicine, University of Otago

Co-investigators: Prof Lisa Stamp, Department of Medicine, University of Otago Christchurch, Prof Simon Stebbings, Department of Medicine, University of Otago and Dr Fraser Harrold, Department of Surgical Sciences, University of Otago

Osteoarthritis (OA) affects over half a million New Zealanders and represents a diverse spectrum of pathological processes culminating in joint damage and loss of function. Recent research has highlighted an inflammatory type of OA, suggesting potential for repurposing existing therapies to target early inflammation. Currently, identifying patients with inflammatory OA typically relies on imaging modalities such as ultrasound or MRI, which are resource-intensive and impractical for widespread screening. Developing a cost-effective biomarker for early inflammatory OA could revolutionise diagnostic and treatment approaches, enabling timely intervention and preventing irreversible joint damage. This project builds on pilot data, potentially identifying pathways for targeted interventions based on inflammatory cytokine signatures.

Identification of the human allopurinol transporter causing side effects in gout treatment

Principal investigator: Dr Andrew Bahn, Department of Physiology, University of Otago

Gout is a painful inflammation of the joints induced by high serum uric acid (SUA) based on genetic predisposition and an unhealthy Western diet. The gold standard for gout treatment is allopurinol, inhibiting the synthesis of uric acid in the liver to lower SUA. However, gout is associated with many comorbidities including hypertension, the treatment of which renders gout treatment with allopurinol ineffective. Consequently, the allopurinol dose needs adjustment, exposing the patient to further gout attacks and the risk of life-threatening side effects. We aim to better understand these drug-drug interactions by identifying the liver transporter for allopurinol to ultimately improve gout treatment.

Inflammation in knee osteoarthritis: biomarker response to clinical trial interventions

Principal investigator: Dr Cathy Chapple, School of Physiotherapy, Health Sciences, University of Otago

Knee osteoarthritis is very common, with people suffering from pain, inability to undertake their usual activities and decreased quality of life. Many treatments are available but not everyone responds in the same way, possibly due to different types of osteoarthritis, including an inflammatory type. Biomarkers in blood may be one way to measure inflammation and response to treatment. This study will measure biomarkers in people with knee osteoarthritis taking part in a clinical trial of physiotherapy and anti-inflammatory medication. It will evaluate if biomarkers match patient clinical signs and symptoms, and whether they change in response to treatment.

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Influence of footwear lower limb movement patterns following anterior cruciate ligament reconstruction

Principal investigator: Associate Professor Gisela Sole, School of Physiotherapy, Health Sciences, University of Otago

People with anterior cruciate ligament (ACL) ruptures of the knee have a high risk for developing knee osteoarthritis within 10 years. Movement patterns of the knee during walking, jumping or running can be used to indicate risk for future osteoarthritis. We will explore how such knee movement patterns differ between people with ACL reconstructions and knee- healthy people, and how footwear inserts may change such movement patterns. Those movement patterns will be assessed in a University Human Movement laboratory using three- dimensional movement analysis while participants undertake a series of physical tasks. The results will inform future rehabilitation strategies to improve outcomes of the injury as well as decreasing risk for osteoarthritis.

Excess health losses and costs in osteoarthritis with multimorbidity

Lead Researcher: Dr Ross Wilson, Centre for Musculoskeletal Outcomes Research, Department of Surgical Sciences, University of Otago

Osteoarthritis is a common, disabling condition, and people with osteoarthritis often have other long-term conditions. The occurrence of multiple co-existing conditions affects >42% of New Zealanders over age 45 years, with Māori and Pasifika disproportionately affected. Little is known about the extent to which having both osteoarthritis and one or more other long-term conditions, such as diabetes, cardiovascular disease, and depression, has an impact on health-related quality of life and the costs of healthcare consumption in the New Zealand healthcare system. This project will answer these questions using data from around 75,000 participants in the annual New Zealand Health Survey and linked administrative health data.

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Identifying Biomarkers in Inflammatory Osteoarthritis

Lead Researcher: Dr Adele Woolley, Department of Pathology, University of Otago

Pona Ngoikore - Osteoarthritis (OA), is a debilitating disease which is projected to affect increasing numbers of our aging population, posing an ongoing and significant health and economic burden to NZ. OA is the most common form of arthritis and is traditionally associated with mechanical ‘wear and tear’. There are limited therapeutic options available, resulting in prolonged disability and decreased quality of life, until the advent of end stage joint replacement. Recent research has found that patients may suffer from different types of OA which are due to a variety of factors including some which are driven by inflammation. This proposal aims to identifying inflammatory biomarkers in patients with this inflammatory subtype which will lead to both early intervention and to greatly improved health outcomes.

Pain sensitisation and lived pain experiences in people knee osteoarthritis

Principal investigator: Dr Ramakrishnan Mani, School of Physiotherapy, University of Otago

Knee osteoarthritis is a common health condition which can result in pain and disability. The knee osteoarthritis pain experience is complex and biopsychosocial with studies revealing that pain is less related to structural joint changes and more related to the sensitivity of the nervous system. Lived experiences and symptoms linked to the pain experience can be captured using smartphones as people go about their daily lives. This research aims to capture biopsychosocial lived experiences of those with knee osteoarthritis using smartphones and determine if these are linked with pain sensitivity.

 

The fibroblast contribution to rheumatoid arthritis

Principal investigator Dr Paul Hessian, Department of Medicine, University of Otago

Pathogenic mechanisms driving extra-articular inflammation in rheumatoid arthritis (RA) are unknown. Rheumatoid subcutaneous nodules are extra-articular lesions associated with severe RA. Recent investigation of rheumatoid nodule tissues revealed evidence of fibroblasts contributing to inflammation in nodule lesions. In this proposal, we investigate the contribution from a unique “intermediate” fibroblast subtype as we work towards understanding the causes of extra-articular rheumatoid inflammation and the potential for new therapeutic strategies that will benefit patients with extra-articular disease.

 

The impact of peritoneal dialysis on oxypurinol and urate handling in gout patients

Principal investigators: Professor Robert Walker, Department of Medicine, and Dr Daniel Wright School of Pharmacy, University of Otago

Gout is common in people with kidney disease who require dialysis to maintain kidney function. Gout can be prevented by reducing uric acid concentrations in the body using medicines such as allopurinol. We do not know how allopurinol is handled in patients who are receiving peritoneal dialysis nor what dose is safe and effective. We will measure the elimination of oxypurinol, the active produce of allopurinol, and uric acid over a 24 hour period in 10 patients receiving peritoneal dialysis. We will use this information to predict the allopurinol dose required to lower uric acid concentrations to prevent gout.