Clinical & Epidemiological Research

Clinical and epidemiological research within the UCSF Division of Rheumatology is an active and engaging enterprise. UCSF faculty members have leadership roles in a number of prominent clinical studies including the Rheumatoid Arthritis Observational Cohort Study, California Lupus Surveillance Project (CLSP), and the Sjögren’s International Collaboration Clinical Alliance (SICCA).

Current Research Areas

Ankylosing Spondylitis

Dr. Lianne Gensler is the Ankylosing Spondylitis (AS) Clinic Director and performs research in AS and related fields. Currently, she is enrolling patients in 2 observational studies to better understand outcomes in patients with AS. One of these is in collaboration with other investigators to better understand the genetic contributions towards the disease. She is also studying a survey tool to identify patients with AS early, with the hope of reducing the current delay to diagnosis of 5-10 years.

Genetics and Epidemiology of Autoimmune Disease

Dr. Lindsey Criswell’s research focuses on identifying the genes that contribute to risk and severity of systemic lupus erythematosus, rheumatoid arthritis, and related diseases. Through this work, Dr. Criswell and her collaborators have helped to define biologic pathways that contribute to the development of these disorders. Ultimately, this work will inform the development of new treatments for these disorders and provide better diagnostic and prognostic tools.

Osteoarthritis

Dr. Chaganti’s primary focus is on clinical patient care. She sees general rheumatology patients on the Parnassus campus and osteoarthritis patients at the Orthopedic Institute at Mission Bay. She has been actively engaged in collaborative research regarding the epidemiology of osteoarthritis, using established multicenter databases based at UCSF and elsewhere.

Rheumatoid Arthritis (RA)

Dr. Graf is the Director of the Rheumatoid Arthritis (RA) Clinic at San Francisco General Hospital and co-director of the UCSF RA cohort. His research focuses on clinical and translational studies of RA, including studies that look at novel therapeutics, biomarkers, and cardiovascular risk in patients with RA. Dr. Graf is also a very talented clinician educator and he has received many teaching awards for his contributions in this area.

Dr. Imboden is the Rheumatology Division Chief at San Francisco General Hospital. He is also the founder of the UCSF RA Cohort. Dr. Imboden’s research interests relate broadly to immune mechanisms in rheumatic disease, spanning from basic laboratory research to studies in humans with RA and other rheumatic disorders.

Scleroderma

The UCSF Scleroderma Cohort Study is a collaborative effort between leading experts in the departments of Rheumatology (Drs. Gross and Gensler), Dermatology (Drs. Haemel and Connolly), and Pulmonology (Drs. Wolters and Golden). The purpose of this study is to develop a prospective cohort of patients with autoimmune cutaneous and rheumatic diseases in order to assess changes in clinical manifestations, disease activity, disease damage, quality of life, and disability over time.

With this information, we plan to better understand the pathophysiology of rheumatic diseases and evaluate the effects of current therapies in hopes to one day, develop even better treatments to help patients.

Although the set of causes of these autoimmune diseases is unknown, it is thought that a gene-environment interaction is necessary. This database will serve to collect clinical information that will be used in conjunction with tissue and or sample collection protocols to determine whether certain clinical manifestations correlate with specific genetic markers. Lastly, we hope to establish a pool of potential patients for enrollment in future studies.

Sjögren’s Syndrome

Drs. Criswell and Sack are contributing to research efforts in Sjögren’s Syndrome through their participation in the NIH-funded Sjögren’s International Collaboration Clinical Alliance (SICCA). In addition to extensive clinical information, a bank of salivary gland tissue, blood and other biospecimens have been obtained from over 3,000 participants and are made available to worldwide investigators. These studies have led to the development of new classification criteria for Sjögren’s Syndrome.

 

Systemic Lupus Erythematosus (SLE)

Dr. Dall’Era is the Director of the UCSF Lupus Clinic, which cares for over 200 patients with systemic lupus erythematosus from all over Northern California. Her research focuses on the design and conduct of clinical trials in order to develop safer and more effective medications for the treatment of lupus. Her work also looks at the symptoms, clinical course, treatments, and outcomes of lupus patients in a prospective registry.

Dr. Lindsey Criswell’s lupus research focuses on identifying the genes that contribute to the risk and severity of the disease. Through this work, Dr. Criswell and her collaborators have helped to define biologic pathways that contribute to the development of SLE. Ultimately, this work will inform the development of new treatments and provide better diagnostic and prognostic tools.

Dr. David Wofsy conducts clinical trials of new therapies designed to translate recent advances in basic research into safe and effective new treatments for people with severe rheumatic diseases, including in particular systemic lupus erythematosus (SLE). Within the past two years, this work has culminated in the demonstration of effective new approaches to induce and maintain remission in people with life-threatening kidney disease due to SLE. This work is based in large part on pioneering basic research conducted at the Rosalind Russell Center by Drs. Wofsy and Daikh. This research has already contributed to the approval of a new drug for rheumatoid arthritis, which is also currently under investigation for use in SLE patients.

A key focus of Jinoos Yazdany's lupus research program has been examining the quality of health care delivered to patients with lupus. In 2009, with lupus experts from around the United States, she spearheaded the development of the first quality measure set for lupus. Subsequently, she has gone on to apply these measures to understand health care quality for patients with lupus. Her work has highlighted gaps in care for the condition, disparities in quality for vulnerable populations such as the uninsured, and also identified preventable medication errors. Dr. Yazdany's research has been informed by her experiences as a physician caring for patients with lupus. She currently co-Directs the Lupus Clinic at UCSF, and also the Lupus Clinic at San Francisco General Hospital. In 2011, she was awarded the Mary Betty Stevens Young Investigator Prize from the Lupus Foundation of America.

 

Vasculitis (Giant Cell Arteritis, Polyarteritis Nodosa, Granulomatosis with polyangiitis)

Dr. Chung’s research and clinical program focuses on the study of vasculitis, a group of life-threatening diseases caused by inflammation of the blood vessels. As the director of the UCSF Vasculitis Clinic, she works with other UCSF specialists to provide expert care in diagnosing and treating these rare and intensively complex diseases. Dr. Chung also leads state-of-the-art genetic and epigenetic research studies, and collaborates with national and international research networks, to help identify the biologic mechanisms that lead to vasculitis in order to develop less toxic treatments and more informative diagnostic tests.