Researchers from the University of Liverpool and Alder Hey children's NHS Foundation Trust will join a UK-wide effort, including colleagues from five other universities, to drive the development of new, targeted treatments for children and young people with juvenile idiopathic arthritis (JIA) and its associated eye-inflammation condition, uveitis.
The CLUSTER (Childhood arthritis and associated uveitis: stratification through endotypes and mechanism) Consortium has been awarded £5 million from the UK's Medical Research Council (MRC) with partnership funding from Arthritis Research UK. It brings together world-leading clinical, academic, scientific, statistical and industry expertise in childhood arthritis and its associated eye inflammation uveitis, in partnership with children, young people and their families. Its aim is to improve the lives of children living with these life-changing, complex conditions. Starting in May 2018, CLUSTER will help clinicians to target specific treatments for patients.
Developing targeted treatments
JIA affects around one in 1000 children and young people and can cause long-term disability, significantly impacting on those affected well into adult life. Up to 15 per cent of children with JIA have uveitis which may cause visual impairment; children and young people can become certified legally blind.
This five year project will systematically analyse data that is captured from national studies and trials of patients with JIA and JIA-uveitis. It will look for gene alterations, immune cell differences, blood proteins and clinical features that are typical of patients who respond to therapies well, and in patients who develop uveitis. Ultimately, the researchers hope to identify a panel of tests that doctors can use to help make sure treatments are targeted specifically to groups of patients with similar characteristics. The work will also help influence, design and monitor future clinical trials allowing researchers to better understand the condition and test advanced treatments for these debilitating conditions.
Leading two of the five CLUSTER work streams is Michael Beresford who is Brough Chair and Professor of Child Health at the University of Liverpool, Director of the NIHR Alder Hey Clinical Research Facility and the UK's first and only 'Experimental Arthritis Treatment Centre for Children' here in Liverpool.
Professor Beresford, said: "This is an excellent demonstration of the strength and expertise we have here in Liverpool, that comes together in the UK's first and only 'Experimental Arthritis Treatment Centre for Children' supported by Arthritis Research UK, the University of Liverpool, and Alder Hey, in developing better, safer therapies for children with arthritis and related conditions. This important and exciting collaboration promises to make a real difference to the way we care for children and young people with these debilitating conditions."
Professor Louise Kenny, Executive Pro-Vice-Chancellor for the Faculty of Health and Life Sciences, University of Liverpool, said: "The University of Liverpool and Alder Hey has significant expertise in developing better, safer medical treatments for children and young people. The health and wellbeing of children in Liverpool, nationally and globally is a strategic priority for our University.
"This landmark, MRC-funded Consortium demonstrates the commitment and leadership of ourselves and colleagues across the UK in working closely with patients and parents in tackling a key priority of finding the very best way of caring for children with arthritis and this serious problem of uveitis.
"We expect this collaboration to be highly effective as we work together over the next five years to develop the stratified medicine solutions required for the challenges faced by young people with arthritis and related rheumatic disorders locally, nationally and internationally."
A 'new level' of research
Professor Lucy Wedderburn, Professor and Consultant of Paediatric Rheumatology at UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital (GOSH) and CLUSTER project lead, said: "We are absolutely delighted to have been awarded this prestigious funding. The consortium builds on our collaborative work carried out in previous studies, brings in new partners from academia, industry, and patients, and will take our understanding of these conditions to a new level. It will ultimately help us to control inflammation earlier, reduce disability and lead to long term benefits for children and young people, and the adults they become."
The research will build on the previous MRC supported-CHART consortium between London, Liverpool and Manchester, which brought together data on 5000 patients with JIA and key collaborative partners from across the UK and beyond with the Arthritis Research-UK supported 'Experimental Arthritis Treatment Centre for Children' (@EATC4Kids). The CLUSTER consortium is supported through the MRC's stratified medicine programme and will be co-funded through a partnership between MRC and Arthritis Research UK. As an integral part of the Consortium's work, CLUSTER will also receive co-funding from GOSH Children's Charity and Olivia's Vision.
The ten CLUSTER co-investigators [Professor Lucy Wedderburn (University College London and GOSH), Professor Wendy Thomson (University of Manchester), Professor Michael Beresford (University of Liverpool and Alder Hey Children's NHS Foundation Trust), Professor Andrew Dick (UCL), Prof. Kimme Hyrich (University of Manchester), Dr Nophar Geifman (University of Manchester), Professor Souyma Raychaudhuri (University of Manchester), Professor. A.V. Ramanan (University Hospitals Bristol NHS Foundation Trust), Dr Chris Wallace (University of Cambridge) and Dr Michael Barnes (Queen Mary's University of London)] have made renowned research contributions in the fields of stratified medicine for childhood arthritis and uveitis.
Case study: Eilean MacDonald
Eilean, a 17-year-old childhood arthritis patient, was diagnosed with arthritis at 18 months and has been looked after by the multi-disciplinary team within the Clinical Academic Department of Paediatric Rheumatology at Alder Hey.
It took years of trying various medications until she found the right treatment to alleviate her pain. Eilean said: "When you think of arthritis you see a 70-year-old lady with stiff hands, not an 18-month-old baby or a teenager. People don't believe children can get arthritis but we do. I've missed school and had to quit activities I loved because of my condition.
"This research is so important - it could mean the next generation of kids with arthritis won't have to go through what I did. They could have the right therapy handpicked for them, they won't have a constant worry about uveitis, and they could have even one piece of their future that's predictable with this disease."
Associated with nine Nobel Laureates, the University is recognised for its high-quality teaching and research. Our research collaborations extend worldwide and address many of the grand challenges facing mankind today.
Alder Hey Children's NHS Foundation Trust provides care for over 275,000 children and young people every year. Alder Hey delivers clinical excellence for all children, for routine illnesses as well as very complex and rare conditions.
One of four stand-alone children's hospitals in the UK, is a European League Against Rheumatism (EULAR) 'Centre of Excellence' for Paediatric Rheumatology, became the first and remains the only LUPUS UK 'Centre of Excellence for Childhood Lupus' in 2010 and is part of the UK's first and only 'Experimental Arthritis Treatment Centre for Children'. It is a national centre for neuro and craniofacial surgery, a regional centre for burns injuries and a Centre of Excellence for children with cancer, heart, spinal and brain disease. The Trust is one of only four epilepsy surgical centres in the UK and one of only two accredited major trauma centres in the North West. Alder Hey is also a respiratory Extracorporeal Membrane Oxygenation (ECMO) surge centre and is the referral centre for the treatment of congenital heart defects in North West England, North Wales and Isle of Man.
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