Ghent-based researchers are the cream of the crop in rheumatology

28 January 2017

​Millions of people around the globe are currently suffering from rheumatism, which has a tremendous impact upon their lives and well-being. As an umbrella term, rheumatism covers dozens of specific diseases of the muscles, joints and bones – which require different treatments. Because an overall cure remains undiscovered, patients and their associations are placing their hopes in science. Saying that VIB is at the vanguard of global rheumatologic research may seem like a bold statement, but the recent achievements of Dirk Elewaut’s team (UGent-UZ Gent) at our VIB Inflammation Research Center speak for themselves.

Rheumatism: facts & figures
 There are over 200 different rheumatic diseases.
• Around 25% of all Europeans (120 million people) suffer from a rheumatic disease.
• 20% of Europeans are undergoing long-term treatment for rheumatism.
• The most common type is rheumatoid arthritis, an inflammation affecting the joints.
• Women suffer from rheumatoid arthritis 2.5 times more frequently than men.

Ghent has been recognized worldwide as region of rheumatology excellence for some time now. In early September, this was once again illustrated by a gathering of world-leading experts in spondyloarthritis (one of the most commonly-occurring types of inflammatory rheumatism) in Ghent for the world’s only spondyloarthritis biannual congress. Dirk Elewaut: “Our department pioneered the use of anti-TNF therapy in spondyloarthritis around the year 2000, for what is now a globally-used indication. And by combining the expertise of VIB, Ghent University and Ghent University Hospital, we have further strengthened our position.”

Ivy League of rheumatology
Earlier this year, the alliance between VIB, Ghent University and Ghent University Hospital was awarded the prestigious quality label Center of Excellence by EULAR, a non-profit scientific and educational association dedicated to facilitating knowledge transfer between research institutes and defending the interests of people with arthritis before Europe’s governing bodies. It is the third time in a row that these Ghent-based researchers and clinicians have received the 5-year quality label.

“Being a Center of Excellence means that you’ve been recognized for being able to present both quality and quantity in publications,” explains Dirk Elewaut, one of the driving forces. “Initiation into this ‘Ivy League of rheumatology’ was a real team effort. But achieving this label of excellence is one thing – maintaining it is the real endeavor. This is why we are planning to continue pooling together VIB and Ghent University’s basic research knowhow with Ghent University Hospital’s clinical expertise and experience.”

The role of macrophages and gut flora
Two recent studies underline this ambition. The first one focused on enthesitis, a commonly occurring inflammation of tendons where they attach to the bone. In collaboration with the Geert van Loo lab (VIB-UGent), Dirk’s team proved that macrophages that lack the antiinflammatory protein A20 develop enthesitis. Since A20 suppresses the activation of STAT1, a signaling molecule that seems to be key in initiating enthesitis, the absence of A20 leads to the development of enthesitis. By using an inhibitor, the scientists were able to prevent the increase of STAT1 and successfully treat the inflammation. This approach may provide options for patients for whom existing inhibitors offer no relief.

The most recent feat of Dirk’s team describes a striking link between spondyloarthritis and the human gut flora composition. Together with VIB’s gut flora expert Jeroen Raes (VIB-KU Leuven), the researchers examined 27 spondyloarthritis patients to find an abundance of a particular gut microbe called Dialister, even in the disease’s early stages. Consequently, these findings may provide opportunities for an improved diagnosis of spondyloarthritis. Dirk and his team are currently taking their research to the next stage, trying to determine what’s so special about Dialister. To be continued!

Publications
Drennan et al., Journal of Experimental
Medicine paper 2016
De Wilde et al., Ann Rheum Dis 2016
Tito et al., Arthritis Reumatol. 2016


Research


Dirk Elewaut
©VIB-Ine Dehandschutter