The organization of our subspecialty clinics with well-defined clinical populations and strong collaborations with other Divisions and Departments, have laid the ground work for a well-funded and productive research program. The clinical research program includes studies of the major paediatric rheumatic diseases focusing on outcomes, prognosis and treatment. The Division of Rheumatology has become the lead centre for a number of international treatment trials for new therapeutic agents in juvenile idiopathic arthritis.
Dr. Silverman has several areas of focus: 1) Neonatal Lupus Erythematosus (NLE) and congenital heart block; 2) Systemic Lupus Erythematosus (SLE); 3) Kawasaki disease and 4) Juvenile Idiopathic Arthritis. His group was the first to describe NLE and endocardial fibroelastosis without conduction defects. They have proven that mothers with SLE are at low risk for the development of congenital heart block in their offspring, but at high risk for the skin rash or other manifestations of NLE. Current studies include the genetics of childhood-onset SLE, the atherosclerotic risk factors in paediatric SLE, the role of pulse steroids in the early therapy of Kawasaki Disease and the development of a protocol to examine specific cytokine blockers in Kawasaki Disease and how they may improve the long-term outcome.
Dr. Tse has two areas of focus include: 1) juvenile spondyloarthritis, 2) juvenile idiopathic arthritis and 3) innovations in medical education including web-based learning modules and simulators. She and her colleagues have been involved in national and international collaborations in the development and validation of disease activity measures (clinical, imaging) in juvenile spondyloarthritis, assessment of predictors and outcomes in juvenile idiopathic arthritis in addition to clinical trials examining the efficacy and safety of biologic agents for the treatment of arthritis and enthesitis. She has also been actively involved in the implementation and studying the effectiveness of using technology to teach rheumatology to learners of all levels from patients and families to the interprofessional health-care team.
Laboratory research is conducted primarily by Dr. Rae Yeung and has focused on disease mechanisms in autoimmunity. Kawasaki disease is a multisystem vasculitis affecting the coronary arteries. It is now the number one cause of acquired heart disease in children in the developed world. Dr. Yeung has developed an animal model of Kawasaki disease which accurately reflects the disease seen in children. Her lab has identified a novel superantigen which initiates the immune response leading to coronary artery damage. Towards understanding the path from systemic inflammation to localized coronary artery disease, they have identified key molecules involved in disease pathogenesis. The ultimate goal of these studies is to identify new molecular targets for development of therapeutic agents to treat children with Kawasaki Disease.