Kaveh Ardalan, MD, MS, assistant professor of pediatrics in the Division of Rheumatology, was recently awarded the 2021 Rheumatology Research Foundation Investigator Award for his project entitled, Psychological Stress and Cardiovascular Health in Juvenile Lupus and Dermatomyositis.
The Investigator Award encourages junior investigators to continue conducting innovative research that will be competitive for more significant funding while they establish themselves as independent investigators.
Patients with juvenile systemic lupus erythematosus (JSLE) and dermatomyositis (JDM) are at high risk of premature cardiovascular disease (CVD). By young adulthood, JSLE/JDM patients are at 8 times greater risk of CVD than the general population. CVD risk in JSLE/JDM starts in childhood, when carotid intimal medial thickness progression is nearly 50% faster than in familial dyslipidemia. Premature loss of ideal cardiovascular health (CVH), defined as the sum of factors protecting against CVD, is evident in JSLE/JDM patients who have high rates of hypertension, dyslipidemia, and obesity. Chronic inflammation in JSLE/JDM patients further contributes to rapidly worsening CVH trajectories. Given that JSLE and JDM are independent CVD risk factors, affected patients urgently require interventions to bolster and maintain protective CVH trajectories.
In addition to biologic factors, psychological stress negatively impacts long-term CVH trajectories. Up to half of JSLE/JDM patients experience sufficient psychological stress to warrant professional mental health referral. Chronic stress triggers systemic inflammation that mediates subsequent declines in CVH. We hypothesize that: 1) high stress and inflammation in JSLE/JDM create a “perfect storm” that depletes CVH, compounding CVD risk, and 2) stress is a modifiable risk factor amenable to intervention. In order to test these hypotheses, we will conduct a prospective longitudinal observational study with the following aims: 1) assess the association of psychological stress and CVH indicators in JSLE/JDM; 2) quantify the mediating effect of inflammation on psychological stress and CVH in JSLE/JDM; and 3) identify optimal stress-reduction intervention targets that moderate the impact of psychological stress on CVH in JSLE/JDM.
Successful completion of this study will produce the following expected outcomes: 1) quantitative support for a novel, generalizable framework relating stress, inflammation, and CVH in pediatric-onset rheumatic diseases and 2) preliminary data that will inform development and pilot testing of stress-reduction interventions to improve CVH in JSLE/JDM.
About the Rheumatology Research Foundation
The Rheumatology Research Foundation is the largest private funding source of rheumatology research and training programs in the United States. Foundation funding is awarded to programs that educate and train medical and graduate students, residents, fellows, physicians and health professionals. Foundation grants are also awarded to researchers who investigate all types of rheumatic disease, including gout, juvenile idiopathic arthritis, lupus, osteoarthritis, rheumatoid arthritis, spondylarthropathies, systemic sclerosis and vasculitis. Since 1985, the Foundation has committed $192M directly to research and training.
For additional information, visit the Rheumatology Research Foundation website.