Pediatric Rheumatology

The pediatric rheumatologists at the Morgan Stanley Children's Hospital of New York-Presbyterian are playing leading roles in clinical trials of new medications and in developing innovative treatment protocols for juvenile arthritis and childhood-onset systemic lupus erythematosus (cSLE). We have also developed regimens to help patients to function better while reducing the long-term side effects of their treatments.

A major component of research at Morgan Stanley Children's Hospital involves identifying the reason why some people develop an autoimmune disease, while others do not. This mainly involves identifying genes that determine susceptibility and how the genes act to determine disease development. Researchers received a grant from the Arthritis Foundation to examine genetic abnormalities that may lead to pediatric autoimmune diseases such as lupus.

Ongoing clinical and laboratory research projects within the Division of Rheumatology include:

• Evaluation of cholesterol-lowering drugs in the prevention of atherosclerosis in children and teenagers with lupus (an NIH-sponsored multi-center trial);
  
  
• Evaluation of a medication to prevent the adverse effects of cyclophosphamide on the ovaries (and fertility) of females when prescribed for lupus nephritis (a FDA-sponsored multi-center trial);
  
  
• Longitudinal examination of neurocognitive effects of lupus in childhood;
  
  
• Evaluation of risk factors for cardiac damage in children with Kawasaki Disease;
  
  
• Examination of new therapies for childhood uveitis (inflammation of the eye) associated with juvenile arthritis and other autoimmune diseases;
  
  
• New directions for understanding and treating autoimmune disease (a National Institutes of Health-funded project);
  
  
• Collaboration with Dr. Anne Davidson from the Division of Medicine and Rheumatology examining the role of new therapies in the treatment of antiphospholipid syndrome (an autoimmune disease that leads to abnormal clotting) in a laboratory model of this disease;
  
  
• Collaboration with Dr. Betty Diamond from the Division of Medicine and Immunology examining new antibodies which may lead to neurocognitive disease in children and adults with lupus;
  
  
• Collaboration with the Departments of Medicine and Nephrology to evaluate possible markers that may indicate the early development of kidney disease in patients who take anti-inflammatory medications;
  
  
• Examination of pediatric physicians' use of anti-inflammatory medications in children with inflammatory and non-inflammatory diseases;
  
  
• Role of chromosomal region abnormalities in regulating arthritis severity and predisposition to developing lupus;
  
  
• Understanding features of the immune cells involved in lupus and joint inflammation;
  
  
• Understanding the genetic basis of susceptibility to psoriatic arthritis (funded by the National Psoriasis Foundation) — a distinctive form of chronic progressive autoimmune arthritis in approximately 10% of individuals with psoriasis;
  
  
• Investigating the role of Aspirin therapy in reducing retreatment in Kawasaki's Disease;
  
  
• Investigating the role of Methylprednisolone in the treatment of Kawasaki's Disease, an NIH funded trial;
  
  
• Investigating the role of Intravenous Gammaglobulin in the treatment of Juvenile Dermatomyositis, and the development of a treatment protocol without steroid therapy.
  
  
• Establishing the optimal treatment of Nephritis in Childhood-onset SLE by collaborative protocol development and by participation in a blinded study using Mycophenolate Mofetil (MMF, or Cellcept);
  
  
• Evaluation of the benefits of an observed versus home physical conditioning exercise program for children and teenagers with juvenile arthritis.