This is the third in an occasional series of stories about the Brigham Research Institute Centers. The BRI includes 10 disease-focused research centers that develop and support collaborative research initiatives. This infrastructure allows our diverse community of clinicians and scientists to communicate more effectively, providing numerous opportunities for them to collaborate on research aimed at curing, treating and preventing human diseases and conditions. The story below highlights some of the exciting work happening in the Musculoskeletal Research Center.

From left: MSK undergraduate summer interns Adel Andemeskel, Anna Nachbor, Anthony Aggouras, Janis Lee and Isaac Donnell, with MSK Research Center co-chair Jeffrey Duryea

The Brigham Research Institute’s Musculoskeletal (MSK) Research Center has been around for nearly as long as the BRI itself. Established in 2007, the interdisciplinary virtual center connects researchers and clinicians pursuing research on bones, joints and muscles and the disorders that affect them.

The interdisciplinary representation of the center’s leadership – composed of co-chairs Jeffrey Duryea, PhD, of Radiology; Nancy Shadick, MD, MPH, of Rheumatology, Immunology and Allergy; and Jessica Whited, PhD, of Orthopaedic Surgery – reflects the variety of disciplines of its investigators. The MSK Center includes physician-investigators and scientists from the departments of Anesthesiology, Perioperative and Pain Medicine; Dermatology; Medicine; Neurology; Physical Medicine and Rehabilitation and others.

“The mission of the center is to synergize and stimulate departmental and individual research focused on musculoskeletal health,” said Shadick. “The center does this by building MSK programs and promoting the cross-disciplinary and vibrant work that its members and teams are doing.”

Center investigators are involved in innovative studies to identify disease risk factors and enhance imaging techniques for earlier detection and monitoring of MSK diseases, as well as employ nanotechnology to develop novel therapies and improve existing treatments. Pivotal research advances by BWH investigators that have impacted the understanding and treatment of MSK diseases include pioneering minimally invasive joint replacement procedures, new medications for rheumatoid arthritis and advancements in cartilage regeneration.

MSK investigators have received grants to conduct interdisciplinary research, including a National Institute of Arthritis and Musculoskeletal Skin Diseases (NIAMS) grant to lead a clinical trial on arthroscopic knee surgery approaches, as well as NIAMS grants to study hip replacements in Medicare patients, the genetics of rheumatoid arthritis and osteoporosis medication compliance.

“The MSK Research Center has been one of our most consistently active BRI research centers,” said Jackie Slavik, PhD, executive director of the BRI. “The center has had a sharp focus on bringing researchers and clinicians together, as well as supporting and recognizing junior researchers, and has been very successful in these efforts. With some of the MSK research community moving into the Building for Transformative Medicine, there should be even more opportunities for collaboration and mutually beneficial activities going forward.”

Interdisciplinary Workshops

The center has fostered MSK collaboration across the Brigham in several important ways. Since 2007, it has held an annual workshop on translational research topics related to MSK health and disorders, including low-back pain, preserving function after injury, and rheumatoid and osteoarthritis. Additionally, the center has taken the lead on several broader BRI-wide workshops on topics that affect a variety of disciplines, such as vitamin D, aging and space health. The workshops attract roughly 100 clinicians and researchers every year.

“These workshops get researchers and clinicians talking to each other about their work and ways to collaborate,” said co-chair Duryea, who first became interested in musculoskeletal imaging research by way of particle and medical physics.

Duryea credits the MSK Center with connecting him to colleagues that he likely wouldn’t have met otherwise.

“In Radiology, I’m somewhat remote from the rest of the hospital’s MSK researchers,” he said. “But through the center, I’ve connected with rheumatologists, physical therapists and orthopedic surgeons, with whom I work closely today. I love the interdisciplinary nature of this work.”

As for the format of workshops, the center has experimented to see what is the most useful for clinicians and investigators. Through the years, the most successful format has proven to be focusing each workshop on a single topic or theme with six to eight short scientific presentations on the topic by researchers followed by a panel of MSK clinician-investigators.

“The clinicians comment on the research and share what the clinical problems are,” said Julie Glowacki, PhD, director of the Skeletal Biology Program in the Department of Orthopaedic Surgery and former chair of the MSK Center. “Rather than to answer questions, the goals are to raise questions and testable hypotheses and to bring clinicians together with investigators to begin new conversations and collaborations.”

Summer Internship Program

Another major accomplishment of the MSK Center is its undergraduate summer internship program, which was piloted last summer. The program is not only expanding to accept more students in the summer of 2017, but its success has also inspired other BRI centers to participate.

Last summer, five undergraduates spent eight weeks working on basic or clinical research projects in five MSK laboratories at BWH. In 2017, the summer internship program will be 10 weeks long, and 18 principal investigators (PIs) across five participating centers have already signed on to host an intern.

“We thought the internship program would be a great opportunity to match interested young students who wanted to pursue research with BWH investigators working on MSK research,” said co-chair Whited, who has championed the program.

Interns worked with Duryea, researching musculoskeletal imaging for a more quantitative analysis of osteoarthritis severity; Shadick, evaluating risk factors and comorbidities impacting the long-term outcome of rheumatoid arthritis; and Nicholas Leigh, PhD, of the Whited Lab, studying the biological factors of regeneration. Interns also worked with Karen Costenbader, MD, MPH, studying biomarkers that help identify the development of rheumatoid arthritis, and Soumya Raychaudhuri, MD, PhD, studying the basis of autoimmune diseases.

At the end of the summer, all five students presented their data at a symposium luncheon for the participating PIs, lab members and others.

“The internship was extremely successful as a pilot program,” said co-chair Shadick. “We were able to get college students interested in MSK and immunology research. The fact that other BRI centers are now following suit and starting undergraduate summer internship programs is a testament to its success.”

Grants and Prizes

Part of the center’s mission has included providing small grants and prizes to its members. In 2008, seven investigators received inaugural MSK awards to evaluate local biospecimen resources and to determine research needs.

“The investigators learned about biospecimen resources and reported their findings back to us, which helped the BRI and BWH understand what PIs needed from the institution,” said Glowacki. “This, in turn, helped us evolve newer approaches for resources.”

In 2011, two $10,000 pilot grants were awarded: one for a project on quality measurement and improvement for outpatient osteoporosis care and one for a project about the comparative effectiveness of operative and non-operative therapy for rotator cuff tears. In 2012, the center initiated prizes for the best research papers published by junior faculty in the previous year, which the center has continued to award each year.

Looking Ahead

The center will continue to foster and advance collaboration through its robust workshops and awards. Duryea says he also hopes clinician-investigators and scientists will write more external grants together and pursue other opportunities for collaboration.

“We want to help people leverage their mutual skills to put together strong applications that can get funded,” he said.

Shadick and Whited agree and see room for growth in the area of networking.

“We’ll be thinking even more about networking opportunities in which people could come to present smaller snippets of their research and see who is also working in their areas to foster more collaborations,” said Shadick.

Added Whited: “The MSK Center is the major place to get new collaborations between scientists and clinicians going. We’re always thinking about ways to get people in the same room and working together.”