Rheumatology seminars

Shimon Sakaguchi, Mary E. Brunkow and Fred Ramsdell explain how peripheral immune tolerance prevents the immune system from attacking the body. Sakaguchi follows the identification of regulatory T cells, the CD25 marker, and the relationship between central tolerance and active suppression of self-reactive cells. He considers how changing regulatory T-cell activity could support cancer treatment and transplantation. Brunkow describes genetic investigation of scurfy mice, identification of FOXP3, and the connection between mutations in this gene and human IPEX syndrome. The work establishes a molecular basis for the development and function of regulatory T cells. Ramsdell traces the move from these basic discoveries toward therapeutic strategies, including engineering a patient’s regulatory T cells to target inflammation in rheumatoid arthritis. He discusses early clinical investigation and the ambition of restoring immune balance; these approaches are presented as developing treatments rather than established cures.

Spatial frequency domain imaging (SFDI) is a diffuse optical measurement technique that can quantify tissue optical absorption and reduced scattering on a pixel by-pixel basis. Measurements of absorption at different wavelengths enable the extraction of molar concentrations of tissue chromophores over a wide field, providing a noncontact and label-free means to assess tissue viability, oxygenation, microarchitecture, and molecular content. In this talk, I will describe openSFDI, an open-source guide for building a low-cost, small-footprint, multi-wavelength SFDI system capable of quantifying absorption and reduced scattering as well as oxyhemoglobin and deoxyhemoglobin concentrations in biological tissue. The openSFDI project has a companion website which provides a complete parts list along with detailed instructions for assembling the openSFDI system. I will also review several technological advances our lab has recently made, including the extension of SFDI to the shortwave infrared wavelength band (900-1300 nm), where water and lipids provide strong contrast. Finally, I will discuss several preclinical and clinical applications for SFDI, including applications related to cancer, dermatology, rheumatology, cardiovascular disease, and others.

Pain has both a sensory and emotional component and is driven by activation of sensory neurones called nociceptors that are tuned to detect noxious stimuli in a process called nociception. Although nociception functions as a detect and protect mechanism. and is found in many organisms, this system becomes dysregulated in a number of conditions where chronic pain presents as a key symptom, for example osteoarthritis. Nociceptors do not innervate empty space though and do not act alone. Going beyond the neurone, other cell types, such as fibroblast-like synoviocytes interact with and modify the function of nociceptors, which is likely a key contributor to the chronification of pain. In this talk, I will look at how combining pre-clinical mouse work with human tissue and genetics might provide a way to accelerate new analgesics from bench to bedside, giving examples from our work in joint pain, bowel pain and labour pain.