RHEUMATOLOGY SYNOVIAL TISSUE TRANSLATIONAL RESEARCH GROUP

29% of Australians are affected by musculoskeletal disorders, including rheumatoid arthritis, osteoarthritis, and gout. Rheumatoid arthritis alone accounts for more than $1 billion just in yearly Pharmaceutical Benefits Scheme (PBS) expenditure.

Our interests include, but are not limited to, understanding the individual variability in response to treatments in rheumatoid arthritis, and how cellular interactions drive these responses. The goal is to personalise treatment in an individual patient to improve treatment response and thus improve symptoms and prevent irreversible joint damage.

OUR RESEARCH

The Rheumatology Research Laboratory houses the largest rheumatoid arthritis synovial tissue (and other biological samples) biobank in the southern hemisphere, backed by clinical data. Together, this forms the backbone for our research, and has enabled ongoing national and international collaborations.

Research in our lab utilises a combination of ‘traditional’ techniques (including immunohistochemistry and flow cytometry) and the latest in ‘omics’ technologies (including RNA sequencing and imaging mass cytometry). Our approach has led to significant research outputs, including:

Identification of inflammatory pathways of therapeutic relevance in autoimmune diseases.
- In Rheumatoid Arthritis
  - CD40-40L pathway
  - PD1-PDL1-PDL2 pathway
  - CD38 as a treatment target
- In Psoriatic Arthritis (PsA)
  - Metrnl/IL-41
- In Sjogren’s syndrome
  - BTLA-HVEM-CD160-LIGHT pathway
Standardisation of synovial tissue biopsy under the support of the International OMERACT (Outcome Measures in Rheumatology Clinical Trials) initiative.
- Arthroscopic vs ultrasound-guided vs blind-needle biopsy
- Multinational OMERACT-guided Special Interest Group in standardisation of outcome measures in synovial tissue analyses
- OMERACT guided multi-national studies on ability of synovial biopsy to predict treatment outcomes
We have established, for the first time in Australia, ultrasound-guided synovial tissue biopsy.
Identification of novel markers of disease activity and treatment response.
- Proteomic mapping of rheumatoid factors in rheumatoid arthritis
Nation-wide, multicentre, collaborative research as a key node and tissue-lead of the Australian & Arthritis Autoimmune Biobank Collaborative (A3BC).

Research projects

Our current research projects include:

Identification of inflammatory pathways of relevance in rheumatoid and psoriatic arthritis, with a focus on co-stimulatory pathways.
Rheumatoid Arthritis disease reconstruction. US National Institutes of Health (NIH)- Accelerating Medicines Partnership (AMP) program Grant funded.
CRE for Better Outcomes in Inflammatory Arthritis - Centre for Research Excellence (CRE) NHMRC Grant-funded.
Targeting PD-1 expressing T-peripheral helper cells and dysregulated checkpoint molecules: Improving outcomes in RA - NHMRC Ideas Grant-funded.
Investigating mechanisms of biologic disease-modifying drug response, by an integrated genomic and biological marker approach
Identification of antigen-specific T- and B-cells in Rheumatoid Arthritis: Implications for Antigen-Specific Immunotherapy - US Congressionally Directed Medical Research Program Grants funded
Australian & Arthritis Autoimmune Biobank Collaborative (A3BC) - a nationwide biobanking project
Cost-Utility Comparison of Down-Titration Strategies for Safer and More Efficient Use of Biologics in Adults with rheumatoid and psoriatic arthritis - NHMRC MRFF Grant-funded
Linking the presence of live Ileal-derived bacteria in the joint as a triggering factor for the development of Spondyloarthropathy - Arthritis Australia Grant-funded

Resources

Australian Arthritis & Autoimmune Biobanking Collaborative

GROUP MEMBERS

Lead: Associate Professor Mihir D Wechalekar

Dr Wechalekar is a Specialist in Rheumatology (FRACP) and Associate Professor, Flinders University, College of Medicine and Public Health. He directs the synovial tissue bank based at the Flinders Medical Centre in Adelaide (the only such facility in Australia) and has expertise in synovial biopsy analyses. His areas of interest are synovial membrane pathology, in health and disease, particularly early rheumatoid arthritis. Dr Wechalekar's work has fostered several national and international collaborations, book chapters and journal publications. He is also a member of the steering committee of the A3BC (Australian Arthritis and Autoimmune Biobank Collaborative), a nation-wide collaborative biobanking project.

In 2017, he was awarded the Flinders University Vice-Chancellor's Early Career Researcher Award.

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Post-doctoral Research Associates

Laboratory Manager

Helen Weedon

WORK WITH US

We welcome enquiries for potential collaborators and from students who are passionate about translational research interested in completing higher degree by research or coursework with a research component. Please contact Associate Professor Mihir Wechalekar for further information.