OKLAHOMA CITY — Rheumatoid arthritis strikes earlier, more viciously and more often in American Indian populations than in European populations. Some experts estimate American Indians are four times as likely to have the disease than those of European ancestry. That can mean harder, shorter lives, which takes a toll on the entire tribe.
A partnership between the Oklahoma Medical Research Foundation and the Chickasaw and Cherokee Nations is providing more rheumatology care to tribal clinics while helping scientists better understand the role race plays in rheumatoid arthritis and related diseases.
"We're trying to identify blood markers that could help us diagnose rheumatoid arthritis earlier," said OMRF scientist Judith James, M.D., Ph.D. "Early diagnosis is crucial in allowing doctors to halt the progression of the disease."
Rheumatoid arthritis is a chronic autoimmune disease in which the body's immune system attacks joints and surrounding tissues. The disease affects 1.5 million Americans and is more common in both females and American Indian populations. RA causes pain, joint swelling, limited movement and other problems.
If rheumatoid arthritis is diagnosed early enough, patients can avoid or delay disability and deformities, said James, who holds the Lou C. Kerr Chair in Biomedical Research at OMRF.
"Most people think of RA as affecting only the joints, but it can affect almost any part of the body," James said. "The increased inflammation seen in RA plays a part in accelerated heart disease, especially in tribal populations, which can lead to earlier mortality."
The partnership allows OMRF scientist-physicians to visit tribal clinics in Ada (Chickasaw Nation) and Muskogee (Cherokee Nation) and to work with health care providers there to administer rheumatology care. Patients who receive care can volunteer to take part in the OMRF research.
"Right now we have more than 120 patients and over 100 healthy controls enrolled in the study," she said. "It's nice for us to go to the tribal clinics, because it's more convenient for the patients. Rather than coming to Oklahoma City, they can get treatment in the same place they get most of their primary care."
Another benefit of the partnership is education for the patients and for tribal personnel. Because they must deal with rheumatoid arthritis so often, it's important for doctors servicing American Indian populations to be well versed in early diagnosis and a variety of treatment options.
"We're lucky to work with excellent doctors like Fabio Mota, M.D., and Tina Cooper, M.D., of the Chickasaw Nation, and others who are so dedicated to providing top-notch patient care to our tribal communities," James said. "The help of epidemiologists at the Cherokee Nation, including Sohail Khan, MBBS, is an invaluable resource."
Though the research focuses mainly on rheumatoid arthritis, scientists are also examining scleroderma, Sjögren's syndrome and lupus—three other autoimmune diseases that affect Native populations.
"This project provides a unique and beneficial opportunity for all involved," said James. "Patients can receive the highest level of care available and play a part in research that could save lives otherwise shortened by rheumatoid arthritis and associated diseases."
Funding for the research is provided by the National Institute of General Medical Sciences through its Native American Research Centers for Health, part of the National Institutes of Health under Award Number U261IHS0049-03.