Mention the Thurston Arthritis Research Center at the University of North Carolina (UNC) at Chapel Hill, and many rheumatologists immediately (and correctly) identify the center with the esteemed Johnston County Osteoarthritis Project (JoCoOA). The project began as a master’s thesis for Joanne M. Jordan, MD, MPH, who is now the Joseph P. Archie Jr. Eminent Professor of Medicine, director, Thurston Arthritis Research Center, and chief, Division of Rheumatology, Allergy and Immunology at UNC. Since its inception in 1990, JoCoOA’s 20-plus-year data sets have yielded important information on the multiple potential causes of osteoarthritis, disability and pain in African American and Caucasian residents of that rural North Carolina county.
Although the JoCoOA comprises “a big part of what we do here, our program really covers the gamut of arthritis and allergy/immunology research,” says Dr. Jordan. “We do osteoarthritis, but we also work on rheumatoid arthritis, as well as other inflammatory arthridites, lupus, Sjögren’s and other autoimmune conditions.” Thurston’s basic science, clinical and epidemiological research endeavors are also “highly collaborative within the Center and across the University, nation and globe,” she notes. For example, “to make the JoCoOA business model work,” it was necessary to collaborate with genetics and molecular biology researchers to identify biomarkers that indicate predisposition for arthritis; with other epidemiologists to examine socioeconomic and other risk factor contributors; and with social scientists and psychologists to refine best interventions and improve outcomes for people living with the disease.
“UNC is a public institution. Thurston is the arthritis research center for the people of North Carolina, and we take that mission of service very seriously,” says Dr. Jordan. The state motto—Esse quam videri, “to be, rather than to seem” (Cicero, On Friendship)—provides a guiding principle for their work. “We like to define our approach to our work as ‘the Carolina way,’ which is excellence with a heart,” she adds.
Another defining feature of the program, says Teresa Tarrant, MD, assistant professor of medicine, is that all faculty members follow patients in the clinic. “The idea of always maintaining a connectedness to patient care to inform the sciences is really emphasized at UNC.” In her clinic, Dr. Tarrant, who is double-boarded in rheumatology and allergy/immunology, addresses the overlap between allergy, immunology and rheumatology. She sees patients who, in addition to their multiple autoimmune diseases, are also “strikingly immune deficient” and unable to protect themselves from infection. The dual disciplinary approach, she notes, has been helpful in the diagnosis and management of those patients.