With the support of the ACR Research and Education Foundation (REF) Awards and Grants program, Ornella Rullo, MD, has developed research that may help rheumatologists better treat pediatric patients.
“Kids and adolescents who are diagnosed with lupus tend to develop more complications than adults,” she says. “So, it’s important for pediatric rheumatologists to know which patients need earlier or more intensive treatments, or need to be followed more closely, in order to help prevent worse outcomes later on.”
Dr. Rullo, a clinical instructor in the Division of Pediatric Rheumatology at Mattel Children’s Hospital UCLA in Los Angeles, recently completed a study that identifies a key marker that could be used by rheumatologists to provide better care for patients who have been diagnosed with pediatric lupus.
Her team enrolled patients in a longitudinal study to determine whether osteopontin levels can help recognize lupus patients who are likely to have serious complications, such as organ damage. The study found that six of the 17 subjects accumulated damage, indicated by an increase in SLICC/ACR Damage Index (SDI) scores. Five of the six patients who accumulated damage had high circulating plasma osteopontin (cOPN) levels in at least one of the two visits prior to the increase on SDI. Eighty percent of the subjects with a high cOPN had an increase in SDI, whereas only 11% of subjects with a cOPN in the bottom three quartiles had an increase in SDI, indicating an increase in SDI was more likely in those patients with a preceding high cOPN. “It looks like it may be a factor,” Dr. Rullo says. She presented the abstract at the ACR’s Pediatric Rheumatology Symposium in Miami in June 2011.
Dr. Rullo credits the leadership of the REF with having the vision to understand the need for supporting physician scientists as their careers develop. “They help support huge transitions in a career. I would not have been able to take the steps to continue on my path without the ACR REF,” she says.
After completing her residency in the Department of Pediatrics at Cedars Sinai Medical Center in Los Angeles, Dr. Rullo began her fellowship in pediatric rheumatology at Mattel Children’s Hospital UCLA in 2006. She was the first fellow in this program to develop a longitudinal research project. “We saw a need to focus on aspects of pediatric lupus that lead to bigger problems,” she says. As a result, she received her first award from the REF—the ACR REF/Amgen Pediatric Rheumatology Research Award, which recognizes and promotes scholarship in the field.
In 2009, Dr. Rullo received the ACR REF Physician Scientist Development Award (PSDA; now the ACR REF Rheumatology Scientist Development Award).
“When I received the PSDA, I was able to help build the pediatric rheumatology research program at UCLA. The PSDA allowed me to spend the majority of my time on research; without it, I would not have had the opportunity to join the faculty in 2009. Because of the award, I was able to devote 80% of my time to pediatric research and have helped further develop that program,” she says.
The next step in her path to becoming an independent physician scientist is to secure federal funding. Last June, Dr. Rullo began the application process for a K series award from the National Institutes of Health. In the meantime, she has once again received support from the REF. The ACR REF/AF Career Development Bridge Funding Award is helping to ensure that Dr. Rullo continues her important research.
“The [K series] application is still in process, so that’s really where the Bridge Funding becomes important,” she says. “You’re in a transition period where you’re trying to grow, and there are few opportunities available to support research. This award had helped me get through that time.”
Once she receives the K series award, Dr. Rullo plans to develop a longer-term, more expanded study of osteopontin levels and other predictors of severe complications that can be associated with pediatric lupus.
“I cannot stress enough how invaluable REF support has been to my career. Studying pediatric lupus is so important. I feel fortunate that the REF has helped me individually, as a researcher, but also globally—supporting the field of pediatric rheumatology,” she says.
The REF funds groundbreaking research resulting in better care and treatment for more than 50 million Americans affected by rheumatic diseases. As the largest private funding source of rheumatology research and training programs in the U.S., the REF has awarded over $50 million to more than 1,000 recipients in the past five years. As a result, rheumatologists and healthcare professionals gain the knowledge and resources to provide their patients with the best possible care. For more information about the REF Awards and Grants program, visit www.rheumatology.org/REF.