NIAID’s Division of Allergy, Immunology, and Transplantation (DAIT) supports a broad range of basic and clinical research programs in autoimmunity. Basic research focuses on understanding the genetics of autoimmunity, elucidating the mechanisms of self-tolerance, developing approaches to induce self-tolerance, and characterizing pathways of immune-mediated tissue destruction. Knowledge gained from basic research studies provides the rationale for clinical strategies to diagnose autoimmune diseases and to develop novel treatments for ongoing disease.
In March 2005, the NIH Autoimmune Diseases Coordinating Committee (ADCC) submitted its third report to Congress. This report summarized FY 2003 NIH funding for autoimmune diseases research, and accomplishments and activities, including ongoing research projects and future initiatives that address components of the ADCC Autoimmune Diseases Research Plan. The Research Plan, mandated in the Children’s Health Act of 2000 (P.L. 106-310), was presented to Congress in 2002, and highlighted opportunities to increase our understanding of autoimmune diseases at the population, individual, and molecular levels, with a focus on the underlying immune mechanisms common to many of these diseases. The plan provided recommendations for future research directions in the following areas: epidemiology and burden of autoimmune diseases; etiology and pathogenesis; diagnosis, treatment, and prevention; and training, education, and information dissemination. The Research Plan can be found at http://www3.niaid.nih.gov/about/organization/dait/PDF/dec2002_ADCC.htm. The March 2005 report can be found at http://www.niaid.nih.gov/publications/pdf/ADCCFinal.pdf.
The NIAID chairs the ADCC, which was established in FY 1998, at the request of Congress, to increase collaboration and facilitate coordination of research among NIH Institutes, Centers, and Offices; other federal agencies; and private organizations and patient advocacy groups with an interest in these diseases.
In addition to its basic autoimmune research portfolio, DAIT supports several clinical research programs on autoimmune diseases. The Autoimmunity Centers of Excellence facilitate close interactions between clinicians and basic researchers to promote collaborative research on autoimmune diseases, including single-site and multisite pilot clinical trials of immunomodulatory therapies; this program recently expanded from four to nine centers. Numerous clinical trials of treatments for SLE are underway or planned, including an ongoing trial of the clinical and immune effects of the immunosuppressant drug sirolimus and a test of a B cell-specific monoclonal antibody.
The Autoimmune Disease Prevention Centers conduct research on the development of new prevention strategies for autoimmune diseases and evaluate these approaches in pilot and clinical studies. In FY 2004, the Prevention Centers supported 16 pilot projects to test innovative prevention approaches or methods to measure biomarkers of autoimmune disease progression.