2023 Department of Pediatrics Academic Annual Report

Dr. Mannion conducts research using epidemiologic analysis related to juvenile idiopathic arthritis (JIA) for which she recently received three years of grant funding from the Rheumatology Research Foundation. Specifically, she is interested in the use of medications to treat juvenile idiopathic arthritis (JIA), the outcomes of JIA in adulthood and the comparative effectiveness of treatment modalities. Her specific research topics include the risk of malignancy associated with biologic treatments and the transition of pediatric arthritis patients into adult rheumatologic care. Dr. Mannion serves as the UAB site leader for the Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) to address related research questions by exploring this large database. She also serves as the site principal investigator for the CARRA Registry. Drs. Mannion and Cron published an invited editorial (Arthritis Care & Research) and an invited review (Current Opinion in Pharmacology) on various strategies for treating JIA. Dr. Mannion also co-authored a publication Dr. Stoll explores the role of the microbiota in children and adults with spondyloarthritis. He has identified various bacterial species in patients with spondyloarthritis that are protective for disease and others that contribute to the pathology. Recently, Dr. Stoll evaluated the metabolic diversity in the gut microbiome and showed diminished diversity in arthritis patients versus controls, as well as alterations in tryptophan metabolism that may alter immune function to allow for autoimmunity. Dr. Stoll also collaborates extensively with Dr. Pamela Weiss (University of Pennsylvania) via various grants to explore pediatric imaging, disease activity measures, microbiome associations and treatment of childhood pediatric spondyloarthritis, resulting in two peer-reviewed publications on spondyloarthritis in 2022 alone. In 2023, Dr. Stoll was first author on an editorial exploring the role of the Schober exam in evaluating children with spondyloarthritis. SYSTEMIC LUPUS ERYTHEMATOSUS Emily Smitherman, M.D., MSCTR, studies patient-centered outcomes with an emphasis on developing and implementing healthcare system interventions to drive improvement in outcomes. Dr. Smitherman published on the real-world experience of belimumab use in pediatric lupus. Recently, Dr. Smitherman received a highly competitive three-year career development grant from the Rheumatology Research Foundation to explore pediatric lupus outcomes, and she has been invited to speak on this topic in several academic settings. Dr. Smitherman also employs the pediatric rheumatology national quality-improvement network, PR-COIN, to address related research questions by exploring this large database. on the PR-COIN quality-improvement efforts in JIA. SPONDYLOARTHRITIS & THE MICROBIOME Ann Rheum Dis. 2023 Oct;82(10):1271-1285. The 2022 EULAR/ACR points to consider at the early stages of diagnosis and management of suspected haemophagocytic lymphohistiocytosis/macrophage activation syndrome (HLH/MAS). Shakoory B, Geerlinks A, Wilejto M, Kernan K, Hines M, Romano M, Piskin D, Ravelli A, Sinha R, Aletaha D, Allen C, Bassiri H, Behrens EM, Carcillo J, Carl L, Chatham W, Cohen JI, Cron RQ, Drewniak E, Grom AA, Henderson LA, Horne A, Jordan MB, Nichols KE, Schulert G, Vastert S, Demirkaya E, Goldbach-Mansky R, de Benedetti F, Marsh RA, Canna SW; HLH/MAS task force. Arthritis Care Res (Hoboken). 2023 Jun 12. Pediatric Rheumatology Care and Outcomes Improvement Network’s Quality Measure Set to Improve Care of Children with Juvenile Idiopathic Arthritis. Bingham CA, Harris JG, Qiu T, Gilbert M, Vora SS, Yildirim-Toruner C, Ferraro K, Lovell DJ, Taylor J, Mannion ML, Weiss JE, Laxer RM, Shishov M, Oberle EJ, Gottlieb BS, Lee TC, Pan N, Burnham JM, Fair DC, Batthish M, Hazen MM, Spencer CH, Morgan EM; Pediatric Rheumatology Care and Outcomes Improvement Network. Arthritis Rheumatol. 2023 Jan;75(1):4-14. Management of Orofacial Manifestations of Juvenile Idiopathic Arthritis: Interdisciplinary Consensus-Based Recommendations. Stoustrup P, Resnick CM, Abramowicz S, Pedersen TK, Michelotti A, Küseler A, Koos B, Verna C, Nordal EB, Granquist EJ, Halbig JM, Kristensen KD, Kaban LB, Arvidsson LZ, Spiegel L, Stoll ML, Lerman MA, Glerup M, Defabianis P, Frid P, Alstergren P, Cron RQ, Ringold S, Nørholt SE, Peltomaki T, Larheim TA, Herlin T, Peacock ZS, Kellenberger CJ, Twilt M; Temporomandibular Joint Juvenile Arthritis Working Group. Lupus. 2023 Aug;32(9):1111-1116. Real-world use and outcomes of belimumab in childhood-onset lupus: A single-center retrospective study. Roberts JE, Burn C, Sadun RE, Smitherman EA, Wenderfer SE, Son MBF. EXTRAMURAL AWARDS & LEADERSHIP ROLES Randy Cron, M.D., Ph.D., was selected for a volunteer position on the American College of Rheumatology Division Directors Committee. Dr. Cron was appointed to a six-year appointment to the American Board of Pediatrics (ABP) Sub-board of Pediatric Rheumatology. Dr. Cron was invited to speak in 2023 on cytokine storms syndromes at several institutions throughout the year: LSU Shreveport; Mount Sinai (New York, New York); Bangalore, India; Rainbow Babies (Cleveland, Ohio); Pediatric Rheumatology European Society (Rome, Italy); Alabama Society of Allergy, Asthma and Immunology (Orange Beach, Alabama); UCSF (San Francisco, California). Matthew Stoll, M.D., Ph.D., MSCS, was selected as the Governance Committee Chair of the Spondyloarthritis Research and Treatment Network (SPARTAN). 2023 PUBLICATIONS HIGH-IMPACT PUBLICATIONS Annu Rev Med. 2023 Jan 27;74:321-337. Cytokine Storm Syndrome. Cron RQ, Goyal G, Chatham WW. Click here for the full list of publications from the division faculty in 2023.

2023 Academic Annual Report

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