Biopsy investigation of Oxford Synovitis Cohort (BIOPSICO)

Background: Imagine a world in which there were no maps to guide you on your journey. This is the current situation we are faced with for people with arthritis. While we can image joints with remarkable clarity using MRI scans, we can’t see what’s going on, at an individual cell level in key tissues of people with arthritis. This is because it has been difficult to get access to such tissue and harder still to work out what types of cells are in those samples. This is not the case in cancer, where tissue maps have enabled some forms of cancers to be cured. A revolution in ultrasound guided tissue sampling and new techniques that count the type of cells in tissues means that we are now able to draw maps in several important tissues in people with arthritis and observe how these maps change over time and with different treatments. Aims. The aim of our project is to offer all patients with all forms of arthritis the opportunity to provide us with samples of their tissues so we can become better at drawing maps and improve the treatment of arthritis by generating very detailed tissue maps down to the level of a single cell. This would be the equivalent of using Google Maps to identify a single car or person at street level. Having maps like these across as many forms of arthritis as we can manage will (1) tell us how similar different forms of arthritis (2) tell us how treatments work at the level of individual cells and (3) tell us in which tissues of the body they are working. We think having these maps will help us in our quest to cure arthritis Plan. We have identified a dedicated clinical research space within our specialist musculoskeletal hospital, the Nuffield Orthopaedic Centre where we have begun to sample joint tissue (biopsy) and fluid from patients attending arthritis clinics. Now, we want to run dedicated research clinics in this facility so our patients can be offered a one stop shop: from clinic to biopsy. The current space we use requires modest adjustment to make it suitable to run research clinics to collect small samples of tissue from synovium (joints), and lymph nodes. We also need the help of a specialist radiographer to help increase our capacity to perform these studies and some equipment (needles) to perform the biopsy. Everything else, including the necessary health care professionals and scientists to help us draw the maps is already in place and funded. Patient Benefit. We have demonstrated the value of tissue sampling through several clinical studies underway with colleagues in Birmingham, Glasgow and Newcastle as part of the Versus Arthritis Rheumatoid arthritis Centre of Excellence (RACE) but the number of patients offered the opportunity to take part is limited to those with Rheumatoid Arthritis (RA). We know there are over 100 types of arthritis, so we want to be able to map all these forms of arthritis, not just RA.