It’s not every day you get to rub shoulders with the vice president of the United States and The Terminator as part of your job.

Robert Kimberly

The White House invited ARRA recipients to participate in an Oct. 30 news conference led by Biden. Kimberly was one of five researchers picked by the NIH to answer questions from audience members on a new, multi-site, UAB-led national study on finding a genetic link to end-stage renal disease (ESRD) in lupus patients. The $3.35 million Grand Opportunity grant from the National Institute of Arthritis, Musculoskeletal and Skin Diseases (NIAMS) will create a national consortium to conduct a genome-wide association study.

“The project is an effort to define biologic factors that make it more likely that people with lupus will end up with severe kidney injury,” Kimberly says. “If we can identify those people in advance by perhaps some genetic factor, we’ll know better how to tailor the therapy needed for each individual patient.”

The consortium already has a substantial head start, building on established networks and clinical research infrastructure already in place.

“It’s a unique project — one that’s never been done before,” Kimberly says. “It’s a very special collaboration with nephrologists and rheumatology doctors who typically take care of lupus patients to work together to assemble persons with this condition from the Southeast to conduct a genome-wide association study, or GWAS. Basically, it compares people with and without this severe renal injury to define genetic factors different between them that would be able to predict the occurrence of that part of the disease. If we can do that, then we know who to treat more aggressively to prevent the kidney damage from occurring.”

Feasible study
End-stage renal disease is a costly complication of lupus, seen much more frequently in African-American patients than those of European descent. Scientists at UAB already have identified two genes through to be factors in increased risk for ESRD, but believe that additional genes are involved in the genetic susceptibility of African-Americans and others with lupus.

Advances in technology have overcome limitations in genotyping and make the study feasible, Kimberly says.

In fact, Kimberly believes he was selected to attend the news conference and talk about this project because of the science behind the research, the achievability of the project and the potential for the results to reduce health-care costs.

“For example, among people who have lupus and this severe kidney damage, the costs for dialysis currently exceed $300 million a year,” Kimberly says. “If we could reduce the number of people needing dialysis by 50 percent, which is not an unreasonable estimate, we could save the health-care system $150 million a year. The NIH and the government would get an enormous return on their investment because a $3.3 million grant may end up saving $150 million a year. That’s not too bad.”

Data collection under way
The stimulus money has enabled Kimberly to hire two new employees at UAB already, and he anticipates hiring many more at UAB and other sites in the next month.

In addition to the CAMAC, CIR and the Nephrology Research Center at UAB, other schools participating in the consortium are Emory University, Johns Hopkins University, Medical University of South Carolina, Northwestern University, Ohio State University, Oklahoma Medical Research Foundation, University of Florida and Wake Forest University.

A team of rheumatologists, nephrologists and statistical geneticists with active research protocols has been assembled. Clinical infrastructure is in place, and data collection already has begun.

“This is a brand new project, and it’s built on a foundation of strong collaborative work,” Kimberly says. “I hope this is perceived positively. And while it’s very nice to have the NIH believe that our lupus end-stage renal disease project had the elements they wanted to be at the press conference — both the scientific potential and health-care impact potential — it also probably means they’re going to be watching and working with us closely. To say that we all feel a little bit of pressure right now is probably an understatement. But that’s OK. We’ll get it done.”