Molecular Diagnostics
GCA can be difficult to diagnose because the presenting features tend to mimic symptoms that can be common in people over the age of 50 years (such as headache, scalp tenderness, sweats and elevation of inflammatory markers). Diagnosis is currently verified by a positive temporal artery biopsy, but false-negatives often occur due to the presence of extra-cranial GCA, skip lesions and delays in biopsy. Ultrasound is less invasive and increasingly explored. It can be a clinically useful and cost effective diagnostic test, providing it is performed within 4 days of starting glucocorticoid therapy and combined with biopsy in those cases where the ultrasound scan is negative. To implement this would require significant re-organisation of NHS resources, but the benefits would be more accurate diagnosis of GCA, thus reserving the burden of glucocorticoid toxicity to those with disease and at risk of complications. It would require establishment of rapid access clinics and training programs to ensure that those responsible for this service (rheumatologists, ophthalmologists, neurologists, radiologists and pathologists) had appropriate training and support to ensure that their service was effective.
Projects
Tissue Diagnostics
- Development of a GCA histopathology atlas and standardised scoring template (Dr Aruna Chakrabarty, Consultant Pathologist, Leeds Teaching Hospitals NHS Foundation Trust; Dr Sarah Mackie)
- Development of a Th1/Th17 molecular diagnostic (Professor Ann Morgan; Newcastle Molecular Pathology Node)
- Mapping the cellular composition of GCA-affected temporal artery tissue by single cell RNAseq (Dr Gary Reynolds, Clinical Fellow, University of Newcastle Upon Tyne, The Newcastle Hospitals NHS Trust)
Protein diagnostics
- Serum proteomic profiling in GCA (Professor Ann Morgan; Dr Sarah Mackie; Professor Roz Banks, Professor of Biomedical Proteomics, University of Leeds; Myriad)
- Diagnostic protein biomarker discovery in polymyalgia rheumatica (Dr Sarah Mackie; Professor Ann Morgan; Dr Jim Robinson, Independent Research Fellow, University of Leeds; Olink Proteomics, Uppsala, Sweden)
Metabolomics
- Metabolomic profiling of GCA (Dr Stephen Young, Reader in Experimental Rheumatology, University of Birmingham; Dr Sarah Mackie; Professor Ann Morgan)