Overview of the Penn Center for Musculoskeletal Disorders
Director: Louis J. Soslowsky, PhD
Associate Director: Maurizio Pacifici, PhD
Musculoskeletal-related conditions in the United States account for 132 million visits to physicians' offices, 29 million visits to emergency rooms, 15 million hospital outpatient visits, and cost over $850 billion each year. Further, musculoskeletal injuries in the United States cause workers to miss more than 440 million days of work annually. In fact, more than one in four Americans has a musculoskeletal impairment. With the widespread increase in athletic and recreational activities, and the increase of the elderly population at large, these numbers are expected to rise substantially. Musculoskeletal injuries represent a critical health concern which must be better understood and better treated. To do so, a dedicated and focused strategic effort is required that optimizes research translation from the bench to the bedside in an efficient and effective manner.
The Penn Center for Musculoskeletal Disorders (PCMD) will continue to enhance the research productivity and provide critical resources and programs to investigators, with a wide variety of expertise, to address multidisciplinary research strategies for musculoskeletal problems. The overall goal of this Center is to promote a cooperative interaction among investigators to enhance the effectiveness of ongoing research and promote new research. The theme of our Center is “Musculoskeletal Tissue Injury and Repair”. This theme is both broad (as it includes all musculoskeletal tissue types, such as bone, cartilage, disc, ligament, meniscus, muscle, and tendon), focused (as it includes similarities of approaches across all tissue types, with particular emphasis on applications using small animal models), and clinically significant (as it fosters development of assays, procedures and new knowledge with direct translational relevance). It is important to note that our PCMD is not a “bone center”, nor is it a “muscle center”. Indeed, one of the major strengths that differentiates our efforts is our inclusive home for all musculoskeletal researchers at Penn.
One focus of the Core Center will be to apply research themes, approaches, and paradigms that are consistent across different tissues. Musculoskeletal tissues have much in common, as they are primarily comprised of collagen and proteoglycan and largely serve a biomechanical function. Notably, their similarities are often overlooked when focusing upon only a single tissue type. For example, the role of inflammatory cytokines is well studied in several tissue injury and repair scenarios; yet specific findings in one tissue-type are not always known and applied to other tissues. Similarly, the role and availability of technologies for imaging new blood vessel formation in vivo in order to monitor healing in a single tissue are not always known to researchers in other tissues. In general, approaches used to evaluate mechanisms present in one tissue are not always known and applied by researchers in other tissues.
While forming research groups “within” tissue types has benefits, this approach also has some limitations. Currently, many investigators consider themselves “bone researchers” or “cartilage researchers” and are often not aware of advances made on other tissues that may be relevant to their own. This issue is exacerbated by the fact that many scientific conferences do not construct their programs based on themes, approaches, and paradigms. Programs are generally constructed as “tissue specific” (e.g., typical sessions at the Orthopaedic Research Society meeting are on Tendon Injury, Bone Mechanics, Intervertebral Disc, etc.). In fact, some conferences are focused on a single area (e.g., Sun Valley Hard Tissue Workshop, International Symposium on Tendons and Ligaments).While these specialty meetings have high scientific value and are important venues for exchange of information, they are usually only attended by investigators active in these particular areas. Bringing multidisciplinary researchers together, focusing not on a specific tissue, but on research approaches or paradigms, will enhance and advance the research programs for all investigators and serve to foster collaborative research efforts. An example of this concept is the Gordon Conferences where meetings on “Proteoglycans” or “Musculoskeletal Science” cross tissue types and can address higher level paradigms.
To provide a further focus for our Center, we will develop programs with an emphasis on small animal models of human musculoskeletal disorders. Although both large and small animal models for various human diseases currently exist and continue to be developed, the use of small animals (e.g., mouse and rat) has become increasingly preferred for many reasons. These reasons include the availability of transgenic and knockout animals, the ease of procuring consistent animals in large numbers, animal cost, handling, housing, and other practical management issues. More importantly, the sequencing of their genomes and the varieties of molecular analyses currently available have made the mouse and rat increasingly preferred. However, some technical difficulties remain in performing certain assays and experiments simply because of the small size of the mouse and rat, and these difficulties can often not be overcome in single investigator laboratories.
Thus, the primary aims of this Center are to enhance and advance the research productivity of investigators in musculoskeletal tissue injury and repair by:
Aim 1: Developing critical research core facilities in fundamental areas that cross disciplines and hierarchies. These core facilities are Molecular Profiling, Imaging, biomechanics, and Histology.
Aim 2: Developing a pilot and feasibility grant program for new and established investigators whereby new approaches, ideas, and collaborations can be developed prior to seeking extramural funding, and,
Aim 3: Developing educational, training, and research enrichment programs for the musculoskeletal community spanning multiple tissue types, research approaches, and paradigms, through which investigators can learn from each other, and from national leaders, in areas where they are not expert.
High quality musculoskeletal research is currently being conducted by many groups using molecular, cellular, tissue, and/or organ-level approaches. Examples include genetic analyses using microarrays, structural assays using sophisticated imaging modalities, and evaluation of the stiffness and strength of tissues using biomechanical analyses. While these and many other modalities are commonly brought to bear on musculoskeletal problems, very few research groups have the required expertise and specialized facilities to perform high quality work in all of these areas in their own labs. Furthermore, most investigators are not aware of approaches utilized and results obtained in other tissues that may have direct relevance on their primary research questions. This PCMD provides an environment and a forum for such expertise and exchanges.
Ultimately, close cooperation, communication, and collaboration among researchers across all musculoskeletal tissue types and from a wide variety of disciplines will significantly enhance the musculoskeletal research opportunities at the University of Pennsylvania. The Center will provide opportunities to integrate multi-disciplinary techniques to determine mechanisms for tissue function, injury, and repair, with an ultimate goal to advance the ability to diagnose, treat, and prevent diseases and injuries of the musculoskeletal system and its component tissues.