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Standing Committee on Investigative Rheumatology
  1. F C BREEDVELD
  1. Leiden University Medical Centre
  2. Department of Rheumatology
  3. 2300 R C Leiden, The Netherlands

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    This standing committee generally meets twice a year: during the annual EULAR Congress and during the European Workshop for Rheumatology Research. During these meetings information is provided about the activities of the study groups and of the EULAR organisation. Last year the standing committee contributed again to the organisation of the EULAR-ACR exchange programme. Four academic rheumatologists were selected to visit research centres in the United States in November 2000. The European investigators were Drs Grahame, Pap, Guerne, and Kamashta. This year a similar number of American investigators will visit European research centres. Furthermore, several members of this standing committee participated in the scientific programme of the annual EULAR Congress as well as in committees that selected candidates for research prizes.

    The reports of the study groups can be summarised as follows.

    Consensus study group on autoantibodies

    The group's annual exercise was run in the autumn of 2000. As with the previous year's exercise, this consisted of two parts: (a) 10 sera which had to be analysed for autoantibodies by the laboratories current techniques; (b) 20 digital images of antinuclear antibody patterns which had to be identified.

    Forty laboratories took part and, despite some problems with delivery, 38 laboratories returned at least part data. Two new laboratories took part this year, and three further laboratories are on the waiting list.

    The results of both exercises were reviewed at the meeting in Vienna in March 2001. Overall, the performances were good and most laboratories scored well. At that meeting a further expansion of the group's activities was also discussed to encompass the clinical evaluation of results obtained from autoantibody tests. A pilot scheme may be run as part of the 2001–2002 exercise, which would also continue to have both sera and image components. At this meeting it was agreed that Professor Manfred Renz from Karlsruhe, Germany, should join the organising committee.

    ORGANISING COMMITTEE

    Co-chairmen: Allan Wiik, Copenhagen, Denmark and Ruud Smeenk, Amsterdam, The Netherlands.

    Members: Manfred Renz, Karlsruhe, Germany and Peter Charles, London, UK.

    Consensus study group on cytokines

    This study group has focused on the standardisation of cytokine measurements—tumour necrosis factor, interleukin 8 (IL8), IL10, and IL6. Serum samples were sent around and results were distributed among participating centres. However, during the past year the number of participating centres dropped. This may be attributed to the fact that many assays are commercial and that this group has neither the infrastructure nor ambition to assure a quality control system. Future activities of this group were discussed in Prague.

    Study group on synovitis

    The activities of the synovitis study group focus on the development of the synovial biopsy technique for the diagnostic armamentarium of rheumatologists. Now, training courses in arthroscopy are regularly organised by EULAR. A recently completed survey of arthroscopy in rheumatology identified 24 centres in 10 European countries that frequently use arthroscopic techniques. The participants of this study group collaborate in research on (a) the need to establish acceptable guidelines for training European rheumatologists in arthroscopic techniques; (b) issues relating to tissue selections and preparation; and (c) the methodology needed to quantify the immunohistochemical features of synovial inflammation. The process developed informally with biannual meetings, and a useful forum has evolved for discussing research protocols and data that incorporated synovial biopsy and tissue analysis.

    ad. a. After considerable discussion, this task has been completed and a document submitted to ILAR for approval and distribution. The document, which will be published, identifies minimum requirements for accreditation of trainers and training centres, and outlines a basic curriculum for acquiring the necessary skills in arthroscopy. In addition, procedures for the assessment and accreditation of trainees are proposed.

    ad. b. Collaborative research established that given the practical advantages the use of the closed needle biopsy is justified in many clinicopathological studies.

    ad. c. Close correlations were reported between quantitative and semiquantitative scoring methods. The various studies also provided support for further development and wider applications of digital image analysis. Standardisation of processes for quantifying the features of synovial analysis and inflammation, both macroscopically and microscopically, will be completed in the coming year. Other major interests of the group have been the evaluation of pathophysiological processes in the synovial tissue and the changes in these processes in patients receiving new targeted treatments.

    This study group is coordinated by Professors PP Tak (Amsterdam) and B Bresnihan (Dublin).

    For review see Bresnihan B et al. Synovial biopsy in arthritis research. Ann Rheum Dis 2000;59:506–10.

    Study group on biochemical markers for cartilage and bone metabolism

    The activities of this group came to an end because the coordinator discontinued his activities. This field is confronted with the fact that clearly effective markers are not available. This lessens the need for a study group, particularly when consensus and implementation issues are involved. In Prague, June 2001, a scientific symposium on biochemical markers was held, followed by discussions on the future of this study group.

    A new study group on genomics and proteomics will be formed.

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