Mån 15 apr / År 42 / Nr 1 2024

CBAR- making way for future treatments of osteoporosis and rheumatoid arthritis

The Institute of Medicine is the largest of the six institutes at the Sahlgrenska Academy, University of Gothenburg. The institute conducts research connected to all widespread diseases with cancer and neurological diseases as exceptions. The Sahlgrenska Academy is widely known for its expertise and well-developed research in the field of osteoporosis and rheumatology. The newly-founded Centre for Bone and Arthritis Reseach (CBAR) is primarily looking to target the complex issues of identifying markers for predicting these diseases, understanding their origins and making way for future treatments.

The Centre for Bone and Arthritis Research (CBAR) is built up by multidisciplinary teams and is part of a strong international platform. With an overall aim to improve the prevention, diagnosis and treatment of osteoporosis and rheumatoid arthritis, the research environment at the centre was described as excellent in the evaluation of research at University of Gothenburg, the RED10 report.

Background – two of the most common diseases in Sweden
Interestingly, osteoporosis and rheumatoid arthritis are two of the most common diseases in Sweden. The general cause is still under investigation, but it is now known that Sweden and Norway have the highest percentage of individuals suffering from osteoporosis in the world.
Hans Carlsten, Director at the Institute of Medicine, has in close collaboration with a dedicated team of researchers conducted several studies which have established that estrogen exerts a dichotomous effect on the immune system. Knowing that estrogen is an important regulator of both bone metabolism and immune functions it has been proposed that the immune system is involved in the effects of estrogen on bone.
The estrogenic effects on bone are positive, thus helping to prevent conditions such as osteoporosis and rheumatoid arthritis. However, the use of medical drugs to add estrogen can also bring about undesirable side effects, as previously proven in clinical studies.

Present activities – operating at the heart of where the knowledge is needed
Hans Carlsten, Claes Ohlsson, Dan Mellström and Ulf Lerner are working together in a mission to uncover the knowledge required to make way for new treatments to prevent bone loss in osteoporosis and rheumatoid arthritis, using estrogen but trying to eliminate the adverse effects.
“By improving our models for identifying the risks of some patients to develop osteoporosis and rheumatoid arthritis, we can also develop new drug targets”, Claes Ohlsson underlines.
The risk is greater in women; therefore most of the research dating back from the early 1980ies until now is concerned with women.
“It is only in later years, say four years back that we have started to seriously investigate the conditions in men too”, Claes Ohlsson reveals.
Ulf Lerner continues: “It has taken many years to identify the condition low bone-mass, first treated in the 1980ies but not fully understood even then. We must strive to increase our understanding of these illnesses; we are operating at the heart of where this kind of knowledge is really needed as we know that Sweden and Norway are most vulnerable with the highest occurrence of osteoporosis in the world”.

Future – possibly preventing the diseases altogether?
At CBAR, the research ranges from basic and fundamental at cell level to advanced clinical trials.
“We have strong teams based on knowledge from different disciplines. The understanding of these complex conditions is best generated from a multidisciplinary point of view. We also have strong connections with prominent researchers across the globe. Above all, we hope that these collaborations can assist us in the task of generating the knowledge required in order to develop better treatments for bone fractures caused by osteoporosis and rheumatoid arthritis, and in the future possibly finding measures to prevent the diseases altogether”, Claes Ohlsson concludes.