The research programmes of the Cluster are addressing questions of clinical and translational research in the fields of rheumatology, balneology and rehabilitation. The focus of clinical research is on the two major rheumatic diseases, rheumatoid arthritis (RA) and osteoarthritis (OA), the focus of translational research is on cellular and molecular mechanisms of balneotherapy, especially sulphur spa therapy and nuclear magnetic resonance therapy because only few studies have so far adressed these issues and scientific evidence for effectiveness of these therapies is scarce and still doubtful.
RA is the most common and most severe of the inflammatory joint diseases affecting about 1% of the adult population while OA is the most common degenerative joint disorder affecting a large proportion of the elderly population aged above 60 years. Despite the very effective biological therapeutics developed in the past decade for treatment of RA and other chronic inflammatory conditions definite cure of RA is still not possible and treatment of OA is mainly conservative and largely ineffective because regeneration of cartilage tissue cannot be achieved. Therefore, balneotherapy, and particularly sulphur spa therapy is still widely used for treatment of this disease. However, the clinical efficacy is uncertain because studies are rare, often underpowered and have sometimes led to controversial results. Moreover, the underlying molecular mechanisms have so far not been investigated in great detail and are therefore still poorly understood. Nevertheless, interest in the mode of action of H2S has increased in recent years when it became evident that H2S is a natural gaseous transmitter molecule comaprable to nitric oxide. This growing interest is reflected by two international conferences held in 2012 in Europe and the USA.
The sesearch programmes RHEUMATOLOGY and BALNEOLOGY of the Cluster are both strongly focused on sulphur bath therapy.
The major aim is to investigate the efficacy of sulphur bath therapy and to elucidate the underlying cellular and molecular mechanisms
The major questions addressed are:
- Which cell types are responsive to sulphur (NaHS) treatment?
- Which are the primary effects, stimulation or suppression?
- What are the underlying molecular mechanisms?
- Apart from NaHS, do other sulphur containing drugs exert similar effects?
- What are the effects of sulphur therapy in animal models of arthritis?
- What are the clinical and cellular effects of sulphur bath therapy in patients with OA?
The research programme REHABILITATION is focused on developing novel therapeutic tools for rehabilitation programmes and on analysing the effectiveness and sustainability of cure and rehabilitation programmes.
The focus of basic research is on nuclear magnetic resonance therapy (NMRT). This newly-developed therapy method was claimed to reduce pain of patients with OA, osteoporosis or chronic low back pain. However, similar to sulphur bath therapy evidence for the efficacy of this therapy is scarce and so far only a few small studies have been published. Therefore a multicenter study was designed aiming at evaluating the value of NMRT concerning pain reduction in patients suffering from painful shoulder disorders during an inpatient rehabilitation stay, adressing the following questions:
- Can NMRT induce a reduction of shoulder pain in a clearly defined patient population during inpatient rehabilitation?
- Is the NMRT induced modulation of specific biomarkers associated with pain, inflammation, and/or stress?
- If so, can there a correlation be found between laboratory and clinical parameters using validated scores?