The word "systemic" doesn't sound all that bad. But put it with rheumatic disease and you are talking about inflammation, loss of function of one or more of your joints, tendons, ligaments, bones, or muscles - and pain. With juvenile arthritis, the inflammation affects one or more joints, causing pain, stiffness and swelling. With paediatric vasculitis, it affects blood vessels, and in some cases can lead to heart damage and aneurysms, which can be life-threatening. Lupus can affect many parts of the body, including heart, lungs, skin, joints, kidneys, and the nervous system.  "Systemic" means everything is affected. At best you are experiencing intense discomfort. At worst, severe pain, chronic suffering, and even the danger of death.  

Many cases are not severe, and for that lucky majority the inflammation is manageable. Children with severe cases, however, need specialized centres of research and care like SickKids.  

Research
Research is critical to the understanding of these life-long challenges and to developing new therapies to improve outcomes and quality of life for patients. With its focus on clinical research, SickKids Division of Rheumatology has become the lead centre for a number of international treatment trials for new therapeutic agents in juvenile arthritis.  

The generous help of Joshua's Voyageurs made it possible for Dr. Jonathan Akikusa, a visiting Fellow from Australia, to focus his research on Juvenile Idiopathic Arthritis (JIA) in 2005-06. Dr. Akikusa accomplished a number of studies of clinical therapies and research which added to our knowledge of JIA and its complications - including a link between JIA and Kawasaki disease (the most common form of paediatric vasculitis). He also completed a large study of Wegener's granulomatosis (another form of vasculitis) - the largest paediatric series reported to date.  

Dr. Brian Feldman's focus is on two main areas: 1) practical studies of new therapies for rheumatic illness and 2) methods for improving the study of rare diseases. This involves the continuing implementation and development of several national and international clinical trials; and ongoing studies examining the usefulness of alternative clinical trial designs.  

Dr. Rae Yeung's laboratory research has focused on Kawasaki disease, the number one cause of acquired heart disease in children in the developed world. Her lab has developed an animal model of the disease and identified a novel superantigen which initiates the immune response leading to coronary artery damage. Her ultimate goal is to identify therapeutic agents to treat children with Kawasaki disease.

Dr. Earl Silverman has several areas of focus: including Lupus, Juvenile Rheumatoid Arthritis, and Kawasaki disease. Current studies include the genetics of childhood-onset Lupus; risk factors in paediatric Lupus, and the role of pulse steroids in the early therapy of Kawasaki disease.

Education
Graduates of the Division's training program have taken their skills to hospitals in Canada and around the world, including (in 2005-06) the USA, South America, the Middle East, Europe, Israel, England, Denmark, Argentina and Australia.  

Of equal importance has been the training in rheumatology given to residents in general paediatrics. These future paediatricians are able to recognize rheumatic disease in the critical early phases and deliver timely care.

Thank You!
This could not have been possible without the loyal support of Joshua's Voyageurs. For your commitment to this research we are deeply grateful.