National Institute of Arthritis and Musculoskeletal and Skin Diseases Mission | Important Events | Legislative Chronology | Director | Programs | Appropriations

Until May 19, 1972, the National Institute of Arthritis and Metabolic Diseases; until June 23, 1981, the National Institute of Arthritis, Metabolism, and Digestive Diseases; until April 8, 1986, the National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases.

Mission

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) was established in 1986. The mission of NIAMS is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases, the training of basic and clinical scientists to carry out this research, and the dissemination of information on research progress in these diseases.

The Institute also conducts and supports basic research on the normal structure and function of joints, muscles, bones, and skin. Basic research involves a wide variety of scientific disciplines, including immunology, genetics, molecular biology, structural biology, biochemistry, physiology, virology, and pharmacology. Clinical research includes rheumatology, orthopaedics, dermatology, metabolic bone diseases, heritable disorders of bone and cartilage, inherited and inflammatory muscle diseases, and sports and rehabilitation medicine.

Important Events in NIAMS History

November 20, 1985 – The Health Research Extension Act of 1985 (P.L. 99-158) authorized the establishment of the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

April 8, 1986 – NIAMS was established.

February 18, 1987 – The first meeting of the National Arthritis and Musculoskeletal and Skin Diseases Advisory Council was held.

April 15, 1996 – NIAMS held a 10th anniversary symposium: “Progress and Promise in Chronic Disease.”

NIAMS Legislative Chronology

August 1950 – An arthritis program was established within the National Institute of Arthritis and Metabolic Diseases under P.L. 81-692.

May 1972 – The Institute was renamed the National Institute of Arthritis, Metabolism and Digestive Diseases, P.L. 92-305.

1973 – Senator Alan Cranston introduced legislation that would eventually lead to the National Arthritis Act. Companion legislation was introduced in the House by Congressman Paul Rogers.

January 1975 – The National Arthritis Act (P.L. 93-640) established the National Commission on Arthritis and Related Musculoskeletal Diseases to study the problem of arthritis in depth and to develop an arthritis plan. The act also established the position of associate director for arthritis and related musculoskeletal diseases and authorized an interagency arthritis coordinating committee, community demonstration project grants, an arthritis data bank, an information clearinghouse, and comprehensive centers for research diagnosis, treatment, rehabilitation, and education.

April 1976 – After a year of study and public hearings, the commission issued a comprehensive plan aimed at diminishing the physical, economic, and psychosocial effects of arthritis and musculoskeletal diseases. It laid the groundwork for a national program encompassing research, research training, education, and patient care.

October 1976 – P.L. 94-562, the Arthritis, Diabetes, and Digestive Diseases Amendments of 1976, established the National Arthritis Advisory Board to review and evaluate the implementation of the Arthritis Plan, prepared in response to the National Arthritis Act (P.L. 93-640).

December 1980 – P.L. 96-538 changed the name of the Institute to the National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases.

1982 – The Department conferred bureau status on the Institute, resulting in creation of the Division of Arthritis, Musculoskeletal, and Skin Diseases and the appointment of a division director.

November 1985 – The Health Research Extension Act of 1985, P.L. 99-158, established the National Institute of Arthritis and Musculoskeletal and Skin Diseases to bring increased emphasis to research on these disorders. The legislation provided for the development of a plan for a national arthritis and musculoskeletal diseases program, and establishment of two interagency coordinating committees, one on arthritis and musculoskeletal diseases and one on skin diseases. It also expanded the activities of the National Arthritis Advisory Board to include musculoskeletal and skin diseases.

Biographical Sketch of NIAMS Director Stephen I. Katz, M.D., Ph.D.

Dr. Katz was born in New York City in 1941 and grew up in the Washington, D.C. and Bethesda, Md. areas. He earned a B.A. degree cum laude in history from the University of Maryland, College Park; an M.D. degree cum laude from Tulane University Medical School, New Orleans, La.; and a Ph.D. degree in immunology from the University of London, England. He completed a medical internship at Los Angeles County Hospital, Calif.; a residency in dermatology at the University of Miami School of Medicine, Fla.; military service at Walter Reed General Hospital in Washington, D.C.; and postdoctoral work at the Royal College of Surgeons of England.

In 1974 he joined the National Institutes of Health (NIH) as a senior investigator in the Dermatology Branch of the National Cancer Institute (NCI), becoming acting chief in 1977 and chief in 1980. From 1989 to 1995, he also served as Marion B. Sulzberger professor of dermatology at the Uniformed Services University of the Health Sciences in Bethesda. On August 1, 1995, he was appointed Director of NIAMS.

Dr. Katz’s studies of Langerhans cells and epidermally derived cytokines have demonstrated that skin is a critical component of the immune system both in its normal function and as a target in immunologically mediated diseases. He has also made seminal discoveries in the field of inherited and acquired blistering skin diseases.

At NCI, he has led a program of investigations in fundamental biological and clinical problems in neoplastic and inflammatory diseases of the skin. He has trained a large number of immunodermatologists from the United States and abroad. These individuals are now leading their own independent research programs.

Dr. Katz has received many Government and private sector honors and awards, including the Presidential Distinguished Rank Award, Presidential Executive Meritorious Rank Award, PHS Superior Service Award, NIH Director’s Award, Sulzberger Lecture Award from the American Academy of Dermatology, D. Martin Carter Mentor Award from the American Skin Association, Outstanding Alumnus Award of Tulane University School of Medicine, Stephen Rothman Memorial Award of the Society for Investigative Dermatology (SID), Inflammatory Skin Disorders Research Award, Scleroderma Foundation’s Messenger of Hope Award, honorary membership in many international dermatologic societies, and election into the Institute of Medicine of the National Academy of Sciences.

He has served many scientific organizations in leadership positions such as president of the Society for Investigative Dermatology, membership on the board of directors of SID and of the Association of Professors of Dermatology, secretary-general of the World Congress of Dermatology, and secretary-treasurer of the Clinical Immunology Society. In addition, he was named president of the International League of Dermatological Societies in 1997, for a 5-year term.

Dr. Katz has also served on the editorial boards of most clinical and investigative dermatology journals and many immunology journals. He has authored or coauthored more than 180 scientific articles and 50 book chapters and edited several conference proceedings and books.

NIAMS Directors

Research Programs
Extramural | Intramural

NIAMS supports a multidisciplinary program of basic and clinical investigations, epidemiologic research, research centers, and research training for scientists within its own facilities as well as grantees at universities and medical schools nationwide. It also supports the dissemination of research results and information through the National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse and through the NIH Osteoporosis and Related Bone Diseases’ National Resource Center.

The NIAMS Intramural Research Program conducts basic research in structural biology, biology of the immune system, biology of the skin, muscle biophysics, and development of bone and cartilage. It does clinical research on lupus, rheumatoid arthritis, genetic skin diseases, and inflammatory muscle diseases.

The Extramural Program supports research via grants and contracts in four branches: Rheumatic Diseases, Musculoskeletal Diseases, Skin Diseases, and Muscle Biology. Support also is provided for the Epidemiology/Data Systems Program and the Centers Program. A wide array of basic and clinical research and research training in the fields of rheumatology, muscle biology, orthopaedics, bone and mineral metabolism, and dermatology are being pursued through these programs.

Extramural Research Program

Rheumatic Diseases Branch. The mission of this program is to promote and support research leading to prevention, diagnosis, and cure of rheumatic and related diseases. The Branch supports basic, epidemiologic, and clinical research on etiology, pathogenesis, course, interventions, and outcomes in rheumatic and related diseases.

Immunology and Inflammation Program. This program supports basic research aimed at understanding the etiology, pathogenetic mechanisms, and systems affected in rheumatoid arthritis, adjuvant and chemically induced inflammatory arthritis, systemic lupus erythematosus, systemic scleroderma, and general autoimmunity. Relevant research comes from the areas of genetics, biochemistry, cellular and molecular biology, biophysics, enzymology, immunology, pathology, and physiology.

Cartilage and Connective Tissue Program. This program supports research aimed at understanding normal function of cartilage and components of connective tissues, and etiology and pathogenic mechanisms in osteoarthritis and heritable disorders of connective tissue.

Behavioral and Prevention Research Program. This program seeks to foster basic and clinical biopsychosocial research in arthritis, systemic lupus erythematosus, fibromyalgia, and related diseases. Research supported includes examination of behavioral, psychological, and social factors and their interaction with physiological processes in the prevention, etiology, course, management, and outcomes of disease. Multidisciplinary collaboration is encouraged.

Genetics and Clinical Studies Program. This program supports genetic studies in rheumatic diseases, both in animal models and in humans; clinical trials and complex clinical studies, including epidemiology, outcomes, and prevention of rheumatic and related diseases; and research on Lyme disease and infection-related arthritis.

Epidemiology and Data Systems Programs. The epidemiology program provides an administrative core for efforts to encourage epidemiologic research in the fields of rheumatic, musculoskeletal, and skin diseases. Epidemiologic studies of these diseases contribute knowledge related to prevalence, economic and social burdens, natural history, risk factors, and etiologies.

The data systems program fosters systematic acquisition, storage, retrieval, and analysis of information concerning arthritis and skin diseases. Program effort is focused on ensuring validity and comparability of data collected in separate institutions, and integrating data resources with data needs.

Musculoskeletal Diseases Branch. This program supports studies of the skeleton and associated connective tissues. Broad areas of interest include skeletal development, metabolism, mechanical properties, and responses to injury. Research on osteoporosis, a disease afflicting many of the Nation’s growing population of older people, is a major area of emphasis. Other diseases and skeletal disorders under investigation are osteogenesis imperfecta, a genetic disorder that leads to fragile, easily fractured bones; Paget’s disease, which results in irregular bone formation and subsequent deformity; and genetic disorders of bone growth and development such as osteomalacia.

Other studies focus on the causes and treatment of acute and chronic injuries, including carpal tunnel syndrome, repetitive stress injury, and low back pain. The program supports development of technologies with the potential to improve treatment of skeletal disorders and facilitate the repair of trauma in the normal skeleton. These include drugs and nutritional interventions, joint replacement, bone and cartilage transplantation, and gene therapy. Sports medicine and musculoskeletal fitness are also areas of special research emphasis.

Research areas supported through this branch include:

• Bone diseases – epidemiology and development of disease – environmental and genetic risk factors – treatment, prevention, and diagnosis.
• Bone biology – mechanisms of bone resorption – hormone, growth factor, and cytokine effects on bone-resorbing and bone-forming cells – regulation of bone growth and development – interactions among proteins, minerals, and cells in bone – mechanisms of mineralization.
• Orthopaedic research – skeletal architecture and mechanical properties – mechanisms of fracture repair – biomaterials, orthopaedic devices, and joint replacement and repair – rehabilitation.
• Osteoarthritis and Diagnostic Imaging - clinical studies of osteoarthritis - bone quality - whole body imaging of bones and joints.

Muscle Biology Branch. This program supports research on skeletal muscle, its diseases and disorders, and its central role in human physiology and exercise. Topics include the molecular structure of muscle and the molecular mechanisms that produce force and motion. An aim is understanding the alterations in muscle resulting from increased exercise and, conversely, the atrophy that follows immobilization during injury or illness. Specific aims include understanding the molecular structure and assembly of muscle components, including those responsible for contraction and regulation of muscle action; the molecular basis of genetic muscle diseases, such as Duchenne/Becker muscular dystrophy, facioscapulohumeral dystrophy, myotonic dystrophy, myotonias, and malignant hyperthermia; genetic processes of muscle development and assembly; musculoskeletal fitness, metabolism, and adaptive mechanisms; the role of growth factors and hormones; altered metabolism during aging; the effects of therapeutic drugs and abused substances on basic muscle processes; the cellular basis for impaired muscle function in disease; inflammatory muscle diseases and inflammation resulting from exercise or injury; molecular mechanisms of muscle repair and regeneration; and development of more satisfactory methods of treatment and recovery.

Specific research covered by the branch includes:

• Muscle physiology.
• Structure and function of muscle and of individual muscle proteins.
• Mechanisms of muscle contraction and force generation.
• Muscle development and specialization.
• Musculoskeletal fitness and adaptive biology, including exercise physiology.
• Muscle diseases and disorders.
• Sports medicine, and muscle injury and repair.

Skin Diseases Branch. Research studies supported by this program are increasing understanding of the mechanisms underlying normal and abnormal skin function and development. Research investigations are conducted on the molecular structures of various skin cells, the immunologic functions of the skin in normal and disease conditions, and the development of diagnostic tests and effective therapies for an array of skin diseases that can cause discomfort, disfigurement, and/or chronic disability. The range of skin diseases includes keratinizing disorders such as psoriasis and ichthyosis, atopic dermatitis and other chronic inflammatory skin disorders, blistering diseases such as epidermolysis bullosa and pemphigus, disorders of pigmentation such as vitiligo, and disorders of the hair and nails.

Basic science and disease areas in skin research include:

• Metabolic studies of skin.
• Immunologically mediated skin disorders.
• Disorders of keratinization, pigmentation, and hair growth.
• Photobiology, photoallergy, and phototoxic reactions.
• Bullous diseases and the basement membrane of skin.
• Acne and physiologic activity of sebaceous glands.
• Skin manifestations of diffuse connective tissue disorders.
• Heritable connective tissue diseases.
• Skin manifestations of HIV infection and AIDS.

Centers Program. NIAMS supports three types of Center mechanisms to advance the NIAMS mission and to meet the needs of the public and the research community.

The Multidisciplinary Clinical Research Centers (MCRC) focus on the assessment and improvement of clinical outcomes for patients with arthritis and musculoskeletal and skin diseases. Patient-oriented research is derived from many disciplines, and the center director is a clinician/scientist.

The Specialized Centers of Research (SCORs) are targeted to specific diseases and are aimed at expediting transfer of advances in basic science into clinical applications and improved patient care. NIAMS supports SCORs in rheumatoid arthritis, osteoporosis, osteoarthritis, systemic lupus erythematosus, and scleroderma.

Each Research Core Center (RCC) is directed to one of three research areas: skin diseases, musculoskeletal disorders or rheumatic diseases. RCCs have a minimum of two research cores and include a pilot and feasibility program.

Information and Education Program. The Office of Communications and Public Liaison (OCPL) leads the NIAMS efforts in information dissemination, public input, and health education. OCPL disseminates health and program news and updates, creates print and Web publications, manages the NIAMS Web site, coordinates outreach and promotion, and serves as a point of contact for the media, the public, and public organizations. OCPL oversees the NIAMS Information Clearinghouse, which operates a toll-free service to provide information and information sources on all forms of arthritis, orthopaedic and connective tissue disorders, sports injuries, and skin diseases. OCPL also works closely with the NIH Osteoporosis and Related Bone Diseases~National Resource Center, which disseminates information on bone diseases.

Intramural Research Program

The NIAMS intramural program has seven main components: the Arthritis and Rheumatism Branch, Laboratory of Physical Biology, Laboratory of Skin Biology, Laboratory of Structural Biology Research, Protein Expression Laboratory, Autoimmunity Branch, and Cartilage Biology and Orthopaedics Branch.

The Arthritis and Rheumatism Branch (ARB) conducts a variety of basic and clinical investigations. The historical focus of the ARB has been the study of the autoimmune rheumatic diseases - particularly rheumatoid arthritis, systemic lupus erythematosus, and myositis. In addition, studies in the laboratories and clinics focus on genetic diseases affecting inflammation and the musculoskeletal system, such as the autoinflammatory periodic diseases familial Mediterranean fever and familial Hibernian fever (TRAPS), as well as immunodeficiency diseases; the basic mechanisms of signaling in the cells of inflammation, such as mast cells, lymphocytes, and monocytes; new animal models of disease (e.g., for myositis and Pompe syndrome); genetic-epidemiologic research; and a variety of novel approaches to the interruption of inflammation.

The Laboratory of Physical Biology conducts a broad range of muscle and structural biology research, including the molecular mechanisms of contraction; muscle elasticity and plasticity; the differentiation and assembly of muscle cells; pathobiology of muscle diseases; and the application of radiation, proteomics, and nanotechnology in life science. Researchers examine the roles of structural, mechanochemical and regulatory proteins in the assembly and function of the force generating structure of skeletal and cardiac muscles. Nanotechnological and protein-engineering techniques, such as atomic force microscopy, confocal microscopy, single-molecule fluorescence spectroscopy, and laser tweezers, are used to the study molecular motors and molecular springs in skeletal and cardiac muscles. The molecular mechanism and control of muscle contraction is examined. Functional and structural studies of the interactions between actin and myosin and the conversion of metabolic energy to mechanical forces in living muscle tissues are also studied. The molecular mechanisms of assembly of myofibrils and their attachment to the myotendenous junction in skeletal and cardiac muscles is another area of study. Researchers examine the role of transcriptional factors in the gene expression and differentiation of muscle cells. Lastly, the effects of ionizing radiation on the disruption of molecular structure and biological activity of macromolecules in solution and in living tissues are examined.

The Laboratory of Skin Biology conducts basic research on the skin and skin diseases, with particular emphasis on the epidermis in the outermost layer of the skin. Basic research includes study of the various structural proteins and enzymes and their genes which are specifically expressed in the epidermis; the processes by which these molecules are assembled to form a normal epidermis; and the processes of abnormal cornification (keratinization) that occur in a variety of genetic skin diseases.

The Laboratory of Structural Biology Research conducts research into the structural basis of the assembly and functioning of macromolecules (large biological molecules) and their complexes such as viruses, cell membrane and cytoskeletal proteins, and proteins that control their assembly. These investigations make extensive use of cryoelectron microscopy and three-dimensional image processing in multidisciplinary investigations of virus infection and replication; renewal of the epidermis, with maintenance of barrier function; prionogenesis; and intracellular protein quality control by energy-dependent proteases.

The Protein Expression Laboratory, formerly under the NIH Office of the Director, joined NIAMS in 1996. This lab plans and conducts research on the expression, purification, and structural characterization of HIV and HIV-related proteins. Laboratory scientists also collaborate with NIH intramural researchers studying the structure and function of HIV and HIV-related proteins. The lab serves as a support and resource group for the expression and purification of these proteins.

The Autoimmunity Branch conducts basic and clinical research directed toward developing new insights into the molecular basis of autoantibody formation. Autoimmune diseases such as systemic lupus erythematosus are characterized by the formation of a variety of tissue-damaging autoantibodies. The basis of the abnormal formation of these autoantibodies is not known. The scientists of the Autoimmunity Branch are using molecular and cell biologic techniques as well as multiparameter flow cytometry (a technique that allows large numbers of individual cells to be characterized in detail) to analyze the basis of autoantibody formation in patients with systemic lupus erythematosus and other autoimmune diseases.

The Cartilage Biology and Orthopaedics Branch conducts basic and clinical research directed towards understanding the mechanisms regulating cartilage function and the basis of cartilage and orthopaedic diseases, such as osteoarthritis, and the development of functional cartilage tissue substitutes. Osteoarthritis is the most common degenerative joint disease, affecting nearly 20 million persons in the United States. The researchers in the Cartilage Biology and Orthopaedics Branch are using cellular, molecular, and bionomic approaches to analyze cartilage development, growth, diseases and aging, as well as applying the emerging technology of tissue engineering for functional cartilage.

NIAMS Appropriations – Grants and Direct Operations

1 Includes research and development contracts, intramural research, and funds necessary for NIAMS administrative program management.
2 Comparable amount. Appropriations for arthritis and musculoskeletal and skin diseases are included in the NIDDK appropriation for FY 1986.